| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,838.84 |
$3,677.68 |
1.5× |
| Abdomen 2 views (74019) |
$169.38 |
$338.76 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$866.35 |
$1,732.70 |
2.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,561.52 |
$3,123.02 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$1,579.73 |
$3,159.45 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,579.73 |
$3,159.45 |
0.6× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,079.12 |
$4,158.22 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,843.50 |
$7,687 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,843.50 |
$7,687 |
1.4× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,499.69 |
$4,999.38 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,117.74 |
$4,235.48 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,847 |
$7,694 |
1.4× |
| Ankle 2 views (73600) |
$44.60 |
$89.20 |
0.6× |
| Antegrade urography radiological supvj & interpj (74425) |
$337.35 |
$674.70 |
1.1× |
| Aortogram thoracic (75605) |
$2,037.55 |
$4,075.10 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,816.50 |
$3,633 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,816.50 |
$3,633 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,671.80 |
$5,343.60 |
1.0× |
| Arthrogram elbow (73085) |
$629 |
$1,258 |
2.1× |
| Arthrogram hip (73525) |
$629 |
$1,258 |
2.1× |
| Arthrogram shoulder (73040) |
$629 |
$1,258 |
2.1× |
| Arthrogram wrist (73115) |
$622 |
$1,244 |
2.0× |
| Arthrography knee lt (73580) |
$629 |
$1,258 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$368.39 |
$736.78 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$428.06 |
$856.13 |
1.2× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$933.68 |
$1,867.36 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,241.98 |
$2,483.96 |
3.5× |
| Bone age studies (77072) |
$110.51 |
$221.01 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$1,396.06 |
$2,792.11 |
4.0× |
| Bone survey complete (77075) |
$576.26 |
$1,152.53 |
6.3× |
| Brachytx isodose complex (77318) |
$782 |
$1,564 |
2.4× |
| Brachytx isodose intermed (77317) |
$497.74 |
$995.48 |
1.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$401.12 |
$802.24 |
1.2× |
| Brain image w/flow 4 + views (78606) |
$834 |
$1,668 |
1.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$760.46 |
$1,520.92 |
2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,598.78 |
$9,197.56 |
3.7× |
| Cervical spine 2 or 3 views (72040) |
$105.50 |
$211 |
1.4× |
| Chest 1 view (71045) |
$190.40 |
$380.80 |
2.5× |
| Chest 3 views (71047) |
$197.50 |
$395 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$290.15 |
$580.30 |
1.9× |
| Clavicle complete (73000) |
$99 |
$198 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,025 |
$2,050 |
11.2× |
| Continuing medical physics consltj pr wk (77336) |
$643.33 |
$1,286.66 |
5.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,320.50 |
$6,641 |
10.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,705.30 |
$3,410.60 |
8.2× |
| CT abdomen w contrast (74160) |
$1,610.50 |
$3,221 |
10.5× |
| CT abdomen w wo contrast (74170) |
$1,354.61 |
$2,709.22 |
8.8× |
| CT abdomen w/o contrast (74150) |
$947.34 |
$1,894.68 |
10.3× |
| CT angiography upper extremity lt (73206) |
$909 |
$1,818 |
5.9× |
| CT c-spine w/o contrast (72125) |
$1,211.83 |
$2,423.66 |
13.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,731.95 |
$3,463.90 |
11.3× |
| CT cervical spine with contrast (72126) |
$1,455.78 |
$2,911.56 |
4.8× |
| CT chest w/wo contrast (71270) |
$1,656.90 |
$3,313.78 |
10.8× |
| CT chest with contrast (71260) |
$1,315.06 |
$2,630.11 |
8.6× |
| CT head/brain with contrast (70460) |
$1,215.41 |
$2,430.82 |
7.9× |
| CT head/brain without and with contrast (70470) |
$1,500.94 |
$3,001.88 |
9.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$181.58 |
$363.16 |
2.4× |
| CT iac w contrast (70481) |
$1,269 |
$2,538 |
8.3× |
| CT lower ext w/o (73700) |
$639.50 |
$1,279 |
7.0× |
| CT lower extremity w wo contrast (73702) |
