| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,683.60 |
$21,709 |
6.3× |
| Abdomen 2 views (74019) |
$141.80 |
$354.50 |
1.4× |
| Acute gi blood loss imaging (78278) |
$2,840 |
$7,100 |
7.2× |
| Angio Adrenal Bilat Select (75733) |
$2,771.80 |
$6,929.50 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,743.40 |
$6,858.50 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$2,205.60 |
$5,514 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$1,771.20 |
$4,428 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,063.40 |
$5,158.50 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,212.60 |
$5,531.50 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,970.80 |
$4,927 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,424.80 |
$23,562 |
1.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$796.80 |
$1,992 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,063.40 |
$5,158.50 |
0.7× |
| Ankle 2 views (73600) |
$510.40 |
$1,276 |
5.9× |
| Aortogram thoracic (75605) |
$5,016 |
$12,540 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,187 |
$5,467.50 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,640.60 |
$6,601.50 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,063.40 |
$5,158.50 |
0.7× |
| Arthrogram ankle (73615) |
$296.80 |
$742 |
0.9× |
| Arthrogram elbow (73085) |
$354.80 |
$887 |
1.0× |
| Arthrogram hip (73525) |
$519.20 |
$1,298 |
1.5× |
| Arthrogram knee (73580) |
$520.20 |
$1,300.50 |
1.5× |
| Arthrogram shoulder (73040) |
$447.60 |
$1,119 |
1.3× |
| Arthrogram wrist (73115) |
$499 |
$1,247.50 |
1.4× |
| Basic dosimetry (77300) |
$655.20 |
$1,638 |
4.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,629.80 |
$4,074.50 |
4.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$2,839.20 |
$7,098 |
7.2× |
| Bone &/joint imaging whole body (78306) |
$2,839.20 |
$7,098 |
7.2× |
| Bone age studies (77072) |
$164 |
$410 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$2,122.20 |
$5,305.50 |
5.4× |
| Bone survey complete (77075) |
$584 |
$1,460 |
5.6× |
| Bone survey infant (77076) |
$292.40 |
$731 |
2.8× |
| Bowel imaging (78290) |
$2,590.40 |
$6,476 |
6.5× |
| Brachytx isodose complex (77318) |
$1,544.20 |
$3,860.50 |
4.2× |
| Brachytx isodose intermed (77317) |
$881.60 |
$2,204 |
2.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$776.80 |
$1,942 |
2.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$9,301.80 |
$23,254.50 |
6.6× |
| Brain Imaging Vascular Flow Only (78610) |
$287.60 |
$719 |
0.5× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,587.60 |
$6,469 |
6.5× |
| Cardiac shunt detection (78428) |
$697 |
$1,742.50 |
1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$618 |
$1,545 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$347.60 |
$869 |
4.0× |
| Chest 1 view (71045) |
$172.40 |
$431 |
2.0× |
| Chest xray 3 views (71047) |
$156.80 |
$392 |
1.8× |
| Cholecystography, oral contrast Non-Facility (74290) |
$295.60 |
$739 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$360.80 |
$902 |
2.1× |
| Clavicle complete (73000) |
$382.40 |
$956 |
4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$240 |
$600 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$886.40 |
$2,216 |
6.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,569.80 |
$8,924.50 |
10.3× |
| CT abdomen and pelvis without contrast (74176) |
$2,608 |
$6,520 |
11.0× |
| CT abdomen w contrast (74160) |
$2,125.20 |
$5,313 |
12.2× |
| CT abdomen w wo contrast (74170) |
$3,405.20 |
$8,513 |
19.6× |
| CT abdomen w/o contrast (74150) |
$1,370 |
$3,425 |
13.2× |
| CT angio hrt w/3d image (75574) |
$1,218.60 |
$3,046.50 |
3.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,526 |
$3,815 |
8.8× |
| CT angiography upper extremity lt (73206) |
$1,526.40 |
$3,816 |
8.8× |
| CT c-spine w/contrast (72126) |
$2,559.20 |
$6,398 |
7.4× |
