| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,723.75 |
$6,770.46 |
2.7× |
| Abdomen 2 views (74019) |
$315.70 |
$574 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,124.64 |
$2,044.80 |
2.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,649.14 |
$6,634.80 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$2,816.88 |
$5,121.60 |
0.9× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,719.76 |
$6,763.20 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,470.84 |
$8,128.80 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,235.42 |
$4,064.40 |
0.7× |
| Angiography Spinal Selective Rs&I (75705) |
$3,113 |
$5,660 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,216.64 |
$9,484.80 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$752.40 |
$1,368 |
0.2× |
| Ankle 2 views (73600) |
$219.18 |
$398.50 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$591.36 |
$1,075.20 |
1.7× |
| Aortogram thoracic (75605) |
$2,929.74 |
$5,326.80 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,666.86 |
$8,485.20 |
1.5× |
| Aortography abdominal serialography rs&i (75625) |
$3,502.62 |
$6,368.40 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,929.74 |
$5,326.80 |
0.9× |
| Arthrogram elbow (73085) |
$1,046.10 |
$1,902 |
3.0× |
| Arthrogram hip (73525) |
$708.18 |
$1,287.60 |
2.0× |
| Arthrogram shoulder (73040) |
$588.06 |
$1,069.20 |
1.7× |
| Arthrogram wrist (73115) |
$506 |
$920 |
1.4× |
| Arthrography knee lt (73580) |
$487.85 |
$887 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$358.05 |
$651 |
2.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$784.08 |
$1,425.60 |
2.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$827.64 |
$1,504.80 |
2.1× |
| Bone &/joint imaging whole body (78306) |
$999.90 |
$1,818 |
2.5× |
| Bone age studies (77072) |
$610.50 |
$1,110 |
5.8× |
| Bone Imaging 3 Phase (78315) |
$1,124.64 |
$2,044.80 |
2.8× |
| Bone survey complete (77075) |
$517.44 |
$940.80 |
4.9× |
| Brachytx isodose complex (77318) |
$540.97 |
$983.58 |
1.4× |
| Brachytx isodose intermed (77317) |
$540.97 |
$983.58 |
1.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$232.49 |
$422.71 |
0.6× |
| Brain image w/flow 4 + views (78606) |
$1,061.94 |
$1,930.80 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,161.30 |
$7,566 |
2.9× |
| Brain Imaging Vascular Flow Only (78610) |
$981.42 |
$1,784.40 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$238.15 |
$433 |
2.7× |
| Chest 1 view (71045) |
$263.64 |
$479.35 |
3.0× |
| Chest 3 views (71047) |
$317.60 |
$577.46 |
3.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$468.60 |
$852 |
2.7× |
| Clavicle complete (73000) |
$308.88 |
$561.60 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$293.04 |
$532.80 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$419.94 |
$763.53 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,362.14 |
$4,294.80 |
6.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,873.08 |
$3,405.60 |
7.8× |
| CT abdomen w contrast (74160) |
$1,058.64 |
$1,924.80 |
6.0× |
| CT abdomen w wo contrast (74170) |
$1,302.84 |
$2,368.80 |
7.4× |
| CT abdomen w/o contrast (74150) |
$895.62 |
$1,628.40 |
8.6× |
| CT angio hrt w/3d image (75574) |
$648.12 |
$1,178.40 |
1.9× |
| CT angiography upper extremity lt (73206) |
$1,302.84 |
$2,368.80 |
7.4× |
| CT c-spine w/o contrast (72125) |
$819.72 |
$1,490.40 |
7.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,191.96 |
$2,167.20 |
6.8× |
| CT cervical spine with contrast (72126) |
$968.88 |
$1,761.60 |
2.8× |
| CT chest w/wo contrast (71270) |
$1,302.84 |
$2,368.80 |
7.4× |
| CT chest with contrast (71260) |
$1,058.64 |
$1,924.80 |
6.0× |
| CT head/brain with contrast (70460) |
$1,043.46 |
$1,897.20 |
5.9× |
| CT head/brain without and with contrast (70470) |
$1,191.96 |
$2,167.20 |
6.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$81.18 |
