| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,891.92 |
$10,961 |
5.3× |
| Abdomen 1 View (74018) |
$426.24 |
$592 |
4.6× |
| Abdomen 2 views (74019) |
$527.04 |
$732 |
4.7× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,972.08 |
$2,739 |
4.6× |
| Angio internal mammary (75756) |
$6,820.56 |
$9,473 |
2.0× |
| Angio pulmonary bilat (75743) |
$6,798.24 |
$9,442 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$6,798.24 |
$9,442 |
2.0× |
Angiography extremity unilateral rs&i (75710)
range across 2 matching MRF lines |
$6,798.24–$6,798.96 |
$9,442–$9,443 |
varies |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,798.24 |
$9,442 |
2.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$7,077.60 |
$9,830 |
2.1× |
| Ankle 2 views (73600) |
$526.32 |
$731 |
5.6× |
| Aortography thoracic serialography rs&i (75605) |
$11,676.24 |
$16,217 |
2.0× |
| Artery X-Rays Abdomen (75726) |
$10,153.44 |
$14,102 |
1.7× |
| Artery X-Rays Pelvis (75736) |
$10,153.44 |
$14,102 |
1.7× |
| Artery X-Rays Spine (75705) |
$12,255.84 |
$17,022 |
2.1× |
| Arthrogram ankle (73615) |
$843.12 |
$1,171 |
2.3× |
| Arthrogram hip (73525) |
$771.12 |
$1,071 |
2.1× |
| Arthrogram Wrist (73115) |
$1,164.96 |
$1,618 |
3.1× |
| Basic radiation dosimetry calculation (77300) |
$862.56 |
$1,198 |
6.0× |
| Bone age studies (77072) |
$497.52 |
$691 |
4.4× |
| Bone Imaging 3 Phase (78315) |
$2,489.76 |
$3,458 |
5.8× |
| Bone Imaging Limited Area (78300) |
$1,663.20 |
$2,310 |
3.9× |
| Bone Imaging Multiple Areas (78305) |
$1,708.56 |
$2,373 |
4.0× |
| Bone Imaging Whole Body (78306) |
$2,501.28 |
$3,474 |
5.8× |
| Bone marrow imaging; whole body (78104) |
$1,180.80 |
$1,640 |
2.8× |
| Bone survey infant (77076) |
$546.48 |
$759 |
4.9× |
| Brain Image W/Flow < 4 Views (78601) |
$1,180.80 |
$1,640 |
2.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,189.52 |
$3,041 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$12,839.04 |
$17,832 |
8.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$2,529.36 |
$3,513 |
5.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,523.04 |
$6,282 |
12.1× |
| Cat Scan Follow-Up Study (76380) |
$2,108.16 |
$2,928 |
22.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,406.96 |
$3,343 |
4.1× |
| Cerebrospinal Fluid Scan (78630) |
$2,204.64 |
$3,062 |
3.8× |
| Chest 1 view (71045) |
$377.28 |
$524 |
4.0× |
| Chest 2 views (71046) |
$403.92 |
$561 |
4.3× |
| Chest 3 views (71047) |
$358.56 |
$498 |
3.8× |
| Chest 4 or more views (71048) |
$359.28 |
$499 |
3.2× |
| Clavicle complete (73000) |
$429.84 |
$597 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$380.16 |
$528 |
3.4× |
| Continuing medical physics consltj pr wk (77336) |
$980.64 |
$1,362 |
6.8× |
| Contrast Exam Abdominl Aorta (75625) |
$6,798.24 |
$9,442 |
2.0× |
| Contrast X-Ray Bladder (74430) |
$785.52 |
$1,091 |
2.1× |
| Contrast X-Ray Of Elbow (73085) |
$771.12 |
$1,071 |
2.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$843.12 |
$1,171 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,861.52 |
$8,141 |
15.7× |
| CT abdomen and pelvis without contrast (74176) |
$4,839.12 |
$6,721 |
18.9× |
| CT abdomen w contrast (74160) |
$3,390.48 |
$4,709 |
18.0× |
| CT abdomen w wo contrast (74170) |
$3,655.44 |
$5,077 |
19.4× |
| CT abdomen w/o contrast (74150) |
$2,744.64 |
$3,812 |
24.5× |
| CT Angio Abdomen and Pelvis (74174) |
$5,711.04 |
$7,932 |
15.3× |
| CT Angio Chest (71275) |
$3,619.44 |
$5,027 |
19.3× |
| CT Angio Head (70496) |
