| Abdomen 2 views (74019) |
$270.69 |
$886.45 |
2.2× |
| Acute gi blood loss imaging (78278) |
$932.15 |
$3,052.64 |
2.0× |
| Angio Adrenal Bilat Select (75733) |
$2,698.33 |
$8,836.67 |
0.7× |
| Angiography extremity bilateral rs&i (75716) |
$2,692.22 |
$8,816.65 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,686.73 |
$8,798.67 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$2,962.42 |
$9,701.54 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,545.90 |
$11,612.34 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,253.49 |
$7,379.87 |
0.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$2,361.20 |
$7,732.62 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,847.18 |
$9,324.12 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,755.33 |
$9,023.34 |
0.8× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$2,747.86 |
$8,998.87 |
0.7× |
| Basic dosimetry (77300) |
$478.28 |
$1,566.29 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$796.90 |
$2,609.73 |
1.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$829.82 |
$2,717.55 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$1,448.91 |
$4,744.97 |
3.1× |
| Bone age studies (77072) |
$206.27 |
$675.48 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,521.35 |
$4,982.22 |
3.3× |
| Bone Marrow Imaging Limited Area (78102) |
$484.91 |
$1,588.01 |
1.0× |
| Bone survey complete (77075) |
$439.37 |
$1,438.85 |
3.6× |
| Bone survey infant (77076) |
$245.32 |
$803.36 |
2.0× |
| Bowel imaging (78290) |
$634.43 |
$2,077.66 |
1.4× |
| Brachytx isodose complex (77318) |
$1,567.28 |
$5,132.63 |
3.6× |
| Brain Imaging < 4 Static Views W Vascular Flow (78601) |
$583.51 |
$1,910.89 |
1.3× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$816.91 |
$2,675.25 |
1.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,775.80 |
$9,090.36 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$624.78 |
$2,046.07 |
1.0× |
| Brain imaging, minimum 4 static views; Non-Facility (78605) |
$583.51 |
$1,910.89 |
0.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,253.01 |
$4,103.42 |
2.7× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,128.23 |
$3,694.80 |
2.4× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$1,517.91 |
$4,970.95 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,517.91 |
$4,970.95 |
3.7× |
| Cardiac shunt detection (78428) |
$813.28 |
$2,663.37 |
1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$839.87 |
$2,750.46 |
1.3× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$895.33 |
$2,932.06 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$272.31 |
$891.78 |
2.7× |
| Chest 1 view (71045) |
$202.96 |
$664.66 |
2.0× |
| Chest xray 3 views (71047) |
$265.88 |
$870.70 |
2.6× |
| Cholecystography, oral contrast Non-Facility (74290) |
$205.85 |
$674.10 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$590.17 |
$1,932.70 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$66.27 |
$217 |
0.5× |
| Continuing medical physics consltj pr wk (77336) |
$683.46 |
$2,238.22 |
4.4× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$515.74 |
$1,688.97 |
2.5× |
| Corpora cavernosography (74445) |
$333.52 |
$1,092.21 |
2.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,136.68 |
$13,547.07 |
10.2× |
| CT abdomen and pelvis without contrast (74176) |
$3,134.83 |
$10,266.14 |
11.3× |
| CT abdomen w contrast (74160) |
$1,880.07 |
$6,156.96 |
9.2× |
| CT abdomen w wo contrast (74170) |
$2,021.07 |
$6,618.73 |
9.9× |
| CT abdomen w/o contrast (74150) |
$1,535.39 |
$5,028.18 |
12.6× |
| CT angio hrt w/3d image (75574) |
$1,007.88 |
$3,300.66 |
2.5× |
| CT c-spine w/contrast (72126) |
$1,547.82 |
$5,068.91 |
3.8× |
| CT c-spine w/o contrast (72125) |
$1,407.11 |
$4,608.10 |