$147.60 |
0.9× |
| CT iac w contrast (70481) |
$968.88 |
$1,761.60 |
5.5× |
| CT limited/localized follow up study (76380) |
$339.24 |
$616.80 |
3.9× |
| CT lower ext w/o (73700) |
$844.80 |
$1,536 |
8.1× |
| CT lower extremity w wo contrast (73702) |
$1,228.92 |
$2,234.40 |
7.0× |
| CT lower extremity with contrast (73701) |
$998.58 |
$1,815.60 |
5.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,302.84 |
$2,368.80 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$895.62 |
$1,628.40 |
8.6× |
| CT lumbar spine with contrast (72132) |
$1,058.64 |
$1,924.80 |
3.0× |
| CT maxillofacial w contrast (70487) |
$968.88 |
$1,761.60 |
5.5× |
| CT maxillofacial w/o contrast (70486) |
$819.72 |
$1,490.40 |
7.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,191.96 |
$2,167.20 |
6.8× |
| CT neck soft tissue w contrast (70491) |
$998.58 |
$1,815.60 |
5.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,191.96 |
$2,167.20 |
6.8× |
| CT orbits w/o contrast (70480) |
$819.72 |
$1,490.40 |
7.8× |
| CT pelvis w & w/o contrast (72194) |
$1,085.70 |
$1,974 |
6.2× |
| CT pelvis w/o contrast (72192) |
$746.35 |
$1,357 |
7.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,228.92 |
$2,234.40 |
7.0× |
| CT soft tissue neck w/o contrast (70490) |
$844.80 |
$1,536 |
8.1× |
| CT thoracic spine w/contrast (72129) |
$998.58 |
$1,815.60 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$844.80 |
$1,536 |
8.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,228.92 |
$2,234.40 |
7.0× |
| CT thorax w/o contrast (71250) |
$546.54 |
$993.70 |
5.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,302.84 |
$2,368.80 |
7.4× |
| CT upper extremity w/o contrast rt (73200) |
$895.62 |
$1,628.40 |
8.6× |
| CT upper extremity with contrast (73201) |
$1,058.64 |
$1,924.80 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,791.90 |
$3,258 |
10.2× |
| Cta Abdomen (74175) |
$1,302.84 |
$2,368.80 |
7.4× |
| CTA abdomen pelvis (74174) |
$1,302.84 |
$2,368.80 |
3.7× |
| CTA chest (71275) |
$1,873.08 |
$3,405.60 |
10.7× |
| Cta Head (70496) |
$1,191.96 |
$2,167.20 |
6.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,302.84 |
$2,368.80 |
7.4× |
| Cta Neck (70498) |
$968.88 |
$1,761.60 |
5.5× |
| Cta Pelvis (72191) |
$895.62 |
$1,628.40 |
5.1× |
| Cystography minimum 3 views rs&i (74430) |
$719.07 |
$1,307.40 |
2.1× |
| Diskogram cervical (72285) |
$6,099.72 |
$11,090.40 |
3.1× |
| Diskography lumbar (72295) |
$6,102.36 |
$11,095.20 |
3.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$224.40 |
$408 |
2.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$166.98 |
$303.60 |
1.9× |
| Echoencephalography real time imaging (76506) |
$711.71 |
$1,294.02 |
6.8× |
| Esophagus (74220) |
$422.95 |
$769 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$509.99 |
$927.26 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$509.99 |
$927.26 |
4.9× |
| Fluoroscopy up to 1 hr (76000) |
$551.76 |
$1,003.20 |
2.3× |
| Foot 2 views (73620) |
$151.80 |
$276 |
1.7× |
| Forearm 2 views (73090) |
$225.50 |
$410 |
2.6× |
| Gated Heart Planar Single (78472) |
$1,626.24 |
$2,956.80 |
4.1× |
| Hand 2 views (73120) |
$166.65 |
$303 |
1.6× |
| Hand 3 views (73130) |
$247.50 |
$450 |
2.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,607.15 |
$2,922.09 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,958.98 |
$3,561.78 |
2.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,251.70 |
$4,094 |
3.2× |
| Heart Infarct Image (78466) |
$605.22 |
$1,100.40 |
1.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,118.04 |
$2,032.80 |
2.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$869.22 |
$1,580.40 |
2.2× |
| Ht muscle image spect sing (78451) |
$2,432.76 |
$4,423.20 |
1.9× |
| Humerus Min 2 Views Left (73060) |
$212.52 |
$386.40 |
2.4× |
| Hysterosalpingogram (74740) |
$1,044.78 |
$1,899.60 |
4.4× |
| Image fusion (77399) |