$3,368.88 |
$4,679 |
17.9× |
| CT angio hrt w/3d image (75574) |
$3,641.76 |
$5,058 |
9.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$6,305.76 |
$8,758 |
33.5× |
| CT Angio Neck (70498) |
$3,405.60 |
$4,730 |
18.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,144.32 |
$5,756 |
22.0× |
| CT cervical spine w/ contrast (72126) |
$3,231.36 |
$4,488 |
8.6× |
| CT cervical spine w/o contrast (72125) |
$2,933.28 |
$4,074 |
26.2× |
| CT cervical spine w/wo cont (72127) |
$3,444.48 |
$4,784 |
18.3× |
| CT chest w contrast (71260) |
$2,705.04 |
$3,757 |
14.4× |
| CT chest w/wo contrast (71270) |
$3,309.84 |
$4,597 |
17.6× |
| CT head/brain with contrast (70460) |
$2,561.04 |
$3,557 |
13.6× |
| CT head/brain without and with contrast (70470) |
$3,216.24 |
$4,467 |
17.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,491.20 |
$3,460 |
6.7× |
| CT iac w contrast (70481) |
$3,219.12 |
$4,471 |
17.1× |
| CT l-spine w&w/o contrast (72133) |
$3,207.60 |
$4,455 |
17.1× |
| CT lower ext w/o (73700) |
$2,381.76 |
$3,308 |
21.3× |
| CT lower extremity w/contrast material (73701) |
$2,467.44 |
$3,427 |
13.1× |
| CT lumbar spine w contrast (72132) |
$2,967.84 |
$4,122 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$2,428.56 |
$3,373 |
21.7× |
| CT maxillofacial w contrast (70487) |
$2,995.20 |
$4,160 |
15.9× |
| CT maxillofacial wo contrast (70486) |
$2,496.96 |
$3,468 |
22.3× |
| CT neck tissue combo (70492) |
$3,538.80 |
$4,915 |
18.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,066.48 |
$4,259 |
16.3× |
| CT orbits w/o contrast (70480) |
$2,903.04 |
$4,032 |
25.9× |
| CT pelvis w&w/o contrast (72194) |
$3,218.40 |
$4,470 |
17.1× |
| CT pelvis w/o contrast (72192) |
$2,508.48 |
$3,484 |
22.4× |
| CT scan of leg combo (73702) |
$2,864.16 |
$3,978 |
15.2× |
| CT scans face/jaw combo (70488) |
$3,403.44 |
$4,727 |
18.1× |
| CT soft tissue neck w contrast (70491) |
$2,937.60 |
$4,080 |
15.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,507.76 |
$3,483 |
22.4× |
| CT thoracic spine w contrast (72129) |
$2,591.28 |
$3,599 |
13.8× |
| CT thoracic spine w/o contrast (72128) |
$2,381.76 |
$3,308 |
21.3× |
| CT thoracic spine w/wo cont (72130) |
$2,764.80 |
$3,840 |
14.7× |
| CT thorax w/o contrast (71250) |
$2,408.40 |
$3,345 |
21.5× |
| CT upper ext wo (73200) |
$2,748.96 |
$3,818 |
24.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,912.40 |
$4,045 |
15.5× |
| CT upper extremity with contrast (73201) |
$2,875.68 |
$3,994 |
7.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,578.40 |
$4,970 |
19.0× |
| Cta Abdomen (74175) |
$3,845.52 |
$5,341 |
20.5× |
| CTA pelvis (72191) |
$3,322.08 |
$4,614 |
17.7× |
| Dilation ureters/urethra rs&i (74485) |
$4,425.12 |
$6,146 |
2.0× |
| Diskography lumbar (72295) |
$4,217.76 |
$5,858 |
2.0× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$582.48 |
$809 |
5.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$906.48 |
$1,259 |
8.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$354.96 |
$493 |
3.2× |
| Dxa Bone Density Axial (77080) |
$778.32 |
$1,081 |
6.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$566.64 |
$787 |
6.1× |
| Echo exam of fetal heart (76825) |
$1,665.36 |
$2,313 |
2.8× |
| Echo exam uterus (76831) |
$903.60 |
$1,255 |
3.5× |
| Echo Guide For Artery Repair (76936) |
$1,285.92 |
$1,786 |
5.6× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$882.72 |
$1,226 |
3.5× |
| Echograp Trans R Pros Study (76873) |
$272.88 |
$379 |
2.4× |