$908 |
$1,816 |
5.9× |
| CT lower extremity with contrast (73701) |
$908 |
$1,816 |
5.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,499.30 |
$2,998.61 |
9.8× |
| CT lumbar spine w/o contrast (72131) |
$1,211.83 |
$2,423.66 |
13.2× |
| CT lumbar spine with contrast (72132) |
$1,455.78 |
$2,911.56 |
4.8× |
| CT maxillofacial w contrast (70487) |
$1,215.41 |
$2,430.82 |
7.9× |
| CT maxillofacial w/o contrast (70486) |
$317 |
$634 |
3.5× |
| CT maxillofacial w/wo contrast (70488) |
$846.87 |
$1,693.74 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$963.48 |
$1,926.97 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,567.50 |
$3,135 |
10.2× |
| CT orbits w/o contrast (70480) |
$963.50 |
$1,927 |
10.5× |
| CT pelvis w & w/o contrast (72194) |
$1,499.30 |
$2,998.61 |
9.8× |
| CT pelvis w/o contrast (72192) |
$934.60 |
$1,869.18 |
10.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,373.25 |
$2,746.50 |
8.9× |
| CT soft tissue neck w/o contrast (70490) |
$878.57 |
$1,757.14 |
9.6× |
| CT thoracic spine w/contrast (72129) |
$1,455.09 |
$2,910.18 |
9.5× |
| CT thoracic spine w/o contrast (72128) |
$1,211.83 |
$2,423.66 |
13.2× |
| CT thoracic spine w/wo contrast (72130) |
$673.50 |
$1,347 |
4.4× |
| CT thorax w/o contrast (71250) |
$934.60 |
$1,869.18 |
10.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$908 |
$1,816 |
5.9× |
| CT upper extremity w/o contrast rt (73200) |
$639.50 |
$1,279 |
7.0× |
| CT upper extremity with contrast (73201) |
$908 |
$1,816 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,363 |
$2,726 |
8.9× |
| Cta Abdomen (74175) |
$828.76 |
$1,657.52 |
5.4× |
| CTA abdomen pelvis (74174) |
$771.90 |
$1,543.79 |
2.5× |
| CTA chest (71275) |
$909 |
$1,818 |
5.9× |
| Cta Head (70496) |
$866.88 |
$1,733.77 |
5.6× |
| CTA lwr ext w&w/o contrast (73706) |
$909 |
$1,818 |
5.9× |
| Cta Neck (70498) |
$866.88 |
$1,733.77 |
5.6× |
| Cta Pelvis (72191) |
$828.76 |
$1,657.52 |
5.4× |
| Cystography minimum 3 views rs&i (74430) |
$362.56 |
$725.11 |
1.2× |
| Diskogram cervical (72285) |
$2,285 |
$4,570 |
1.3× |
| Diskography lumbar (72295) |
$4,523.54 |
$9,047.08 |
2.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$99.25 |
$198.50 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$124.50 |
$249 |
1.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$153 |
$306 |
1.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$189.61 |
$379.22 |
2.1× |
| Echo exam of eye (76529) |
$112.05 |
$224.09 |
1.5× |
| Echo exam of fetal heart (76825) |
$542.75 |
$1,085.50 |
1.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$253 |
$506 |
1.2× |
| Echoencephalography real time imaging (76506) |
$469.18 |
$938.37 |
5.1× |
| Esophagus (74220) |
$262.30 |
$524.60 |
1.7× |
| Fetal biophysical profile non-stress testing (76818) |
$132.50 |
$265 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$451.45 |
$902.89 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$153.90 |
$307.79 |
0.7× |
| Foot 2 views (73620) |
$40.58 |
$81.15 |
0.5× |
| Forearm 2 views (73090) |
$72 |
$144 |
0.9× |
| Gated Heart Planar Single (78472) |
$1,703.50 |
$3,407 |
4.9× |
| Hand 2 views (73120) |
$44.60 |
$89.20 |
0.5× |
| Hand 3 views (73130) |
$72.50 |
$145 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,013.10 |
$2,026.21 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,013.10 |
$2,026.21 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,013.10 |
$2,026.21 |
1.7× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$280.44 |
$560.86 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,008.66 |
$2,017.32 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,008.66 |
$2,017.32 |
2.9× |
| Ht muscle image spect sing (78451) |
$902.76 |
$1,805.51 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$66.50 |
$133 |
0.9× |
| Hysterosalpingogram (74740) |
$383.32 |
$766.62 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$1,429.56 |
$2,859.11 |
2.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,530.98 |
$3,061.96 |
2.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,072.08 |