11.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,688.54 |
$5,529.72 |
8.3× |
| CT chest w contrast (71260) |
$1,867.31 |
$6,115.19 |
9.2× |
| CT chest w/wo contrast (71270) |
$2,016.70 |
$6,604.41 |
9.9× |
| CT colonography screening (74263) |
$987.22 |
$3,233 |
3.6× |
| CT colonography w/dye (74262) |
$809.17 |
$2,649.90 |
4.0× |
| CT colonography w/o cntrst (74261) |
$735.61 |
$2,409 |
6.1× |
| CT head/brain with contrast (70460) |
$1,463.27 |
$4,792.01 |
7.2× |
| CT head/brain without and with contrast (70470) |
$1,638.86 |
$5,367.05 |
8.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,007.88 |
$3,300.66 |
2.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$79.52 |
$260.40 |
0.8× |
| CT hrt w/3d image congen (75573) |
$1,007.88 |
$3,300.66 |
2.5× |
| CT iac w contrast (70481) |
$1,442.43 |
$4,723.77 |
7.1× |
| CT limited/localized follow up study (76380) |
$619.38 |
$2,028.36 |
6.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,531.55 |
$5,015.62 |
7.5× |
| CT lumbar spine w/contrast (72132) |
$1,403.92 |
$4,597.65 |
3.5× |
| CT lumbar spine w/o contrast (72131) |
$1,276.29 |
$4,179.68 |
10.5× |
| CT maxillofacial w contrast (70487) |
$1,305.27 |
$4,274.58 |
6.4× |
| CT maxillofacial w/wo contrast (70488) |
$1,465.75 |
$4,800.14 |
7.2× |
| CT maxillofacial wo contrast (70486) |
$359.49 |
$1,177.26 |
3.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,464.46 |
$4,795.89 |
7.2× |
| CT orbits w/o contrast (70480) |
$1,321.32 |
$4,327.12 |
10.9× |
| CT pelvis w/o contrast (72192) |
$1,384.20 |
$4,533.05 |
11.4× |
| CT pelvis w/wo contrast (72194) |
$1,845.59 |
$6,044.06 |
9.1× |
| CT soft tissue neck w contrast (70491) |
$1,443.47 |
$4,727.15 |
7.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,756.21 |
$5,751.36 |
8.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,287.09 |
$4,215.04 |
10.6× |
| CT thoracic spine w/contrast (72129) |
$1,474.12 |
$4,827.54 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,340.11 |
$4,388.67 |
11.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,608.13 |
$5,266.40 |
7.9× |
| CT thorax w/o contrast (71250) |
$1,661.91 |
$5,442.52 |
13.7× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$1,858.37 |
$6,085.91 |
9.1× |
| Cta Abdomen (74175) |
$1,958.63 |
$6,414.26 |
9.6× |
| CTA abdomen pelvis (74174) |
$4,080.49 |
$13,363.05 |
10.1× |
| CTA chest (71275) |
$2,406.06 |
$7,879.51 |
11.8× |
| Cta Head (70496) |
$1,850.35 |
$6,059.64 |
9.1× |
| Cta Neck (70498) |
$1,942.87 |
$6,362.62 |
9.5× |
| Cta Pelvis (72191) |
$1,758.41 |
$5,758.56 |
8.6× |
| Cystography minimum 3 views rs&i (74430) |
$448.07 |
$1,467.34 |
1.1× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$1,100.15 |
$3,602.83 |
0.5× |
| Diskogram cervical (72285) |
$2,131.56 |
$6,980.56 |
0.9× |
| Diskography lumbar (72295) |
$2,030.05 |
$6,648.14 |
0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$261.55 |
$856.53 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$363.85 |
$1,191.56 |
3.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$156.47 |
$512.39 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$585.20 |
$1,916.43 |
4.8× |
| Esophageal motility (78258) |
$477.24 |
$1,562.87 |
1.0× |
| Esophagus (74220) |
$564.11 |
$1,847.38 |
2.8× |
| Facial bones min 3 views (70150) |
$249.65 |
$817.57 |
2.1× |
| Fetal biophysical profile non-stress testing (76818) |
$378.45 |
$1,239.35 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$354.79 |
$1,161.89 |
2.9× |
| Fetal Echo (76825) |
$571.24 |
$1,870.72 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$406.85 |
$1,332.38 |
1.5× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,389.22 |
$4,549.51 |
3.0× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$1,662.65 |
$5,444.94 |
2.6× |