| CT c-spine w/o contrast (72125) |
$1,502.40 |
$3,756 |
14.5× |
| CT cervical spine w&w/o contrast (72127) |
$3,400 |
$8,500 |
19.5× |
| CT chest w contrast (71260) |
$1,891.60 |
$4,729 |
10.9× |
| CT chest w/wo contrast (71270) |
$2,254.80 |
$5,637 |
13.0× |
| CT head/brain with contrast (70460) |
$1,456 |
$3,640 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,714.40 |
$4,286 |
9.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$608.20 |
$1,520.50 |
1.8× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$460.80 |
$1,152 |
5.3× |
| CT iac w contrast (70481) |
$967.40 |
$2,418.50 |
5.6× |
| CT limited/localized follow up study (76380) |
$676.40 |
$1,691 |
7.8× |
| CT lower ext w/o (73700) |
$907.60 |
$2,269 |
8.8× |
| CT lower extremity w wo contrast (73702) |
$1,444.40 |
$3,611 |
8.3× |
| CT lower extremity w/contrast material (73701) |
$1,023.60 |
$2,559 |
5.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,425.20 |
$8,563 |
19.7× |
| CT lumbar spine w/contrast (72132) |
$3,136 |
$7,840 |
9.1× |
| CT lumbar spine w/o contrast (72131) |
$2,592.40 |
$6,481 |
25.0× |
| CT maxillofacial w contrast (70487) |
$873.60 |
$2,184 |
5.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,329.60 |
$3,324 |
7.6× |
| CT maxillofacial wo contrast (70486) |
$942.80 |
$2,357 |
9.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,473.60 |
$3,684 |
8.5× |
| CT orbits w/o contrast (70480) |
$840.80 |
$2,102 |
8.1× |
| CT pelvis w/o contrast (72192) |
$1,506 |
$3,765 |
14.5× |
| CT pelvis w/wo contrast (72194) |
$3,539.20 |
$8,848 |
20.3× |
| CT scan of arm combo (73202) |
$1,912.80 |
$4,782 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$2,590.40 |
$6,476 |
14.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,117.20 |
$7,793 |
17.9× |
| CT soft tissue neck w/o contrast (70490) |
$2,288 |
$5,720 |
22.1× |
| CT thoracic spine w/contrast (72129) |
$1,723.20 |
$4,308 |
9.9× |
| CT thoracic spine w/o contrast (72128) |
$1,453.20 |
$3,633 |
14.0× |
| CT thoracic spine w/wo contrast (72130) |
$2,432.80 |
$6,082 |
14.0× |
| CT thorax w/o contrast (71250) |
$1,662.40 |
$4,156 |
16.0× |
| CT upper ext wo (73200) |
$1,122 |
$2,805 |
10.8× |
| CT upper extremity with contrast (73201) |
$1,269.20 |
$3,173 |
3.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,442.80 |
$6,107 |
14.0× |
| Cta Abdomen (74175) |
$2,442.80 |
$6,107 |
14.0× |
| CTA abdomen pelvis (74174) |
$3,208.60 |
$8,021.50 |
9.3× |
| CTA chest (71275) |
$1,660.40 |
$4,151 |
9.5× |
| Cta Head (70496) |
$3,867.20 |
$9,668 |
22.2× |
| Cta Neck (70498) |
$2,938.40 |
$7,346 |
16.9× |
| Cta Pelvis (72191) |
$4,246 |
$10,615 |
24.4× |
| Cystography minimum 3 views rs&i (74430) |
$347.80 |
$869.50 |
1.0× |
| Diskogram cervical (72285) |
$1,917.20 |
$4,793 |
1.0× |
| Diskography lumbar (72295) |
$1,699 |
$4,247.50 |
0.9× |
| Esophagus (74220) |
$326.40 |
$816 |
1.9× |
| Facial bones min 3 views (70150) |
$666.80 |
$1,667 |
6.4× |
| Fetal biophysical profile non-stress testing (76818) |
$306 |
$765 |
3.0× |
| Fetal Echo (76825) |
$763 |
$1,907.50 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$428 |
$1,070 |
1.8× |
| Foot 2 views (73620) |
$248 |
$620 |
2.9× |
| Forearm 2 views (73090) |
$265.60 |
$664 |
3.1× |
| Hand 2 views (73120) |
$252 |
$630 |
2.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,647.20 |
$6,618 |
4.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,838.40 |
$4,596 |
4.6× |
| Hysterosalpingogram (74740) |
$375.60 |
$939 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$4,752 |
$11,880 |
6.9× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,786.60 |
$4,466.50 |
2.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,609 |
$4,022.50 |
2.9× |
| Kidney imaging morphology (78700) |
$854 |
$2,135 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,145.80 |