$2,144.15 |
2.2× |
| Intracavitary radiation source applic simple (77761) |
$766.70 |
$1,533.38 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$652.50 |
$1,305 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,536.07 |
$3,072.14 |
3.2× |
| Knee 3 views (73562) |
$99 |
$198 |
1.3× |
| Liver & spleen imaging static only (78215) |
$1,074.86 |
$2,149.72 |
3.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,149.92 |
$2,299.83 |
3.3× |
| Lung perfusion differential (78597) |
$1,797.50 |
$3,595 |
5.1× |
| Lymphoscintigraphy (78195) |
$950 |
$1,900 |
2.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$100.50 |
$201 |
1.3× |
| Meckels Diverticulum (78290) |
$866.35 |
$1,732.70 |
2.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$338.21 |
$676.42 |
1.0× |
| Mr safety determination physician/other qhp (76016) |
$107 |
$214 |
1.4× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$72 |
$144 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$60 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$111.50 |
$223 |
1.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$293.50 |
$587 |
1.4× |
| MRA head w & w/o contrast (70546) |
$2,268.65 |
$4,537.30 |
7.4× |
| MRA head w/o contrast (70544) |
$1,612.36 |
$3,224.72 |
7.7× |
| MRA head with contrast (70545) |
$1,675.48 |
$3,350.95 |
5.5× |
| MRA neck w contrast (70548) |
$1,978.50 |
$3,957 |
6.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,268.65 |
$4,537.30 |
7.4× |
| MRA neck w/o contrast (70547) |
$1,612.36 |
$3,224.72 |
7.7× |
| MRI abdomen w contrast (74182) |
$1,562.18 |
$3,124.36 |
5.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,218.53 |
$4,437.06 |
7.3× |
| MRI abdomen w/o contrast (74181) |
$1,713 |
$3,426 |
8.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,978.50 |
$3,957 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,804.30 |
$3,608.61 |
2.6× |
| MRI breast w/o contrast bilateral (77047) |
$858 |
$1,716 |
4.1× |
| MRI breast w/o contrast unilat (77046) |
$858 |
$1,716 |
4.1× |
| MRI c-spine with contrast (72142) |
$656.16 |
$1,312.32 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$1,562.18 |
$3,124.36 |
7.5× |
| MRI chest w/o & w/contrast material (71552) |
$1,661.96 |
$3,323.91 |
5.4× |
| MRI chest w/o contrast (71550) |
$1,411.36 |
$2,822.71 |
6.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,804.30 |
$3,608.61 |
5.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,978.50 |
$3,957 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,713 |
$3,426 |
8.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,411.36 |
$2,822.71 |
6.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,004.56 |
$4,009.12 |
6.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,630.11 |
$3,260.22 |
5.3× |
| MRI pelvis w contrast (72196) |
$1,978.50 |
$3,957 |
6.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,432.50 |
$4,865 |
8.0× |
| MRI pelvis w/o contrast (72195) |
$1,713 |
$3,426 |
8.2× |
| MRI scan of arm joint before and after contrast (73223) |
$2,004.56 |
$4,009.12 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$2,432.50 |
$4,865 |
8.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,218.53 |
$4,437.06 |
7.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$656.16 |
$1,312.32 |
2.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,218.53 |
$4,437.06 |
7.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$656.16 |
$1,312.32 |
2.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,218.53 |
$4,437.06 |
7.3× |
| MRI thoracic spine w/o contrast (72146) |
$1,562.18 |
$3,124.36 |
7.5× |
| MRI tmj (70336) |
$1,562.18 |
$3,124.36 |
7.5× |
| MRI upper ext joint w/o contrast (73221) |
$1,411.36 |
$2,822.71 |
6.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,432.50 |
$4,865 |
8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,713 |
$3,426 |
8.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,058.62 |
$4,117.22 |
1.8× |
| Neck soft tissue (70360) |
$98 |
$196 |
1.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$651.22 |
$1,302.45 |
