| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,548.30 |
$11,906 |
4.7× |
| Abdomen 2 views (74019) |
$242 |
$440 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$806.30 |
$1,466 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$4,401.65 |
$8,003 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$2,673 |
$4,860 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$1,384.35 |
$2,517 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,378.55 |
$7,961 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,762.45 |
$8,659 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,841.20 |
$6,984 |
1.2× |
| Angiography Spinal Selective Rs&I (75705) |
$4,022.70 |
$7,314 |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,309.35 |
$6,017 |
0.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,172.60 |
$2,132 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,381.50 |
$4,330 |
0.8× |
| Ankle 2 views (73600) |
$185.08 |
$336.50 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$562.65 |
$1,023 |
1.6× |
| Aortogram thoracic (75605) |
$4,105.75 |
$7,465 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,776.20 |
$8,684 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$4,105.75 |
$7,465 |
1.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,734.50 |
$6,790 |
1.2× |
| Arthrogram elbow (73085) |
$686.95 |
$1,249 |
2.0× |
| Arthrogram hip (73525) |
$921.80 |
$1,676 |
2.6× |
| Arthrogram shoulder (73040) |
$831.60 |
$1,512 |
2.4× |
| Arthrogram wrist (73115) |
$561 |
$1,020 |
1.6× |
| Arthrography knee lt (73580) |
$1,065.35 |
$1,937 |
3.0× |
| Basic radiation dosimetry calculation (77300) |
$744.15 |
$1,353 |
5.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$550 |
$1,000 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$825 |
$1,500 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$1,045 |
$1,900 |
2.6× |
| Bone age studies (77072) |
$189.20 |
$344 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$1,375 |
$2,500 |
3.4× |
| Bone Marrow Imaging Limited Area (78102) |
$964.70 |
$1,754 |
2.4× |
| Bone survey complete (77075) |
$437.25 |
$795 |
4.2× |
| Brain image w/flow 4 + views (78606) |
$1,182.50 |
$2,150 |
2.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$385 |
$700 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,655.85 |
$6,647 |
2.6× |
| Brain Imaging Vascular Flow Only (78610) |
$398.20 |
$724 |
0.7× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$155.65 |
$283 |
14.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,612.60 |
$2,932 |
4.6× |
| Cardiac shunt detection (78428) |
$537.90 |
$978 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$381.70 |
$694 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$275 |
$500 |
3.2× |
| Chest 1 view (71045) |
$197.45 |
$359 |
2.3× |
| Chest 3 views (71047) |
$363 |
$660 |
4.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$368.50 |
$670 |
2.1× |
| Cisternography Positive Contrast Rs&I (70015) |
$614.35 |
$1,117 |
0.8× |
| Clavicle complete (73000) |
$220 |
$400 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$101.20 |
$184 |
1.0× |
| Continuing medical physics consltj pr wk (77336) |
$1,046.65 |
$1,903 |
7.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,090 |
$3,800 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,650 |
$3,000 |
6.9× |
| CT abdomen w contrast (74160) |
$1,375 |
$2,500 |
7.8× |
| CT abdomen w wo contrast (74170) |
$1,595 |
$2,900 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,155 |
$2,100 |
11.0× |
| CT angio hrt w/3d image (75574) |
$788.70 |
$1,434 |
2.3× |
| CT angiography upper extremity lt (73206) |
$1,746.25 |
$3,175 |
9.9× |
| CT c-spine w/o contrast (72125) |
$1,045 |
$1,900 |
10.0× |
| CT cervical spine w&w/o contrast (72127) |
$2,076.80 |
$3,776 |
11.8× |
| CT cervical spine with contrast (72126) |
$1,571.90 |
$2,858 |
4.5× |
| CT chest w/wo contrast (71270) |
$1,802.35 |
$3,277 |
10.3× |
| CT chest with contrast (71260) |
$1,430 |
$2,600 |
8.1× |
| CT colonography screening (74263) |
$216.49 |
$393.62 |
0.9× |
| CT colonography w/dye (74262) |
$462.55 |
$841 |
2.6× |
| CT head/brain with contrast (70460) |
$1,346.95 |
$2,449 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,684.10 |
$3,062 |
9.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$512.60 |
$932 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,295.25 |
$2,355 |
14.9× |
| CT hrt w/3d image congen (75573) |
$440 |
$800 |
1.3× |
| CT iac w contrast (70481) |
$1,234.75 |
$2,245 |
7.0× |