| Heart first pass single,planar (78481) |
$847.80 |
$2,776.43 |
1.3× |
| Heart Infarct Image (78466) |
$813.28 |
$2,663.37 |
1.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,260.77 |
$7,403.71 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,461.09 |
$4,784.86 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,241.51 |
$4,065.77 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,179.43 |
$3,862.48 |
2.5× |
| Hysterosalpingogram (74740) |
$398.33 |
$1,304.45 |
1.4× |
| Image fusion (77399) |
$627.74 |
$2,055.75 |
4.0× |
| Interstitial radiation source applic complex (77778) |
$2,355.95 |
$7,715.41 |
2.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$167.77 |
$549.42 |
1.4× |
| Kidney imaging morphology (78700) |
$701.25 |
$2,296.48 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,009.11 |
$3,304.70 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,026.22 |
$3,360.71 |
1.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,077.53 |
$3,528.74 |
1.7× |
| Liver & spleen imaging static only (78215) |
$753.35 |
$2,467.11 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$810.02 |
$2,652.70 |
1.7× |
| Liver imaging static only (78201) |
$781.60 |
$2,559.61 |
1.2× |
| Liver imaging w/vascular flow (78202) |
$753.85 |
$2,468.75 |
1.2× |
| Lung perf&ventilat diferentl (78598) |
$1,215.84 |
$3,981.69 |
1.9× |
| Lung perfusion differential (78597) |
$807.58 |
$2,644.72 |
1.7× |
| Lung ventilation imaging (78579) |
$557.86 |
$1,826.92 |
1.2× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,906.64 |
$6,244 |
0.5× |
| Lymphangiography, extremity only, bilateral, radiological supervision and interpretation Facility (75803) |
$778.04 |
$2,547.98 |
0.4× |
| Lymphoscintigraphy (78195) |
$1,198.86 |
$3,926.10 |
1.9× |
| Mammary ductogram or galactogram multiple (77054) |
$485.56 |
$1,590.13 |
1.8× |
| Mammary ductogram or galactogram single (77053) |
$451.91 |
$1,479.92 |
1.6× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$238.29 |
$780.36 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,116.27 |
$6,930.50 |
4.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$18.70 |
$61.23 |
0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$70.08 |
$229.48 |
0.6× |
| Mr safety implt pos&/immoblj (76019) |
$45.35 |
$148.50 |
0.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$184.53 |
$604.30 |
0.7× |
| MRA head w & w/o contrast (70546) |
$2,247.43 |
$7,360.03 |
5.5× |
| MRA head w/o contrast (70544) |
$1,528.87 |
$5,006.82 |
5.5× |
| MRA head with contrast (70545) |
$1,666.46 |
$5,457.43 |
4.1× |
| MRA neck w contrast (70548) |
$1,619.50 |
$5,303.64 |
4.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,570.64 |
$8,418.49 |
6.3× |
| MRA neck w/o contrast (70547) |
$1,490.97 |
$4,882.73 |
5.4× |
| MRI abdomen w contrast (74182) |
$1,924.51 |
$6,302.52 |
4.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,624.34 |
$8,594.35 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,364.66 |
$4,469.06 |
4.9× |
| MRI bone marrow blood supply (77084) |
$1,329.39 |
$4,353.55 |
4.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,499.90 |
$4,911.97 |
5.4× |
| MRI c-spine with contrast (72142) |
$2,031.11 |
$6,651.60 |
5.0× |
| MRI cardiac w/o cont stress (75559) |
$1,226.98 |
$4,018.19 |
1.9× |
| MRI cardiac w/o contrast (75557) |
$1,075.19 |
$3,521.09 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$1,997.81 |
$6,542.56 |
7.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,628.54 |
$8,608.12 |
6.5× |
| MRI chest w/o contrast (71550) |
$1,599.03 |
$5,236.60 |
5.8× |
| MRI chest with contrast (71551) |
$1,927.60 |
$6,312.62 |
2.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,354.50 |
$4,435.79 |
4.9× |
| MRI orbit face neck w contrast (70542) |