| Esophagram (74220) |
$781.92 |
$1,086 |
4.2× |
Fetal Biophys Profile W/Nst (76818)
range across 2 matching MRF lines |
$643.68–$858.96 |
$894–$1,193 |
varies |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$403.20 |
$560 |
3.6× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,996.72 |
$5,551 |
15.6× |
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines |
$583.92–$1,044 |
$811–$1,450 |
varies |
| Follow-Up Angiography (75898) |
$6,798.24 |
$9,442 |
2.0× |
| Foot 2 views (73620) |
$511.92 |
$711 |
5.5× |
| Forearm 2 views (73090) |
$458.64 |
$637 |
4.9× |
| Gastric emptying imaging study (78264) |
$2,414.16 |
$3,353 |
5.6× |
| Gastroesophageal Reflux Exam (78262) |
$2,011.68 |
$2,794 |
4.7× |
| Gated Heart Planar Single (78472) |
$3,098.88 |
$4,304 |
7.2× |
| Hand 2 views (73120) |
$468.72 |
$651 |
4.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,798.24 |
$9,442 |
2.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$6,798.24 |
$9,442 |
2.0× |
| Hepatobil Syst Image W/Drug (78227) |
$3,083.04 |
$4,282 |
5.3× |
| Hepatobiliary System Imaging (78226) |
$3,083.04 |
$4,282 |
7.2× |
| Ht Muscle Image Spect Sing (78451) |
$3,489.84 |
$4,847 |
2.5× |
| Hysterosalpingogram (74740) |
$915.84 |
$1,272 |
3.6× |
| Image fusion (77399) |
$313.20 |
$435 |
2.2× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$1,434.24 |
$1,992 |
15.4× |
| Infant hip ultrasound, limited static exam (76886) |
$1,154.88 |
$1,604 |
12.4× |
| Joint Survey Single View (77077) |
$263.52 |
$366 |
2.4× |
| K Flow/Funct Image Multiple (78709) |
$4,206.24 |
$5,842 |
7.2× |
| K Flow/Funct Image W/Drug (78708) |
$2,123.28 |
$2,949 |
3.6× |
| K Flow/Funct Image W/O Drug (78707) |
$1,206.72 |
$1,676 |
2.1× |
| Kidney Imaging Morphol (78700) |
$2,952.72 |
$4,101 |
6.9× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$2,115.36 |
$2,938 |
4.9× |
| Knee 3 Views (73562) |
$794.16 |
$1,103 |
8.5× |
| Leveen/Shunt Patency Exam (78291) |
$1,795.68 |
$2,494 |
4.2× |
| Liver & Spleen Imaging Static Only (78215) |
$1,895.76 |
$2,633 |
4.4× |
| Lung perfusion differential (78597) |
$999.36 |
$1,388 |
2.3× |
| Lymph System Imaging (78195) |
$2,434.32 |
$3,381 |
4.2× |
| Magnetic Image Jaw Joint (70336) |
$5,635.44 |
$7,827 |
22.0× |
| Mammary ductogram or galactogram multiple (77054) |
$572.40 |
$795 |
2.2× |
| Mammary ductogram or galactogram single (77053) |
$572.40 |
$795 |
2.2× |
| Meckels Divert Exam (78290) |
$2,291.04 |
$3,182 |
5.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,784.88 |
$2,479 |
4.4× |
| Mr safety determination physician/other qhp (76016) |
$190.08 |
$264 |
2.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$52.56 |
$73 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$198 |
$275 |
1.9× |
| Mr safety implt pos&/immoblj (76019) |
$128.16 |
$178 |
2.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$522 |
$725 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,388.40 |
$6,095 |
11.7× |
| MRA head w/o contrast (70544) |
$3,422.88 |
$4,754 |
13.4× |
| MRA head with contrast (70545) |
$3,684.96 |
$5,118 |
9.9× |
| MRA neck w contrast (70548) |
$3,852.72 |
$5,351 |
10.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,520.88 |
$6,279 |
12.1× |
| MRA neck w/o contrast (70547) |
$3,414.96 |
$4,743 |
13.4× |
| MRI abdomen w contrast (74182) |
$4,188.96 |
$5,818 |
11.2× |
| MRI abdomen w/o contrast (74181) |
$4,068.72 |
$5,651 |
15.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,906 |
$5,425 |