$252.75 |
$459.55 |
1.9× |
| Interstitial radiation source applic complex (77778) |
$7,309.59 |
$13,290.16 |
10.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$121.44 |
$220.80 |
1.2× |
| Kidney imaging morphology (78700) |
$498.30 |
$906 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,061.94 |
$1,930.80 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,061.94 |
$1,930.80 |
2.0× |
| Knee 3 views (73562) |
$253.55 |
$461 |
2.9× |
| Liver & spleen imaging static only (78215) |
$884.40 |
$1,608 |
2.2× |
| Liver imaging static only (78201) |
$693.66 |
$1,261.20 |
1.3× |
| Lung perf&ventilat diferentl (78598) |
$817.08 |
$1,485.60 |
1.5× |
| Lung Ventilation Imaging (78579) |
$772.86 |
$1,405.20 |
1.9× |
| Lymphoscintigraphy (78195) |
$1,088.34 |
$1,978.80 |
2.0× |
| Mammary ductogram or galactogram single (77053) |
$273.45 |
$497.19 |
1.1× |
| Meckels Diverticulum (78290) |
$969.54 |
$1,762.80 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,477.68 |
$2,686.69 |
3.9× |
| MRA head w & w/o contrast (70546) |
$1,399.86 |
$2,545.20 |
4.0× |
| MRA head w/o contrast (70544) |
$957.66 |
$1,741.20 |
4.0× |
| MRA head with contrast (70545) |
$1,179.42 |
$2,144.40 |
3.4× |
| MRA neck w contrast (70548) |
$1,399.86 |
$2,545.20 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,842.72 |
$3,350.40 |
5.3× |
| MRA neck w/o contrast (70547) |
$957.66 |
$1,741.20 |
4.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI abdomen w/o contrast (74181) |
$1,180.08 |
$2,145.60 |
4.9× |
| MRI any jnt lwr ext with con lt (73722) |
$1,366.20 |
$2,484 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,366.20 |
$2,484 |
1.7× |
| MRI breast w/o contrast bilateral (77047) |
$778.80 |
$1,416 |
3.3× |
| MRI breast w/o contrast unilat (77046) |
$467.28 |
$849.60 |
2.0× |
| MRI c-spine with contrast (72142) |
$1,436.82 |
$2,612.40 |
4.1× |
| MRI cervical spine w/o contrast (72141) |
$1,399.86 |
$2,545.20 |
5.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,521.96 |
$2,767.20 |
4.4× |
| MRI chest w/o contrast (71550) |
$1,133.55 |
$2,061 |
4.7× |
| MRI chest with contrast (71551) |
$1,304.16 |
$2,371.20 |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,304.16 |
$2,371.20 |
3.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,180.08 |
$2,145.60 |
4.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$957.66 |
$1,741.20 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,842.72 |
$3,350.40 |
5.3× |
| MRI orbit/face/neck w/contrast (70542) |
$1,326.60 |
$2,412 |
3.8× |
| MRI pelvis w contrast (72196) |
$1,304.16 |
$2,371.20 |
3.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI pelvis w/o contrast (72195) |
$1,149.06 |
$2,089.20 |
4.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,842.72 |
$3,350.40 |
5.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,086.80 |
$1,976 |
3.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,293.60 |
$2,352 |
3.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,211.10 |
$2,202 |
3.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI thoracic spine w/o contrast (72146) |
$1,180.08 |
$2,145.60 |
4.9× |
| MRI tmj (70336) |
$1,149.06 |
$2,089.20 |
4.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,180.08 |
$2,145.60 |
4.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,552.32 |
$2,822.40 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,180.08 |
$2,145.60 |
4.9× |
| Myelogram Cervical (72240) |
$938.52 |
$1,706.40 |
1.2× |
| Myelogram Lumbar (72265) |
$815.10 |
$1,482 |
1.0× |
| Myelogram thoracic (72255) |
$938.52 |
$1,706.40 |
1.2× |
| Myelography 2 or more regions (72270) |
$979.44 |
$1,780.80 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,090.88 |
$3,801.60 |
1.6× |
| Myocardial infarct spect (78469) |
$808.50 |
$1,470 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,880.90 |
$5,238 |
2.2× |
| Neck soft tissue (70360) |
$317.46 |