$2,864.50 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,222.80 |
$3,057 |
2.3× |
| Knee 3 views (73562) |
$306.80 |
$767 |
3.6× |
| Liver & spleen imaging static only (78215) |
$2,155.80 |
$5,389.50 |
5.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,044.20 |
$5,110.50 |
5.2× |
| Lung perf&ventilat diferentl (78598) |
$1,595.60 |
$3,989 |
3.0× |
| Lymphoscintigraphy (78195) |
$2,308.20 |
$5,770.50 |
4.3× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$3,578.40 |
$8,946 |
4.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,805.40 |
$4,513.50 |
5.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,457.20 |
$8,643 |
10.0× |
| Mammary ductogram or galactogram multiple (77054) |
$368 |
$920 |
1.6× |
| Mammary ductogram or galactogram single (77053) |
$265.60 |
$664 |
1.1× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$222 |
$555 |
0.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,303.80 |
$3,259.50 |
3.5× |
| MRA head w/o contrast (70544) |
$2,017.80 |
$5,044.50 |
8.5× |
| MRA head with contrast (70545) |
$2,209.20 |
$5,523 |
6.4× |
| MRA neck w contrast (70548) |
$2,556.20 |
$6,390.50 |
7.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,850.80 |
$9,627 |
11.1× |
| MRA neck w/o contrast (70547) |
$2,556.20 |
$6,390.50 |
10.8× |
| MRI abdomen w contrast (74182) |
$1,980.20 |
$4,950.50 |
5.7× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,999.20 |
$9,998 |
11.6× |
| MRI abdomen w/o contrast (74181) |
$2,165.80 |
$5,414.50 |
9.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,548.40 |
$8,871 |
4.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,919.20 |
$9,798 |
11.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,985.20 |
$4,963 |
8.4× |
| MRI breast wo contrast unilateral (77046) |
$1,985.20 |
$4,963 |
8.4× |
| MRI c-spine with contrast (72142) |
$4,048.80 |
$10,122 |
11.7× |
| MRI cervical spine w/o contrast (72141) |
$3,588 |
$8,970 |
15.2× |
| MRI chest w/o & w/contrast material (71552) |
$4,650 |
$11,625 |
13.4× |
| MRI chest w/o contrast (71550) |
$3,198.80 |
$7,997 |
13.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,548.40 |
$8,871 |
10.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,819.80 |
$7,049.50 |
8.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,425.40 |
$6,063.50 |
10.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,285.60 |
$5,714 |
9.7× |
| MRI orbit face neck w contrast (70542) |
$1,805.40 |
$4,513.50 |
5.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,875.40 |
$9,688.50 |
11.2× |
| MRI pelvis w/contrast (72196) |
$2,219.20 |
$5,548 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,644 |
$11,610 |
13.4× |
| MRI pelvis w/o contrast (72195) |
$2,446 |
$6,115 |
10.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$7,271.20 |
$18,178 |
21.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$4,006.40 |
$10,016 |
11.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$6,390.80 |
$15,977 |
18.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$4,109.60 |
$10,274 |
11.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$6,646 |
$16,615 |
19.2× |
| MRI temporomandibular joint (70336) |
$2,028.60 |
$5,071.50 |
8.6× |
| MRI thoracic spine w/o contrast (72146) |
$3,403.60 |
$8,509 |
14.4× |
| MRI up ext w/o contrast (73218) |
$3,308.40 |
$8,271 |
14.0× |
| MRI upper ext joint w/o contrast (73221) |
$3,702 |
$9,255 |
15.6× |
| MRI, joint upper extrem combo (73223) |
$3,954 |
$9,885 |
11.4× |
| Myelogram Cervical (72240) |
$2,048.80 |
$5,122 |
2.6× |
| Myelogram Lumbar (72265) |
$1,819.20 |
$4,548 |
2.3× |
| Myelogram thoracic (72255) |
$1,581.20 |
$3,953 |
2.0× |
| Myelography 2 or more regions (72270) |
$3,292 |
$8,230 |
4.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$9,301.80 |
$23,254.50 |
7.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,406.60 |
$3,516.50 |
1.1× |