4.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$4,364.64 |
$6,062 |
11.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,872.88 |
$5,379 |
4.6× |
| MRI brain functional w/physician admnistration (70555) |
$3,304.80 |
$4,590 |
12.9× |
| MRI Breast W/O Contrast Bilateral (77047) |
$4,110.48 |
$5,709 |
16.1× |
| MRI cardiac w/o contrast (75557) |
$3,664.80 |
$5,090 |
14.3× |
| MRI cervical spine w contrast (72142) |
$5,682.96 |
$7,893 |
15.2× |
| MRI cervical spine w/o cont (72141) |
$3,988.80 |
$5,540 |
15.6× |
| MRI chest w/o contrast (71550) |
$3,564 |
$4,950 |
13.9× |
| MRI chest with contrast (71551) |
$3,816.72 |
$5,301 |
4.5× |
| MRI chest wo w contrast (71552) |
$4,013.28 |
$5,574 |
10.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,841.20 |
$5,335 |
10.3× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$4,727.52 |
$6,566 |
12.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,673.44 |
$5,102 |
14.4× |
| MRI lumbar spine w contrast (72149) |
$5,068.80 |
$7,040 |
13.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$6,441.12 |
$8,946 |
17.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,412.08 |
$4,739 |
13.3× |
| MRI orbit face neck w contrast (70542) |
$3,846.96 |
$5,343 |
10.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,531.68 |
$6,294 |
12.1× |
| MRI pelvis w contrast (72196) |
$3,837.60 |
$5,330 |
10.3× |
| MRI pelvis w/o & w contrast (72197) |
$5,349.60 |
$7,430 |
14.3× |
| MRI pelvis w/o contrast (72195) |
$3,493.44 |
$4,852 |
13.7× |
| MRI spectroscopy (76390) |
$4,472.64 |
$6,212 |
48.0× |
| MRI thoracic spine w/o contrast (72146) |
$3,399.84 |
$4,722 |
13.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$4,186.80 |
$5,815 |
11.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,843.36 |
$5,338 |
15.0× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$4,505.04 |
$6,257 |
12.1× |
| MRI, abdomen, combo (74183) |
$5,265.36 |
$7,313 |
14.1× |
| MRI, dorsal spine combo (72157) |
$5,382 |
$7,475 |
14.4× |
| MRI, dorsal spine contrast (72147) |
$4,641.12 |
$6,446 |
12.4× |
| MRI, joint upper extrem (73221) |
$3,663.36 |
$5,088 |
14.3× |
| MRI, joint upper extrem combo (73223) |
$4,364.64 |
$6,062 |
11.7× |
| MRI, lumbar spine combo (72158) |
$5,527.44 |
$7,677 |
14.8× |
| Myelogram cervical (72240) |
$1,706.40 |
$2,370 |
2.0× |
| Myelogram Lumbar (72265) |
$1,706.40 |
$2,370 |
2.0× |
| Myelography thoracic (72255) |
$1,706.40 |
$2,370 |
2.0× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,255.28 |
$7,299 |
3.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,591.44 |
$6,377 |
3.3× |
| N-invas est c ffr sw aly CTA (75580) |
$3,715.92 |
$5,161 |
4.0× |
| Neck soft tissue (70360) |
$423.36 |
$588 |
4.5× |
| Nm csf leak detection (78650) |
$3,103.92 |
$4,311 |
2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,763.04 |
$10,782 |
5.2× |
| Nuclear Rx Oral Admin (79005) |
$2,123.28 |
$2,949 |
8.5× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$412.56 |
$573 |
4.4× |
| Panoramic X-ray of jaws (70355) |
$490.32 |
$681 |
5.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,506.32 |
$3,481 |
4.3× |
| Parathyroid Planar Imaging (78070) |
$1,516.32 |
$2,106 |
3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,257.92 |
$3,136 |
5.3× |
| Pelvis 1 or 2 views (72170) |
$482.40 |
$670 |
4.3× |
| Pet Image W/Ct Lmtd (78814) |
$3,579.84 |
$4,972 |
2.3× |
| PET image w/CT, full body (78816) |
$7,983.36 |
$11,088 |
5.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$7,351.92 |