1.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$552 |
$1,104 |
1.6× |
| Nm adrenal scan (78075) |
$1,714 |
$3,428 |
1.5× |
| Nm bone marrow wb (78104) |
$1,241.98 |
$2,483.96 |
3.5× |
| Nm gastric emptying study (78264) |
$1,536.07 |
$3,072.14 |
4.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,237.42 |
$4,474.85 |
1.8× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,888 |
$3,776 |
1.5× |
| Nuclear medicine of heart pumping function (78473) |
$2,194.83 |
$4,389.66 |
6.3× |
| Nuclear medicine study of digestive tracts (78299) |
$497.50 |
$995 |
1.4× |
| Nuclear medicine study of endocrine organs (78099) |
$497.50 |
$995 |
1.4× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$257.43 |
$514.86 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$378.28 |
$756.56 |
1.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$264.40 |
$528.80 |
2.9× |
| Orthopantogram (70355) |
$154.18 |
$308.35 |
2.0× |
| Osseous survey infant (77076) |
$289.16 |
$578.31 |
3.2× |
| Parathyrd planar w/spect&CT (78072) |
$652.50 |
$1,305 |
1.4× |
| Parathyrd planar w/wo subtrj (78071) |
$388.18 |
$776.36 |
1.1× |
| Parathyroid imaging (78070) |
$497.50 |
$995 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$36 |
$72 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$4,325 |
$8,650 |
3.5× |
| PET imaging for CT attenuation whole body (78816) |
$4,105.82 |
$8,211.64 |
3.3× |
| Pr MRI brain w/o dye (70557) |
$1,562.18 |
$3,124.36 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,432.50 |
$4,865 |
8.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,656.55 |
$3,313.10 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,265 |
$4,530 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,019 |
$2,038 |
2.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,639.26 |
$3,278.52 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$666 |
$1,332 |
1.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$49.50 |
$99 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$577.64 |
$1,155.29 |
6.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$53 |
$106 |
0.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$483.48 |
$966.94 |
1.0× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$149.42 |
$298.84 |
1.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$342.53 |
$685.06 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$149.94 |
$299.89 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$96.50 |
$192.99 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$154.18 |
$308.35 |
2.0× |
| Radiologic exam colon single contrast study (74270) |
$374.64 |
$749.26 |
2.4× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$170.30 |
$340.60 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$354.50 |
$709 |
2.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$52 |
$104 |
0.7× |
| Radiological examination surgical specimen (76098) |
$168 |
$336 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,656.55 |
$3,313.10 |
0.6× |
| Ribs bilateral 3 views (71110) |
$74.50 |
$149 |
0.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,714 |
$3,428 |
3.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,714 |
$3,428 |
3.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,766.50 |
$3,533 |
1.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,716 |
$3,432 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$323.50 |
$647 |
1.6× |
| Sacroiliac Joints < 3 Views (72200) |
$132.50 |
$265 |
1.4× |
| Salivary gland imaging (78230) |
$305.55 |
$611.09 |
0.9× |
| Scanogram (77073) |
$133 |
$266 |
1.5× |
| Scapula complete (73010) |
$36 |
$72 |
0.4× |
| Screening digital breast tomosynthesis (77063) |
$23.50 |
$47 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$285.12 |
$570.24 |
3.1× |
| Sialogram (70390) |
$472.68 |
$945.37 |
2.3× |
| Simulation intermediate (77285) |
$1,103.54 |
$2,207.09 |
3.4× |
| Small bowel series (74250) |
$421 |
$842 |
2.7× |
| Spec medical radj physics consltj (77370) |
$597.64 |
$1,195.29 |
5.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$413.90 |