| Myocardial spect single study at rest or stress (78451) |
$732.80 |
$1,832 |
0.6× |
| Neck soft tissue (70360) |
$172.80 |
$432 |
2.0× |
| Nm cisternogram (78630) |
$1,499 |
$3,747.50 |
2.8× |
| Nm csf leak detection (78650) |
$1,492 |
$3,730 |
1.2× |
| Nm gastric emptying study (78264) |
$2,041.60 |
$5,104 |
5.1× |
| Nm gastroesophageal reflux study (78262) |
$1,879 |
$4,697.50 |
4.7× |
| Nm kidney scan w/flow (78701) |
$926.80 |
$2,317 |
2.3× |
| Noncardiac Vascular Flow Imaging (78445) |
$393 |
$982.50 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$14,122.60 |
$35,306.50 |
10.3× |
| Nuclear Rx Oral Admin (79005) |
$2,509 |
$6,272.50 |
10.8× |
| Osseous survey limited (77074) |
$339.60 |
$849 |
3.3× |
| Parathyroid Planar Imaging (78070) |
$597.80 |
$1,494.50 |
1.5× |
| Pelvis 1 or 2 views (72170) |
$335.20 |
$838 |
3.2× |
| PET image w/CT, skull-thigh (78815) |
$8,756 |
$21,890 |
6.2× |
| PET imaging CT for attenuation limited area (78814) |
$8,814 |
$22,035 |
6.2× |
| PET imaging for CT attenuation whole body (78816) |
$8,756 |
$21,890 |
6.2× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$8,814 |
$22,035 |
6.9× |
| PET whole body (78813) |
$8,814 |
$22,035 |
6.2× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$8,814 |
$22,035 |
6.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,066 |
$2,665 |
2.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,165.40 |
$2,913.50 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$282.60 |
$706.50 |
0.5× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$437.80 |
$1,094.50 |
5.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$155.40 |
$388.50 |
1.8× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$278.40 |
$696 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$204.80 |
$512 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$325.80 |
$814.50 |
3.1× |
| Radex fingr minimum 2 views (73140) |
$416.40 |
$1,041 |
4.8× |
| Radex Foot Compl Minimum 3 Views (73630) |
$274.20 |
$685.50 |
3.2× |
| Radex Hand Minimum 3 Views (73130) |
$216.60 |
$541.50 |
2.5× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$216.20 |
$540.50 |
2.5× |
| Radex Humerus Minimum 2 Views (73060) |
$252.20 |
$630.50 |
2.9× |
| Radex Kne 1/2 Views (73560) |
$188.60 |
$471.50 |
2.2× |
| Radex Kne Compl 4/More Views (73564) |
$248.80 |
$622 |
2.4× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$349.20 |
$873 |
3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$273.80 |
$684.50 |
3.2× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$217.60 |
$544 |
2.1× |
| Radex Sho Compl Minimum 2 Views (73030) |
$253.80 |
$634.50 |
2.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$248.40 |
$621 |
2.9× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$215.60 |
$539 |
2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$278.40 |
$696 |
3.2× |
| Radex Toe Minimum 2 Views (73660) |
$184 |
$460 |
2.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$134.80 |
$337 |
1.3× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$285.20 |
$713 |
3.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$350.40 |
$876 |
3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,500.80 |
$41,252 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$295.60 |
$739 |
2.9× |
| Radiation treatment delivery level 2 (77407) |
$358.40 |
$896 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$699.20 |
$1,748 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$164.40 |
$411 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$158.20 |
$395.50 |
1.5× |
| Radiologic exam chest 2 views (71046) |
$317.60 |
$794 |
3.7× |
| Radiologic exam colon single contrast study (74270) |
$384.80 |
$962 |
2.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$338.40 |
$846 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$771.20 |
$1,928 |