| CT limited/localized follow up study (76380) |
$563.20 |
$1,024 |
6.5× |
| CT lower ext w/o (73700) |
$1,100 |
$2,000 |
10.5× |
| CT lower extremity w wo contrast (73702) |
$1,854.05 |
$3,371 |
10.6× |
| CT lower extremity with contrast (73701) |
$1,430 |
$2,600 |
8.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,596.10 |
$2,902 |
9.1× |
| CT lumbar spine w/o contrast (72131) |
$880 |
$1,600 |
8.4× |
| CT lumbar spine with contrast (72132) |
$1,408 |
$2,560 |
4.0× |
| CT maxillofacial w contrast (70487) |
$1,290.85 |
$2,347 |
7.3× |
| CT maxillofacial w/o contrast (70486) |
$880 |
$1,600 |
8.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,796.30 |
$3,266 |
10.2× |
| CT neck soft tissue w contrast (70491) |
$1,100 |
$2,000 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,413.50 |
$2,570 |
8.0× |
| CT orbits w/o contrast (70480) |
$770 |
$1,400 |
7.4× |
| CT pelvis w & w/o contrast (72194) |
$1,668.70 |
$3,034 |
9.5× |
| CT pelvis w/o contrast (72192) |
$1,126.40 |
$2,048 |
10.8× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$895.40 |
$1,628 |
10.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,346.95 |
$2,449 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$898.15 |
$1,633 |
8.6× |
| CT thoracic spine w/contrast (72129) |
$1,576.85 |
$2,867 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$935 |
$1,700 |
8.9× |
| CT thoracic spine w/wo contrast (72130) |
$1,858.45 |
$3,379 |
10.6× |
| CT thorax w/o contrast (71250) |
$1,100 |
$2,000 |
10.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,493.80 |
$2,716 |
8.5× |
| CT upper extremity w/o contrast rt (73200) |
$990 |
$1,800 |
9.5× |
| CT upper extremity with contrast (73201) |
$1,265 |
$2,300 |
3.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,320 |
$2,400 |
7.5× |
| Cta Abdomen (74175) |
$1,351.90 |
$2,458 |
7.7× |
| CTA abdomen pelvis (74174) |
$1,980 |
$3,600 |
5.7× |
| CTA chest (71275) |
$1,210 |
$2,200 |
6.9× |
| Cta Head (70496) |
$1,705 |
$3,100 |
9.7× |
| CTA lwr ext w&w/o contrast (73706) |
$1,633.50 |
$2,970 |
9.3× |
| Cta Neck (70498) |
$1,320 |
$2,400 |
7.5× |
| Cta Pelvis (72191) |
$1,802.35 |
$3,277 |
10.3× |
| Cystography minimum 3 views rs&i (74430) |
$631.40 |
$1,148 |
1.8× |
| Diskography lumbar (72295) |
$1,026.30 |
$1,866 |
0.5× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$112.86 |
$205.20 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$291.50 |
$530 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$67.10 |
$122 |
0.8× |
| Dxa bone density study axial skeleton (77085) |
$1,032.35 |
$1,877 |
9.9× |
| Esophageal motility (78258) |
$539.55 |
$981 |
1.3× |
| Esophagus (74220) |
$275 |
$500 |
1.6× |
| Fluoroscopy up to 1 hr (76000) |
$869.82 |
$1,581.50 |
3.6× |
| Foot 2 views (73620) |
$156.48 |
$284.50 |
1.8× |
| Forearm 2 views (73090) |
$170.50 |
$310 |
2.0× |
| Functional MRI brain by tech (70554) |
$1,559.25 |
$2,835 |
6.5× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,236.40 |
$2,248 |
2.3× |
| Gated Heart Planar Single (78472) |
$860.20 |
$1,564 |
2.1× |
| Hand 2 views (73120) |
$127.05 |
$231 |
1.2× |
| Hand 3 views (73130) |
$253 |
$460 |
2.9× |
| Heart Infarct Image (78466) |
$460.90 |
$838 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,854.40 |
$7,008 |
1.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,150.50 |
$3,910 |
4.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,881.55 |
$3,421 |
4.7× |
| Ht muscle image spect sing (78451) |
$2,035 |
$3,700 |
1.6× |
| Humerus Min 2 Views Left (73060) |
$159.50 |
$290 |
1.8× |
| Image fusion (77399) |
$314.05 |
$571 |
2.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$151.25 |
$275 |
1.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$645.15 |
$1,173 |
1.6× |
| Kidney imaging morphology (78700) |
$539.55 |
$981 |
1.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,344.20 |
$2,444 |
2.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,666.50 |
$3,030 |
3.1× |
| Knee 3 views (73562) |
$269.50 |
$490 |
3.1× |
| Liver & spleen imaging static only (78215) |
$591.25 |
$1,075 |
1.5× |
| Liver imaging static only (78201) |
$1,876.60 |
$3,412 |
3.5× |
| Lung perf&ventilat diferentl (78598) |
$789.80 |
$1,436 |
1.5× |
| Lung perfusion differential (78597) |
$752.40 |
$1,368 |
1.9× |
| Lung Ventilation Imaging (78579) |
$766.15 |
$1,393 |
1.9× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$4,441.80 |
$8,076 |
1.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$975.70 |
$1,774 |
0.6× |
| Lymphoscintigraphy (78195) |