$10,211 |
4.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,798.24 |
$9,442 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,799.28 |
$2,499 |
4.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$507.60 |
$705 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,073.52 |
$1,491 |
1.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$578.88 |
$804 |
6.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$347.76 |
$483 |
3.7× |
| Radex elbow complete minimum 3 views (73080) |
$503.28 |
$699 |
5.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$663.84 |
$922 |
5.9× |
| Radex fingr minimum 2 views (73140) |
$443.52 |
$616 |
4.8× |
| Radex foot complete minimum 3 views (73630) |
$522 |
$725 |
5.6× |
| Radex Hand Minimum 3 Views (73130) |
$502.56 |
$698 |
5.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$262.08 |
$364 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$211.68 |
$294 |
2.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$510.48 |
$709 |
5.5× |
| Radex shoulder complete minimum 2 views (73030) |
$543.60 |
$755 |
5.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$303.12 |
$421 |
3.3× |
| Radex Spine 1 View Specify Level (72020) |
$565.92 |
$786 |
6.1× |
| Radex Sternum Minimum 2 Views (71120) |
$402.48 |
$559 |
4.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$361.44 |
$502 |
3.9× |
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines |
$409.68–$569 |
$569 |
varies |
| Radex upper extremity infant minimum 2 views (73092) |
$230.40 |
$320 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$502.56 |
$698 |
5.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,442.08 |
$25,614 |
2.3× |
| Radiation treatment delivery level 1 (77402) |
$672.48 |
$934 |
6.2× |
| Radiation treatment delivery level 2 (77407) |
$835.20 |
$1,160 |
2.0× |
| Radiation treatment delivery level 3 (77412) |
$1,064.16 |
$1,478 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$729.36 |
$1,013 |
6.5× |
| Radiologic exam colon double contrast study (74280) |
$1,107.36 |
$1,538 |
5.9× |
| Radiologic exam colon single contrast study (74270) |
$968.40 |
$1,345 |
5.2× |
| Radiologic exam knee complete 4/more views (73564) |
$794.16 |
$1,103 |
7.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$766.08 |
$1,064 |
6.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$829.44 |
$1,152 |
4.4× |
| Radiologic exam swallow function contrast study (74230) |
$882 |
$1,225 |
4.7× |
| Radiologic exam teeth complete full mouth (70320) |
$522 |
$725 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,102.32 |
$1,531 |
5.9× |
| Radiologic examination femur 1 view (73551) |
$190.08 |
$264 |
2.0× |
| Radiologic examination femur minimum 2 views (73552) |
$463.68 |
$644 |
5.0× |
| Radiologic examination knee 1/2 views (73560) |
$457.92 |
$636 |
4.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$599.04 |
$832 |
5.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$486 |
$675 |
5.2× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$292.32 |
$406 |
3.1× |
| Radiopharm Dacryocystography (78660) |
$2,509.92 |
$3,486 |
5.9× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) |
$686.16 |
$953 |
2.7× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$686.16 |
$953 |
2.7× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$686.16 |
$953 |
2.7× |
| Ribs bilateral 3 views (71110) |
$619.92 |
$861 |
5.5× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,128.24 |
$1,567 |
2.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$10,950.48 |