4.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$701.60 |
$1,754 |
4.0× |
| Radiologic examination femur 1 view (73551) |
$244.60 |
$611.50 |
2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$211.20 |
$528 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$277.20 |
$693 |
3.2× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$385.60 |
$964 |
3.7× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$252.40 |
$631 |
2.4× |
| Radiological examination surgical specimen (76098) |
$311.60 |
$779 |
0.6× |
| Ribs bilateral 3 views (71110) |
$322 |
$805 |
3.1× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$2,339.60 |
$5,849 |
5.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,134.80 |
$5,337 |
4.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,869.80 |
$4,674.50 |
3.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,592 |
$3,980 |
3.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,427.60 |
$3,569 |
1.1× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,158 |
$2,895 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$668.40 |
$1,671 |
2.9× |
| Sacroiliac Joints < 3 Views (72200) |
$183.20 |
$458 |
1.8× |
| Scapula (73010) |
$487.20 |
$1,218 |
4.7× |
| Sella turcica (70240) |
$262 |
$655 |
3.0× |
| Shoulder 1 view (73020) |
$358.80 |
$897 |
4.2× |
| Sialogram (70390) |
$206.20 |
$515.50 |
0.9× |
| Simulation intermediate (77285) |
$1,734.80 |
$4,337 |
4.7× |
| Small bowel series (74250) |
$671.60 |
$1,679 |
3.9× |
| Special dosimetry (77331) |
$277.60 |
$694 |
2.1× |
| Special Physics Consult (77370) |
$1,041.60 |
$2,604 |
7.8× |
| Special treatment procedure (77470) |
$1,915 |
$4,787.50 |
3.5× |
| Spine thoracic 3 views (72072) |
$292.40 |
$731 |
2.8× |
| Stereotactic Body Radiation Delivery (77373) |
$7,214 |
$18,035 |
4.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,522.80 |
$3,807 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,064.40 |
$2,661 |
2.9× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$355.40 |
$888.50 |
1.5× |
| Testicular Imaging With Vascular Flow (78761) |
$1,118.60 |
$2,796.50 |
2.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,021.60 |
$5,054 |
5.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,080.60 |
$2,701.50 |
8.1× |
| Thoracolumbar 2 views (72080) |
$196.40 |
$491 |
2.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,138.80 |
$2,847 |
2.1× |
| Thyroid imaging w/blood flow (78013) |
$939.80 |
$2,349.50 |
2.4× |
| Thyroid uptake measurement (78012) |
$362 |
$905 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,073.20 |
$2,683 |
2.7× |
| Treatment device complex (77334) |
$1,306.80 |
$3,267 |
3.5× |
| Treatment device intermediate (77333) |
$379.60 |
$949 |
2.8× |
| Treatment devices simple (77332) |
$870.40 |
$2,176 |
6.5× |
| Ultrasound breast complete (76641) |
$195.40 |
$488.50 |
1.9× |
| Ultrasound elastography first target lesion (76982) |
$526 |
$1,315 |
5.1× |
| Ultrasound Exam Aaa Screen (76706) |
$291.60 |
$729 |
2.8× |
| Ultrasound, abdomen limited (76705) |
$362.40 |
$906 |
3.5× |
| Umbilical-artery Doppler (OB) (76820) |
$224.60 |
$561.50 |
2.2× |
| Ureteral reflux study (78740) |
$853.20 |
$2,133 |
2.2× |
| Urethrocystogram voiding (74455) |
$518.40 |
$1,296 |
2.2× |
| Urethrocystography retrograde rs&i (74450) |
$393.60 |
$984 |
1.7× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$515 |
$1,287.50 |
3.0× |
| Us breast unilateral limited (76642) |
$168.80 |
$422 |
2.0× |
| Us chest (76604) |
$481.40 |
$1,203.50 |
4.6× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,050.80 |
$2,627 |
4.9× |
| Us compl joint r-t w/image documentation (76881) |
$488.20 |
$1,220.50 |
4.7× |
| Us elastography parenchyma (76981) |
$843.20 |
$2,108 |
8.1× |
| Us hips infant static (76886) |
$193.20 |
$483 |
2.2× |
| Us infant hips w manipulation (76885) |
$399.60 |
$999 |