$827.78 |
1.3× |
| Special dosimetry (77331) |
$294.50 |
$589 |
2.5× |
| Special treatment procedure (77470) |
$1,685.24 |
$3,370.49 |
3.5× |
| Spine thoracic 3 views (72072) |
$58.50 |
$117 |
0.6× |
| Stereotactic body radiation delivery (77373) |
$2,272.98 |
$4,545.96 |
1.5× |
| Superior sagittal sinus venogram (75870) |
$3,847 |
$7,694 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,195.99 |
$2,391.98 |
3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$882.46 |
$1,764.91 |
2.7× |
| Testicular Imaging With Vascular Flow (78761) |
$811.18 |
$1,622.34 |
2.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,470.38 |
$2,940.75 |
4.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$735.40 |
$1,470.80 |
6.2× |
| Thoracolumbar 2 views (72080) |
$61.50 |
$123 |
0.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,274 |
$4,548 |
4.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$400.26 |
$800.52 |
1.1× |
| Thyroid uptake measurement (78012) |
$400.26 |
$800.52 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$687 |
$1,374 |
2.0× |
| Treatment device intermediate (77333) |
$536.12 |
$1,072.24 |
4.6× |
| Treatment devices simple (77332) |
$505.76 |
$1,011.51 |
4.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,082.11 |
$4,164.22 |
4.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$524.75 |
$1,049.50 |
1.5× |
| Tx devices design & construction complex (77334) |
$827.90 |
$1,655.78 |
2.5× |
| Ultrasound elastography first target lesion (76982) |
$406.50 |
$813 |
4.4× |
| Ultrasound, abdomen limited (76705) |
$434.87 |
$869.74 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$103 |
$206 |
1.1× |
| Unlisted fluoroscopic procedure (76496) |
$78.84 |
$157.66 |
1.0× |
| Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) |
$318 |
$636 |
0.9× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) |
$318 |
$636 |
0.9× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$497.50 |
$995 |
1.4× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$318 |
$636 |
0.9× |
| Unlisted Ultrasound Procedure (76999) |
$73.76 |
$147.50 |
1.0× |
| Upper Extremity Infant (73092) |
$83.50 |
$167 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$250.22 |
$500.42 |
1.2× |
| Urethrocystography voiding (74455) |
$288.56 |
$577.11 |
1.4× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$656.10 |
$1,312.20 |
4.3× |
| Us abdl aorta screen aaa (76706) |
$434.87 |
$869.74 |
4.7× |
| Us breast unilateral complete (76641) |
$173.50 |
$347 |
1.9× |
| Us breast unilateral limited (76642) |
$137.50 |
$275 |
1.8× |
| Us chest (76604) |
$152 |
$304 |
1.7× |
| Us elastography parenchyma (76981) |
$406.50 |
$813 |
4.4× |
| Us fetal nuchal translucency 1st gestation (76813) |
$500.50 |
$1,001 |
5.5× |
| Us guided compression repair (76936) |
$379 |
$758 |
2.0× |
| Us infant hips dynamic (76885) |
$107 |
$214 |
1.4× |
| Us kidney transplant (76776) |
$278.63 |
$557.26 |
3.0× |
| Us ob detailed single fetus (76811) |
$265.50 |
$531 |
1.3× |
| Us ob transvaginal (76817) |
$146 |
$292 |
1.6× |
| Us pelvic non ob complete (76856) |
$169.25 |
$338.50 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$82.75 |
$165.50 |
0.9× |
| Us pregnancy ltd (76815) |
$116 |
$232 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$202.50 |
$405 |
2.2× |
| Us retroperitoneal complete (76770) |
$413 |
$826 |
4.5× |
| Us retroperitoneal limited (76775) |
$109.62 |
$219.25 |
1.2× |
| Us scrotum and contents (76870) |
$283.50 |
$567 |
3.1× |
| Us soft tissue head/neck (76536) |
$90.50 |
$181 |
1.0× |
| Us spinal canal and contents (76800) |
$266 |
$532 |
2.9× |
| Us transrectal (76872) |
$359.28 |
$718.56 |
3.9× |
| Us transrectal prostate volume (76873) |
$255.30 |
$510.58 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$245.03 |
$490.05 |
2.7× |
| Us, eye b-scan (76512) |
$135.25 |
$270.50 |
1.5× |
| Venogram extremity bilateral (75822) |
$835.64 |
$1,671.28 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$1,374.51 |
$2,749.02 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$825.59 |