$1,045 |
$1,900 |
1.9× |
| Mammary ductogram or galactogram single (77053) |
$891.55 |
$1,621 |
3.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$454.30 |
$826 |
5.2× |
| Meckels Diverticulum (78290) |
$1,505.35 |
$2,737 |
3.8× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$283.25 |
$515 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,570.25 |
$2,855 |
4.2× |
| Mr elastography (76391) |
$182.05 |
$331 |
0.8× |
| MRA head w & w/o contrast (70546) |
$2,530 |
$4,600 |
7.2× |
| MRA head w/o contrast (70544) |
$1,375 |
$2,500 |
5.8× |
| MRA head with contrast (70545) |
$1,889.25 |
$3,435 |
5.4× |
| MRA neck w contrast (70548) |
$1,935.45 |
$3,519 |
5.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,204.40 |
$4,008 |
6.3× |
| MRA neck w/o contrast (70547) |
$1,666.50 |
$3,030 |
7.0× |
| MRI abdomen w contrast (74182) |
$1,935.45 |
$3,519 |
5.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,849.55 |
$5,181 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$1,398.10 |
$2,542 |
5.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,666.50 |
$3,030 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,980 |
$3,600 |
2.5× |
| MRI bone marrow blood supply (77084) |
$354.75 |
$645 |
1.5× |
| MRI breast w/o contrast bilateral (77047) |
$366.85 |
$667 |
1.5× |
| MRI breast w/o contrast unilat (77046) |
$183.15 |
$333 |
0.8× |
| MRI c-spine with contrast (72142) |
$2,200 |
$4,000 |
6.3× |
| MRI cardiac w/o contrast (75557) |
$699.05 |
$1,271 |
2.9× |
| MRI cervical spine w/o contrast (72141) |
$1,430 |
$2,600 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,795.65 |
$5,083 |
8.0× |
| MRI chest w/o contrast (71550) |
$1,666.50 |
$3,030 |
7.0× |
| MRI chest with contrast (71551) |
$2,221.45 |
$4,039 |
2.8× |
| MRI fetal sngl/1st gestation (74712) |
$3,026.65 |
$5,503 |
12.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,989.35 |
$3,617 |
5.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,035 |
$3,700 |
5.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,485 |
$2,700 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,720.40 |
$3,128 |
7.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,311.65 |
$4,203 |
6.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,989.35 |
$3,617 |
5.7× |
| MRI pelvis w contrast (72196) |
$1,989.35 |
$3,617 |
5.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,311.65 |
$4,203 |
6.6× |
| MRI pelvis w/o contrast (72195) |
$1,300.20 |
$2,364 |
5.4× |
| MRI scan of arm joint before and after contrast (73223) |
$2,310 |
$4,200 |
6.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,935.45 |
$3,519 |
5.5× |
| MRI spectroscopy (76390) |
$1,720.40 |
$3,128 |
19.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,530 |
$4,600 |
7.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,791.90 |
$3,258 |
5.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,530 |
$4,600 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,935.45 |
$3,519 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,472.80 |
$4,496 |
7.1× |
| MRI thoracic spine w/o contrast (72146) |
$1,398.10 |
$2,542 |
5.9× |
| MRI tmj (70336) |
$1,774.30 |
$3,226 |
7.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,430 |
$2,600 |
6.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,204.40 |
$4,008 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,666.50 |
$3,030 |
7.0× |
| Myelogram Cervical (72240) |
$1,739.65 |
$3,163 |
2.2× |
| Myelogram Lumbar (72265) |
$1,739.65 |
$3,163 |
2.2× |
| Myelogram thoracic (72255) |
$1,391.50 |
$2,530 |
1.8× |
| Myelography 2 or more regions (72270) |
$2,659.25 |
$4,835 |
3.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,979.90 |
$5,418 |
2.3× |
| Myocardial infarct spect (78469) |
$494.45 |
$899 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,245 |
$5,900 |
2.5× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,408.35 |
$6,197 |
2.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,856.25 |
$3,375 |
1.3× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,055.25 |
$5,555 |
1.4× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,826.45 |
$5,139 |
1.3× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$2,826.45 |
$5,139 |
1.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,631.85 |
$2,967 |
1.9× |
| Neck soft tissue (70360) |
$212.30 |
$386 |
2.4× |
| Nm cisternogram (78630) |
$879.45 |
$1,599 |
1.6× |
| Nm gastric emptying study (78264) |
$1,035.10 |
$1,882 |
2.6× |
| Nm gastroesophageal reflux study (78262) |