$1,834.21 |
$6,006.80 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,821.87 |
$9,241.24 |
7.0× |
| MRI pelvis w/contrast (72196) |
$1,703.74 |
$5,579.52 |
4.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,839.57 |
$9,299.20 |
7.0× |
| MRI pelvis w/o contrast (72195) |
$1,561.76 |
$5,114.56 |
5.6× |
| MRI spectroscopy (76390) |
$761.99 |
$2,495.39 |
7.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,213.14 |
$10,522.61 |
7.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,123.26 |
$6,953.40 |
5.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,219.70 |
$10,544.09 |
7.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,122.89 |
$6,952.16 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,216.49 |
$10,533.58 |
7.9× |
| MRI temporomandibular joint (70336) |
$1,336.21 |
$4,375.90 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,090.72 |
$6,846.83 |
7.5× |
| Myelogram Cervical (72240) |
$1,064.72 |
$3,486.81 |
1.2× |
| Myelogram Lumbar (72265) |
$1,064.72 |
$3,486.81 |
1.2× |
| Myelogram thoracic (72255) |
$1,064.72 |
$3,486.81 |
1.2× |
| Myelography 2 or more regions (72270) |
$1,215.88 |
$3,981.82 |
1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,792.77 |
$9,145.94 |
1.9× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$860.59 |
$2,818.29 |
1.4× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78491) |
$3,061.77 |
$10,026.90 |
1.8× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78431) |
$4,952.21 |
$16,217.83 |
1.9× |
| Myocardial imaging, positron emission tomography (PET), perfusion study (including ventricular wall motionºs» and/or… (78492) |
$3,144.27 |
$10,297.06 |
1.9× |
| Myocardial infarct spect (78469) |
$988.56 |
$3,237.39 |
1.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$978.62 |
$3,204.85 |
0.7× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$1,283.58 |
$4,203.55 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,731.03 |
$8,943.76 |
1.8× |
| Myocardial spect single study at rest or stress (78451) |
$2,093.79 |
$6,856.88 |
1.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,194.97 |
$10,463.11 |
1.9× |
| N-invas est c ffr sw aly CTA (75580) |
$1,518.54 |
$4,973 |
1.5× |
| Neck soft tissue (70360) |
$177.04 |
$579.77 |
1.8× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$305.49 |
$1,000.43 |
0.7× |
| Nm bone marrow multi (78103) |
$518.86 |
$1,699.17 |
1.1× |
| Nm bone marrow wb (78104) |
$586.74 |
$1,921.49 |
1.3× |
| Nm cardiac blood pool multiple (78473) |
$1,400.89 |
$4,587.71 |
3.0× |
| Nm cisternogram (78630) |
$950.40 |
$3,112.43 |
1.5× |
| Nm csf leak detection (78650) |
$900.46 |
$2,948.86 |
0.6× |
| Nm gastric emptying study (78264) |
$1,071.30 |
$3,508.36 |
2.3× |
| Nm gastroesophageal reflux study (78262) |
$818.45 |
$2,680.31 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$572.98 |
$1,876.42 |
1.2× |
| Noncardiac Vascular Flow Imaging (78445) |
$322.11 |
$1,054.85 |
0.7× |
| Nonvascular shunt X-ray (75809) |
$281.11 |
$920.59 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,861.48 |
$12,645.84 |
2.4× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$605.12 |
$1,981.68 |
1.3× |
| Nuclear Rx Oral Admin (79005) |
$713.60 |
$2,336.94 |
2.6× |
| Ob us nuchal meas 1 gest (76813) |
$343.96 |
$1,126.41 |
2.8× |
| Osseous survey limited (77074) |
$307.56 |
$1,007.19 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$881.93 |
$2,888.18 |
1.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,152.62 |
$7,049.54 |
4.6× |
| Pelvis 1 or 2 views (72170) |
$253.34 |
$829.63 |
2.1× |
| Perineogram (74775) |
$331.19 |
$1,084.60 |
1.2× |
| Peritoneogram after injection (74190) |
$299.06 |
$979.36 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$3,140.32 |
$10,284.12 |