$577.20 |
3.6× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$379.97 |
$690.86 |
1.0× |
| Nm cisternogram (78630) |
$1,175.46 |
$2,137.20 |
2.2× |
| Nm gastric emptying study (78264) |
$999.90 |
$1,818 |
2.5× |
| Nm peritoneal-venous shunt patency (78291) |
$807.84 |
$1,468.80 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,196.61 |
$7,630.20 |
3.0× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,090.88 |
$3,801.60 |
1.6× |
| Nuclear medicine study of digestive tracts (78299) |
$596.64 |
$1,084.80 |
1.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$767.58 |
$1,395.60 |
1.9× |
| Nuclear Rx Oral Admin (79005) |
$1,061.94 |
$1,930.80 |
4.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$484 |
$880 |
4.6× |
| Orthopantogram (70355) |
$278.52 |
$506.40 |
3.2× |
| Osseous survey infant (77076) |
$695.64 |
$1,264.80 |
6.6× |
| Osseous survey limited (77074) |
$456.06 |
$829.20 |
4.4× |
| Parathyrd planar w/spect&CT (78072) |
$839.52 |
$1,526.40 |
1.5× |
| Parathyrd planar w/wo subtrj (78071) |
$812.46 |
$1,477.20 |
2.0× |
| Parathyroid imaging (78070) |
$694.98 |
$1,263.60 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$253.55 |
$461 |
2.4× |
| PET image w/CT, skull-thigh (78815) |
$3,521.10 |
$6,402 |
2.5× |
| PET imaging CT for attenuation limited area (78814) |
$2,447.94 |
$4,450.80 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,841.20 |
$6,984 |
2.7× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$1,197.90 |
$2,178 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,552.32 |
$2,822.40 |
4.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$812.46 |
$1,477.20 |
2.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,061.94 |
$1,930.80 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$362.34 |
$658.80 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$285.78 |
$519.60 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$324.72 |
$590.40 |
3.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$357.50 |
$650 |
3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,703.07 |
$14,005.58 |
1.0× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$375.65 |
$683 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$184.80 |
$336 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$193.60 |
$352 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$378.84 |
$688.80 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$187 |
$340 |
2.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$278.97 |
$507.22 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$590.04 |
$1,072.80 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$989.34 |
$1,798.80 |
5.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$653.40 |
$1,188 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$253.55 |
$461 |
2.9× |
| Radiological examination surgical specimen (76098) |
$488.66 |
$888.48 |
0.9× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$1,705.44 |
$3,100.80 |
4.3× |
| Ribs bilateral 3 views (71110) |
$401.28 |
$729.60 |
3.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,004.52 |
$1,826.40 |
2.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,837.44 |
$3,340.80 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,811.60 |
$5,112 |
2.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,999.14 |
$3,634.80 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,114.74 |
$2,026.80 |
4.8× |
| Sacroiliac Joints < 3 Views (72200) |
$216.48 |
$393.60 |
2.1× |
| Scanogram (77073) |
$316.80 |
$576 |
3.0× |
| Scapula complete (73010) |
$285.78 |
$519.60 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$63.46 |
$115.38 |
2.7× |
| Sialogram (70390) |
$842.82 |
$1,532.40 |
3.5× |
| Simulation intermediate (77285) |
$567.43 |
$1,031.69 |
1.5× |
| Small bowel series (74250) |
$648.12 |
$1,178.40 |
3.7× |
| Spec medical radj physics consltj (77370) |
$372.66 |
$677.56 |