$1,522.95 |
$2,769 |
3.8× |
| Nm peritoneal-venous shunt patency (78291) |
$515.90 |
$938 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,722 |
$14,040 |
5.6× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$2,312.20 |
$4,204 |
1.6× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,174.70 |
$3,954 |
1.7× |
| Nuclear medicine of heart pumping function (78473) |
$2,371.60 |
$4,312 |
5.9× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$5,732.65 |
$10,423 |
4.0× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,482.80 |
$2,696 |
1.0× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,045.45 |
$3,719 |
1.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,035.10 |
$1,882 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$1,505.35 |
$2,737 |
6.4× |
| Nuclr Rx Interstit Colloid (79300) |
$315.15 |
$573 |
1.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$86.61 |
$157.47 |
0.8× |
| Orthopantogram (70355) |
$212.85 |
$387 |
2.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,021.35 |
$1,857 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$860.20 |
$1,564 |
2.1× |
| Parathyroid imaging (78070) |
$806.30 |
$1,466 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$236.50 |
$430 |
2.3× |
| Peritoneogram rs&i (74190) |
$239.25 |
$435 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$3,740 |
$6,800 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$3,025 |
$5,500 |
2.1× |
| PET imaging for CT attenuation whole body (78816) |
$4,070 |
$7,400 |
2.8× |
| PET whole body (78813) |
$5,732.65 |
$10,423 |
4.0× |
| Pr MRI brain w/ dye (70558) |
$591.25 |
$1,075 |
3.4× |
| Pr MRI brain w/o & w/ dye (70559) |
$645.15 |
$1,173 |
3.7× |
| Pr MRI brain w/o dye (70557) |
$422.40 |
$768 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,207.15 |
$4,013 |
6.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,267.55 |
$5,941 |
1.0× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,267.55 |
$5,941 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,075.25 |
$1,955 |
2.7× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,129.15 |
$2,053 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$660 |
$1,200 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$280.50 |
$510 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$336.60 |
$612 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$353.10 |
$642 |
3.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$336.60 |
$612 |
3.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$448.80 |
$816 |
4.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$21,459.90 |
$39,018 |
2.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,069.20 |
$1,944 |
1.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$475.20 |
$864 |
4.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$926.75 |
$1,685 |
2.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$448.80 |
$816 |
4.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$203.50 |
$370 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$312.40 |
$568 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$281.60 |
$512 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$413.05 |
$751 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$574.20 |
$1,044 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$574.20 |
$1,044 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$482.35 |
$877 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$247.50 |
$450 |
2.8× |
| Radiological examination surgical specimen (76098) |
$743.60 |
$1,352 |
1.4× |
| Radiopharm Dacryocystography (78660) |
$248.60 |
$452 |
0.6× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$315.15 |
$573 |
1.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,514.05 |
$4,571 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,692.60 |
$8,532 |
1.5× |
| Ribs bilateral 3 views (71110) |
$240.90 |
$438 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,182.50 |
$2,150 |
3.0× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,236.40 |
$2,248 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,344.20 |
$2,444 |
2.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,150.50 |
$3,910 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,419.45 |
$4,399 |
1.7× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,774.30 |
$3,226 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,627.45 |
$2,959 |
7.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$537.90 |
$978 |
2.3× |
| Rp Therapy Intravenous Administration (79101) |