1.9× |
| PET imaging CT for attenuation limited area (78814) |
$3,009.47 |
$9,855.62 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$3,323.50 |
$10,884.03 |
2.0× |
| Positron emission tomography (PET) imaging; skull base to mid-thigh Non-Facility (78812) |
$3,086.42 |
$10,107.60 |
1.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,401.79 |
$7,865.55 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,465.73 |
$4,800.06 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$703.27 |
$2,303.10 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,191.98 |
$3,903.56 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$346.65 |
$1,135.21 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$677.80 |
$2,219.69 |
6.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$924.27 |
$3,026.84 |
7.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,070.61 |
$3,506.09 |
8.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$211.45 |
$692.45 |
1.7× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$259.14 |
$848.64 |
2.1× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$285.02 |
$933.40 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$235.29 |
$770.52 |
2.3× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$286.27 |
$937.48 |
2.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$198.83 |
$651.13 |
2.0× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$301.82 |
$988.39 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$260.71 |
$853.78 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,147.63 |
$3,758.33 |
9.5× |
| Radiation Delivery Stereotactic Cranial Cobalt (77371) |
$35,004.79 |
$114,636.17 |
4.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$6,281.26 |
$20,570.30 |
0.7× |
| Radiation treatment delivery level 1 (77402) |
$402.58 |
$1,318.38 |
3.4× |
| Radiation treatment delivery level 2 (77407) |
$476.86 |
$1,561.63 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$639.40 |
$2,093.92 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$213.97 |
$700.70 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$305.97 |
$1,002 |
2.5× |
| Radiologic exam chest 2 views (71046) |
$263.85 |
$864.06 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$467.79 |
$1,531.93 |
2.3× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$559.92 |
$1,833.65 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$555.29 |
$1,818.49 |
2.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$639.97 |
$2,095.80 |
3.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$138.52 |
$453.63 |
1.4× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$260.42 |
$852.84 |
2.1× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$187.55 |
$614.20 |
1.5× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$127.67 |
$418.09 |
1.3× |
| Radiological examination surgical specimen (76098) |
$304.25 |
$996.35 |
0.5× |
| Radiopharm Dacryocystography (78660) |
$648.04 |
$2,122.23 |
1.4× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$756.40 |
$2,477.11 |
2.8× |
| Renal Cyst Study (74470) |
$513.42 |
$1,681.37 |
0.8× |
| Ribs bilateral 3 views (71110) |
$243.83 |
$798.51 |
2.0× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$700.29 |
$2,293.34 |
1.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$898.88 |
$2,943.69 |
1.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,630.52 |
$5,339.71 |
2.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,191.53 |
$3,902.09 |
1.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,254.24 |
$4,107.47 |
2.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,630.52 |
$5,339.71 |
1.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$524.64 |
$1,718.10 |
1.9× |
| Rp Therapy Intravenous Administration (79101) |
$749.28 |