2.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$709.29 |
$1,289.61 |
1.9× |
| Special dosimetry (77331) |
$329.31 |
$598.75 |
2.4× |
| Special treatment procedure (77470) |
$1,595.89 |
$2,901.62 |
2.9× |
| Spine thoracic 3 views (72072) |
$302.50 |
$550 |
2.9× |
| Stereotactic body radiation delivery (77373) |
$6,930 |
$12,600 |
3.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$514.51 |
$935.48 |
1.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$289.90 |
$527.10 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,182.14 |
$2,149.35 |
3.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$542.10 |
$985.63 |
4.0× |
| Thoracolumbar 2 views (72080) |
$269.94 |
$490.80 |
3.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,499.52 |
$2,726.40 |
2.8× |
| Thyroid Imaging With Vascular Flow (78013) |
$344.52 |
$626.40 |
0.9× |
| Thyroid uptake measurement (78012) |
$463.98 |
$843.60 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$999.90 |
$1,818 |
2.5× |
| Tomogram (76100) |
$747.78 |
$1,359.60 |
7.1× |
| Treatment device intermediate (77333) |
$502.69 |
$913.99 |
3.7× |
| Treatment devices simple (77332) |
$472.86 |
$859.74 |
3.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,499.52 |
$2,726.40 |
2.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$687.72 |
$1,250.40 |
1.7× |
| Tx devices design & construction complex (77334) |
$768.39 |
$1,397.08 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$574.04 |
$1,043.71 |
5.5× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$480.46 |
$873.56 |
4.7× |
| Unlisted Ultrasound Procedure (76999) |
$354.96 |
$645.38 |
4.1× |
| Upper Extremity Infant (73092) |
$229.02 |
$416.40 |
2.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$349.14 |
$634.80 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$527.34 |
$958.80 |
2.2× |
| Urethrocystography voiding (74455) |
$671.22 |
$1,220.40 |
2.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$780.12 |
$1,418.40 |
4.4× |
| Us abdl aorta screen aaa (76706) |
$313.65 |
$570.28 |
3.0× |
| Us breast unilateral complete (76641) |
$302.50 |
$550 |
2.9× |
| Us breast unilateral limited (76642) |
$258.50 |
$470 |
3.0× |
| Us chest (76604) |
$444.15 |
$807.54 |
4.2× |
| Us compl joint r-t w/image documentation (76881) |
$514.80 |
$936 |
4.9× |
| Us elastography parenchyma (76981) |
$574.04 |
$1,043.71 |
5.5× |
| Us guided compression repair (76936) |
$607.20 |
$1,104 |
2.8× |
| Us infant hips dynamic (76885) |
$337 |
$612.73 |
3.9× |
| Us infant hips limited static (76886) |
$304.68 |
$553.96 |
3.5× |
| Us kidney transplant (76776) |
$423.80 |
$770.54 |
4.0× |
| Us ob transvaginal (76817) |
$416.61 |
$757.48 |
4.0× |
| Us pelvic non ob complete (76856) |
$547.80 |
$996 |
5.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$283.80 |
$516 |
2.7× |
| Us pregnancy ltd (76815) |
$357.50 |
$650 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$467.50 |
$850 |
4.5× |
| Us retroperitoneal complete (76770) |
$498.85 |
$907 |
4.8× |
| Us retroperitoneal limited (76775) |
$492.25 |
$895 |
4.7× |
| Us scrotum and contents (76870) |
$603.37 |
$1,097.04 |
5.8× |
| Us soft tissue head/neck (76536) |
$567.46 |
$1,031.74 |
5.4× |
| Us spinal canal and contents (76800) |
$398.06 |
$723.74 |
3.8× |
| Us transrectal (76872) |
$541.12 |
$983.85 |
5.2× |
| Us transrectal prostate volume (76873) |
$615.34 |
$1,118.80 |
5.9× |
| Us xtr non-vasc lmtd (76882) |
$468.60 |
$852 |
4.5× |
| Venogram extremity bilateral (75822) |
$938.52 |
$1,706.40 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$3,204.30 |
$5,826 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,171.50 |
$2,130 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$469.26 |
$853.20 |
0.3× |
| Wrist 2 views (73100) |
$203.50 |
$370 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$347.60 |
$632 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$363.66 |