$806.30 |
$1,466 |
3.5× |
| Sacroiliac Joints < 3 Views (72200) |
$200.20 |
$364 |
1.9× |
| Scanogram (77073) |
$617.10 |
$1,122 |
5.9× |
| Scapula complete (73010) |
$286 |
$520 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$82.22 |
$149.50 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$179.30 |
$326 |
1.7× |
| Simulation intermediate (77285) |
$1,744.60 |
$3,172 |
4.7× |
| Small bowel series (74250) |
$310.20 |
$564 |
1.8× |
| Spec medical radj physics consltj (77370) |
$1,830.95 |
$3,329 |
13.6× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,046.65 |
$1,903 |
2.8× |
| Special dosimetry (77331) |
$379.50 |
$690 |
2.8× |
| Special treatment procedure (77470) |
$4,187.15 |
$7,613 |
7.6× |
| Speech evaluation complex (70371) |
$314.60 |
$572 |
1.3× |
| Spine thoracic 3 views (72072) |
$330 |
$600 |
3.2× |
| Spleen imaging only (78185) |
$494.45 |
$899 |
1.2× |
| Splenoportograpy rs&i (75810) |
$4,656.85 |
$8,467 |
1.5× |
| Stereotactic body radiation delivery (77373) |
$26,168.45 |
$47,579 |
14.6× |
| Superior sagittal sinus venogram (75870) |
$2,010.80 |
$3,656 |
0.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,268.20 |
$4,124 |
6.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$796.40 |
$1,448 |
2.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$3,837.90 |
$6,978 |
10.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,046.65 |
$1,903 |
7.8× |
| Thoracolumbar 2 views (72080) |
$231 |
$420 |
2.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,828.20 |
$3,324 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$649 |
$1,180 |
1.6× |
| Thyroid uptake measurement (78012) |
$228.25 |
$415 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$537.90 |
$978 |
1.3× |
| Tmj unilateral (70328) |
$134.75 |
$245 |
1.5× |
| Tomogram (76100) |
$398.75 |
$725 |
3.8× |
| Treatment device intermediate (77333) |
$806.30 |
$1,466 |
6.0× |
| Treatment devices simple (77332) |
$723.80 |
$1,316 |
5.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,290.30 |
$2,346 |
2.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$484 |
$880 |
1.2× |
| Tx devices design & construction complex (77334) |
$2,093.30 |
$3,806 |
5.6× |
| Ultrasound elastography first target lesion (76982) |
$117.70 |
$214 |
1.1× |
| Ultrasound scan of cornea to determine thickness (76514) |
$3.30 |
$6 |
0.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$81.18 |
$147.60 |
0.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$211.20 |
$384 |
0.6× |
| Ultrasound, abdomen limited (76705) |
$456.50 |
$830 |
4.4× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$359.70 |
$654 |
4.1× |
| Unlisted magnetic resonance procedure (76498) |
$3,870.90 |
$7,038 |
44.4× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$4,132.15 |
$7,513 |
10.3× |
| Unlisted Ultrasound Procedure (76999) |
$223.30 |
$406 |
2.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$166.65 |
$303 |
1.8× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$1,060.95 |
$1,929 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$528 |
$960 |
2.2× |
| Urethrocystography voiding (74455) |
$631.40 |
$1,148 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$729.85 |
$1,327 |
4.2× |
| Us abdl aorta screen aaa (76706) |
$209 |
$380 |
2.0× |
| Us breast unilateral complete (76641) |
$528.55 |
$961 |
5.0× |
| Us breast unilateral limited (76642) |
$388.30 |
$706 |
4.5× |
| Us chest (76604) |
$382.25 |
$695 |
3.7× |
| Us compl joint r-t w/image documentation (76881) |
$565.95 |
$1,029 |
5.4× |
| Us elastography parenchyma (76981) |
$155.65 |
$283 |
1.5× |
| Us kidney transplant (76776) |
$1,850.20 |
$3,364 |
17.7× |
| Us ob transvaginal (76817) |
$332.75 |
$605 |
3.2× |
| Us pelvic non ob complete (76856) |
$550 |
$1,000 |
5.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$407 |
$740 |
3.9× |
| Us pregnancy ltd (76815) |
$431.75 |
$785 |
4.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$587.40 |
$1,068 |
5.6× |
| Us retroperitoneal complete (76770) |
$556.60 |
$1,012 |
5.3× |
| Us retroperitoneal limited (76775) |
$496.10 |
$902 |
4.7× |
| Us scrotum and contents (76870) |
$550 |
$1,000 |
5.3× |
| Us soft tissue head/neck (76536) |
$517 |
$940 |
4.9× |
| Us transrectal (76872) |
$637.45 |
$1,159 |
6.1× |
| Us transrectal prostate volume (76873) |
$1,521.30 |
$2,766 |
14.5× |
| Us xtr non-vasc lmtd (76882) |
$509.85 |
$927 |
4.9× |
| Us, eye b-scan (76512) |
$105.60 |
$192 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,340.90 |