4.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$502.60 |
$1,256.50 |
4.8× |
| Us ob limited (76815) |
$661.80 |
$1,654.50 |
6.4× |
| Us ob transvaginal (76817) |
$466.40 |
$1,166 |
4.5× |
| Us pelvic non ob complete (76856) |
$493 |
$1,232.50 |
4.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$252.40 |
$631 |
2.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$790.40 |
$1,976 |
7.6× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$477.20 |
$1,193 |
4.6× |
| Us retroperitoneal complete (76770) |
$696 |
$1,740 |
6.7× |
| Us retroperitoneal limited (76775) |
$504.80 |
$1,262 |
4.9× |
| Us scrotum and contents (76870) |
$894.80 |
$2,237 |
8.6× |
| Us soft tissue head/neck (76536) |
$674.40 |
$1,686 |
6.5× |
| Us spinal canal and contents (76800) |
$211.20 |
$528 |
2.0× |
| Us,transplanted kidney, real time/ doppler (76776) |
$620 |
$1,550 |
6.0× |
| Venogram extremity bilateral (75822) |
$721.20 |
$1,803 |
0.5× |
| Venogram Extremity Unilateral (75820) |
$697.60 |
$1,744 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,860.20 |
$4,650.50 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$1,860.20 |
$4,650.50 |
1.2× |
| Venography Renal Bilateral (75833) |
$2,063.40 |
$5,158.50 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,063.40 |
$5,158.50 |
0.7× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,286.60 |
$5,716.50 |
0.4× |
| Wrist 2 views (73100) |
$214.80 |
$537 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$443.20 |
$1,108 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$384.80 |
$962 |
4.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$659.20 |
$1,648 |
3.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$248.80 |
$622 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$289.80 |
$724.50 |
3.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$316.60 |
$791.50 |
3.1× |
| X-ray exam of femur 2/> (73552) |
$314.40 |
$786 |
3.6× |
| X-ray eye for foreign body (70030) |
$330.80 |
$827 |
3.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$400.40 |
$1,001 |
4.6× |
| X-ray IV pyelogram (ivp) (74400) |
$623.60 |
$1,559 |
3.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$246 |
$615 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$196.40 |
$491 |
2.3× |
| X-ray leg, infant (73592) |
$178.40 |
$446 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$363.20 |
$908 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$547.60 |
$1,369 |
5.3× |
| X-ray nose-rectum child f.b. (76010) |
$307.20 |
$768 |
3.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$358.40 |
$896 |
3.5× |
| X-ray retrograde pyelogram (74420) |
$528.80 |
$1,322 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$264.80 |
$662 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$442 |
$1,105 |
4.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$480.80 |
$1,202 |
4.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$322 |
$805 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$463.20 |
$1,158 |
5.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$412 |
$1,030 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$436.80 |
$1,092 |
4.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$261.20 |
$653 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$228.80 |
$572 |
2.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$223.60 |
$559 |
2.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$196.40 |
$491 |
2.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$265.20 |
$663 |
2.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$316 |
$790 |
3.0× |
| Xr bone length studies (77073) |
$273.60 |
$684 |
2.6× |
| Xr c-spine 4 or 5 views (72050) |
$347.60 |
$869 |
3.4× |
| Xr c-spine 6 or more views (72052) |
$434.40 |
$1,086 |
4.2× |
| Xr chest 4+ views (71048) |
$317.60 |
$794 |
3.1× |
| Xr urogram antegrade (74425) |
$437.40 |
$1,093.50 |
1.3× |