$661.20 |
4.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$244.75 |
$445 |
2.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,032.90 |
$1,878 |
5.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$150.70 |
$274 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$253.55 |
$461 |
2.9× |
| X-ray exam hip uni 1 view (73501) |
$246.84 |
$448.80 |
2.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$308.88 |
$561.60 |
3.5× |
| X-ray exam hip uni 4/> views (73503) |
$386.10 |
$702 |
3.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$447.15 |
$813 |
4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$558.80 |
$1,016 |
5.3× |
| X-ray exam of femur 1 (73551) |
$101.20 |
$184 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$689.70 |
$1,254 |
3.9× |
| X-ray eye for foreign body (70030) |
$281.16 |
$511.20 |
3.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$409.86 |
$745.20 |
3.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$374.22 |
$680.40 |
4.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$272.25 |
$495 |
3.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,980.66 |
$3,601.20 |
0.9× |
| X-ray head for orthodontia (70350) |
$168.30 |
$306 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$209 |
$380 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$79.86 |
$145.20 |
0.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$336.05 |
$611 |
3.2× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$235.62 |
$428.40 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$186.78 |
$339.60 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$363.66 |
$661.20 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$475.86 |
$865.20 |
4.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$378.84 |
$688.80 |
3.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$293.70 |
$534 |
3.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$401.28 |
$729.60 |
3.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$255.20 |
$464 |
2.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$848.76 |
$1,543.20 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$244.75 |
$445 |
2.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$287.10 |
$522 |
2.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$450.78 |
$819.60 |
4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$300.96 |
$547.20 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$316.80 |
$576 |
3.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$257.40 |
$468 |
3.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$378.84 |
$688.80 |
4.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$275.22 |
$500.40 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$447.48 |
$813.60 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$440.22 |
$800.40 |
4.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$246.84 |
$448.80 |
2.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$308.88 |
$561.60 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$293.70 |
$534 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$165 |
$300 |
1.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$324.50 |
$590 |
3.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$182.16 |
$331.20 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$246.95 |
$449 |
2.8× |
| Xr c-spine 6 or more views (72052) |
$463.65 |
$843 |
4.4× |
| Xr chest 4+ views (71048) |
$348.87 |
$634.31 |
3.3× |
| Xr finger(s) 2+ views (73140) |
$196.35 |
$357 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$302.28 |
$549.60 |
2.9× |
| Xr shoulder 1 view (73020) |
$145.75 |
$265 |
1.7× |
| Xr spine cervical 4 or 5 views (72050) |
$411.95 |
$749 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$250.80 |
$456 |
2.9× |
| Xr tmj bilateral (70330) |
$267.30 |
$486 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$190.30 |
$346 |
2.2× |