$2,438 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$5,865.20 |
$10,664 |
1.9× |
| Venography caval superior serialography rs&i (75827) |
$2,681.25 |
$4,875 |
1.7× |
| Venography extremity unilateral rs&i (75820) |
$1,282.05 |
$2,331 |
0.8× |
| Venography Renal Bilateral (75833) |
$3,603.60 |
$6,552 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$2,514.05 |
$4,571 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,782.55 |
$3,241 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,162.50 |
$5,750 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$85.25 |
$155 |
1.0× |
| Wrist 2 views (73100) |
$162.25 |
$295 |
1.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$338.80 |
$616 |
3.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$465.30 |
$846 |
5.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$304.70 |
$554 |
3.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$459.25 |
$835 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$178.75 |
$325 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$298.10 |
$542 |
3.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$392.70 |
$714 |
3.8× |
| X-ray exam hip uni 1 view (73501) |
$212.30 |
$386 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$288.20 |
$524 |
3.3× |
| X-ray exam hip uni 4/> views (73503) |
$491.70 |
$894 |
4.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$392.70 |
$714 |
3.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$478.50 |
$870 |
4.6× |
| X-ray exam of femur 1 (73551) |
$220 |
$400 |
2.5× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$376.20 |
$684 |
2.1× |
| X-ray eye for foreign body (70030) |
$126.50 |
$230 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$437.25 |
$795 |
4.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$319.55 |
$581 |
3.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$242 |
$440 |
2.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,262.80 |
$2,296 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$192.50 |
$350 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$392.70 |
$714 |
4.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$335.50 |
$610 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$275 |
$500 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$308 |
$560 |
2.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$518.65 |
$943 |
5.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$101.20 |
$184 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$291.50 |
$530 |
3.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$162.80 |
$296 |
1.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$342.10 |
$622 |
3.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$338.80 |
$616 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$499.40 |
$908 |
1.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$229.90 |
$418 |
2.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$336.60 |
$612 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$398.20 |
$724 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$258.50 |
$470 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$268.95 |
$489 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$247.50 |
$450 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$286 |
$520 |
3.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$268.95 |
$489 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$359.15 |
$653 |
3.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$286 |
$520 |
2.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$263.45 |
$479 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$123.20 |
$224 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$151.25 |
$275 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$258.50 |
$470 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$360.25 |
$655 |
3.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$212.85 |
$387 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$275 |
$500 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$719.40 |
$1,308 |
6.9× |
| Xr chest 4+ views (71048) |
$562.10 |
$1,022 |
5.4× |
| Xr finger(s) 2+ views (73140) |
$187 |
$340 |
2.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$280.50 |
$510 |
2.7× |
| Xr shoulder 1 view (73020) |
$145.75 |
$265 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$363 |
$660 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$231 |
$420 |
2.6× |
| Xr tmj bilateral (70330) |
$268.95 |
$489 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$220 |
$400 |
2.5× |