$2,453.78 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$165.70 |
$542.63 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$466.40 |
$1,527.38 |
1.7× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$593.71 |
$1,944.30 |
1.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$87.15 |
$285.40 |
3.7× |
| Sella turcica (70240) |
$90.35 |
$295.88 |
0.9× |
| Sialogram (70390) |
$357.30 |
$1,170.11 |
1.3× |
| Simulation intermediate (77285) |
$1,180.38 |
$3,865.58 |
2.7× |
| Small bowel series (74250) |
$640.59 |
$2,097.83 |
3.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$891.21 |
$2,918.58 |
2.0× |
| Special dosimetry (77331) |
$275.48 |
$902.15 |
1.8× |
| Special treatment procedure (77470) |
$2,335.05 |
$7,646.96 |
3.6× |
| Speech evaluation complex (70371) |
$452.34 |
$1,481.33 |
1.6× |
| Spine thoracic 3 views (72072) |
$284.71 |
$932.37 |
2.3× |
| Splenoportograpy rs&i (75810) |
$1,382.74 |
$4,528.28 |
0.4× |
| Stereotactic Body Radiation Delivery (77373) |
$4,055.14 |
$13,280.03 |
2.0× |
| Superior sagittal sinus venogram (75870) |
$1,172.64 |
$3,840.23 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,182.59 |
$3,872.82 |
2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$877.09 |
$2,872.34 |
2.0× |
| Testicular Imaging With Vascular Flow (78761) |
$635.75 |
$2,081.99 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,686.26 |
$5,522.26 |
3.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$829.08 |
$2,715.11 |
5.3× |
| Thoracolumbar 2 views (72080) |
$213.18 |
$698.11 |
2.1× |
| Thyroid carcinoma metastases imaging; limited area (eg, neck and chest only) Non-Facility (78015) |
$663.62 |
$2,173.24 |
1.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,121.60 |
$3,673.08 |
1.8× |
| Thyroid imaging w/blood flow (78013) |
$593.38 |
$1,943.22 |
1.3× |
| Thyroid uptake measurement (78012) |
$318.28 |
$1,042.31 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$698.09 |
$2,286.14 |
1.5× |
| Tomogram (76100) |
$341.64 |
$1,118.82 |
2.8× |
| Treatment device complex (77334) |
$886.94 |
$2,904.61 |
2.0× |
| Treatment device intermediate (77333) |
$548.12 |
$1,794.99 |
3.5× |
| Treatment devices simple (77332) |
$387.24 |
$1,268.15 |
2.5× |
| Ultrasound elastography first target lesion (76982) |
$164.26 |
$537.91 |
1.4× |
| Ultrasound Exam Aaa Screen (76706) |
$333.56 |
$1,092.36 |
2.7× |
| Ultrasound, abdomen limited (76705) |
$401.65 |
$1,315.32 |
3.3× |
| Umbilical-artery Doppler (OB) (76820) |
$236.29 |
$773.80 |
1.9× |
| Unlisted fluoroscopic procedure (76496) |
$476.11 |
$1,559.18 |
4.7× |
| Unlisted magnetic resonance procedure (76498) |
$1,495.90 |
$4,898.87 |
14.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,526.38 |
$4,998.67 |
12.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$125.35 |
$410.50 |
11.3× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$231.96 |
$759.62 |
2.5× |
| Ureteral reflux study (78740) |
$640.25 |
$2,096.72 |
1.4× |
| Urethrocystogram voiding (74455) |
$577.45 |
$1,891.05 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$444.19 |
$1,454.65 |
1.6× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$670.01 |
$2,194.17 |
3.3× |
| Us chest (76604) |
$374.72 |
$1,227.14 |
3.1× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$509.36 |
$1,668.07 |
2.0× |
| Us elastography parenchyma (76981) |
$164.26 |
$537.91 |
1.4× |
| Us encephalogram (76506) |
$319.66 |
$1,046.83 |
2.6× |
| Us hips infant static (76886) |
$278.79 |
$912.98 |
2.8× |
| Us infant hips w manipulation (76885) |
$312.66 |
$1,023.90 |
3.1× |
| Us ob detailed single fetus (76811) |
$657.92 |
$2,154.58 |
2.4× |
| Us ob limited (76815) |
$296.20 |
$969.99 |
2.4× |
| Us ob transvaginal (76817) |
$390.59 |
$1,279.10 |
3.2× |