$1,651.18 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$760 |
$1,520 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,547 |
$3,094 |
0.6× |
| Venography renal unilateral selective rs&i (75831) |
$1,547 |
$3,094 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,115.42 |
$2,230.84 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$1,890.26 |
$3,780.52 |
0.4× |
| Wrist 2 views (73100) |
$42.79 |
$85.58 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$401.50 |
$803 |
4.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$144.48 |
$288.96 |
1.9× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$71 |
$142 |
0.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$546.08 |
$1,092.15 |
3.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$78.77 |
$157.53 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$32 |
$64 |
0.4× |
| X-ray exam hip uni 1 view (73501) |
$119.63 |
$239.25 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$118 |
$236 |
1.5× |
| X-ray exam hip uni 4/> views (73503) |
$66.50 |
$133 |
0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$226.07 |
$452.13 |
2.5× |
| X-ray exam of femur 1 (73551) |
$45 |
$90 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$116.52 |
$233.03 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$81.75 |
$163.50 |
1.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,233.50 |
$2,467 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$70.50 |
$141 |
0.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$375.48 |
$750.96 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$51 |
$102 |
0.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$165.18 |
$330.34 |
1.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$42 |
$84 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$110 |
$220 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$98 |
$196 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$79.25 |
$158.50 |
0.9× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$103.50 |
$207 |
1.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$175.30 |
$350.60 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$111.48 |
$222.97 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$190.26 |
$380.52 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$162.94 |
$325.88 |
1.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$478.36 |
$956.70 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$55.50 |
$111 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$49 |
$98 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$60.75 |
$121.50 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$99.83 |
$199.66 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$33.75 |
$67.50 |
0.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$100.50 |
$201 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$82 |
$164 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$104.50 |
$209 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$177.74 |
$355.47 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$124.25 |
$248.50 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$43 |
$86 |
0.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$78.47 |
$156.94 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$170.04 |
$340.08 |
2.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$52.50 |
$105 |
0.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$31.25 |
$62.50 |
0.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$37.50 |
$75 |
0.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$101.50 |
$203 |
1.3× |
| Xr arthrogram ankle (73615) |
$629 |
$1,258 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$66.75 |
$133.50 |
0.7× |
| Xr chest 4+ views (71048) |
$148 |
$296 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$62.50 |
$125 |
0.8× |
| Xr shoulder 1 view (73020) |
$48 |
$96 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$76 |
$152 |
0.8× |
| Xr tibia/fibula 2 views (73590) |
$70.50 |
$141 |
0.9× |
| Xray knee 1 or 2 views rt (73560) |
$86.25 |
$172.50 |
1.1× |