| Us pelvic non ob complete (76856) |
$488.97 |
$1,601.29 |
4.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$350.43 |
$1,147.59 |
2.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$461.33 |
$1,510.79 |
3.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$286.43 |
$938.01 |
2.4× |
| Us retroperitoneal complete (76770) |
$534.89 |
$1,751.68 |
4.4× |
| Us retroperitoneal limited (76775) |
$367.34 |
$1,202.97 |
3.0× |
| Us scrotum and contents (76870) |
$435.59 |
$1,426.49 |
3.6× |
| Us soft tissue head/neck (76536) |
$373.45 |
$1,222.99 |
3.1× |
| Us spinal canal and contents (76800) |
$367.75 |
$1,204.31 |
3.0× |
| Us transrectal (76872) |
$395.03 |
$1,293.66 |
3.3× |
| Us transrectal prostate volume (76873) |
$519.98 |
$1,702.84 |
4.3× |
| Us, eye b-scan (76512) |
$388.53 |
$1,272.37 |
3.2× |
| Venogram extremity bilateral (75822) |
$998.84 |
$3,271.07 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,602.86 |
$8,524.02 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$2,472.72 |
$8,097.82 |
1.4× |
| Venography Renal Bilateral (75833) |
$1,662.05 |
$5,442.97 |
0.5× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,444.57 |
$4,730.78 |
0.4× |
Venous sampling by catheter (75893)
unusually low: confirm this is the full procedure |
$2,361.20 |
$7,732.62 |
0.4× |
| Vertebral fracture assessment via dxa (77086) |
$171.36 |
$561.18 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$335.93 |
$1,100.10 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$241.95 |
$792.35 |
2.4× |
| X-ray b.e. reductn intuss (74283) |
$243.17 |
$796.33 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$569.14 |
$1,863.85 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$235.30 |
$770.55 |
1.9× |
| X-ray eye for foreign body (70030) |
$175.59 |
$575.03 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$199.73 |
$654.06 |
2.0× |
| X-ray IV pyelogram (ivp) (74400) |
$617.57 |
$2,022.45 |
3.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$176.71 |
$578.70 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$194.35 |
$636.45 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$272.31 |
$891.78 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$410.74 |
$1,345.10 |
3.4× |
| X-ray nose-rectum child f.b. (76010) |
$165.12 |
$540.74 |
1.6× |
| X-ray optic foramen (70190) |
$117.10 |
$383.47 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$265.13 |
$868.24 |
2.2× |
| X-ray retrograde pyelogram (74420) |
$699.13 |
$2,289.56 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$307.19 |
$1,006 |
2.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$248.55 |
$813.95 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$221.62 |
$725.77 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$238.60 |
$781.36 |
2.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$353.53 |
$1,157.75 |
2.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$251.03 |
$822.07 |
2.1× |
| X-Ray Small Bowel Enteroclysis (74251) |
$723.87 |
$2,370.55 |
3.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$187.21 |
$613.06 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$189.37 |
$620.15 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$199.34 |
$652.79 |
2.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$249.38 |
$816.67 |
2.1× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$313.80 |
$1,027.65 |
2.6× |
| Xr bone length studies (77073) |
$253.55 |
$830.33 |
2.1× |
| Xr c-spine 4 or 5 views (72050) |
$383.51 |
$1,255.92 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$426.62 |
$1,397.12 |
3.5× |
| Xr chest 4+ views (71048) |
$264.86 |
$867.38 |
2.2× |
| Xr myelogram posterior fossa (70010) |
$904.56 |
$2,962.29 |
2.2× |
| Xr urogram antegrade (74425) |
$425.31 |
$1,392.82 |
1.0× |