$15,209 |
25.6× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,169.44 |
$4,402 |
5.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$3,797.28 |
$5,274 |
6.5× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,169.44 |
$4,402 |
5.4× |
| Rp Therapy Intravenous Administration (79101) |
$2,003.04 |
$2,782 |
8.0× |
| Scapula (73010) |
$487.44 |
$677 |
4.4× |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 2 matching MRF lines |
$97.92–$105.12 |
$136–$146 |
varies |
| Shoulder 1 view (73020) |
$423.36 |
$588 |
4.5× |
| Shoulder Arthrography (73040) |
$1,044 |
$1,450 |
2.8× |
| Sialogram (70390) |
$969.84 |
$1,347 |
3.8× |
| Skull less than 4 views (70250) |
$580.32 |
$806 |
5.2× |
| Special dosimetry (77331) |
$668.16 |
$928 |
4.6× |
| Special Physics Consult (77370) |
$2,178.72 |
$3,026 |
15.1× |
| Special teletherapy port plan (77321) |
$832.32 |
$1,156 |
2.1× |
| Special treatment procedure (77470) |
$3,106.08 |
$4,314 |
5.2× |
| Stereotactic Body Radiation Delivery (77373) |
$5,680.80 |
$7,890 |
3.0× |
| Sternoclavicular joints (71130) |
$338.40 |
$470 |
3.6× |
| Superior sagittal sinus venogram (75870) |
$6,798.24 |
$9,442 |
2.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,193.12 |
$3,046 |
5.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,689.84 |
$2,347 |
4.2× |
| Testicular Imaging W/Flow (78761) |
$1,711.44 |
$2,377 |
4.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,457.36 |
$3,413 |
6.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,914.48 |
$2,659 |
4.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,380.24 |
$1,917 |
9.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$483.84 |
$672 |
2.6× |
| Thoracic spine 2 views (72070) |
$547.20 |
$760 |
4.9× |
| Thoracic spine 3 views (72072) |
$672.48 |
$934 |
6.0× |
| Thoracolumbar 2 views (72080) |
$198 |
$275 |
2.1× |
| Thyroid Met Imaging Body (78018) |
$3,352.32 |
$4,656 |
5.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,250.64 |
$1,737 |
2.9× |
| Tx Devices Design & Construction Complex (77334) |
$2,038.32 |
$2,831 |
5.1× |
| Tx devices design & construction intermediate (77333) |
$1,391.76 |
$1,933 |
9.7× |
| Tx devices design & construction simple (77332) |
$1,249.92 |
$1,736 |
8.7× |
| Ultrasound Breast Limited (76642) |
$919.44 |
$1,277 |
9.9× |
| Ultrasound elastography first target lesion (76982) |
$285.12 |
$396 |
2.5× |
| Ultrasound Elastography Parenchyma (76981) |
$285.12 |
$396 |
2.5× |
| Ultrasound Exam Aaa Screen (76706) |
$626.40 |
$870 |
5.6× |
| Ultrasound, abdomen limited (76705) |
$1,147.68 |
$1,594 |
10.2× |
| Umbilical-artery Doppler (OB) (76820) |
$316.80 |
$440 |
2.8× |
| Unlisted magnetic resonance procedure (76498) |
$211.68 |
$294 |
2.3× |
| Upper gi w/o kub (74240) |
$856.80 |
$1,190 |
4.6× |
| Ureteral Reflux Study (78740) |
$1,916.64 |
$2,662 |
4.5× |
| Urethrocystogram voiding (74455) |
$856.80 |
$1,190 |
3.4× |
| Urethrocystography retrograde (74450) |
$1,009.44 |
$1,402 |
3.9× |
| Us breast unilateral complete (76641) |
$1,212.48 |
$1,684 |
10.8× |
| Us chest (76604) |
$671.04 |
$932 |
6.0× |
| Us complete joint (76881) |
$1,070.64 |
$1,487 |
9.6× |
| Us exam, pelvic, limited (76857) |
$712.80 |
$990 |
6.4× |
| Us head (76506) |
$1,169.28 |
$1,624 |
10.4× |
| Us kidney transplant (76776) |
$1,267.92 |
$1,761 |
11.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$768.24 |
$1,067 |
6.9× |
| Us ob detailed single fetus (76811) |
$964.80 |
$1,340 |
3.8× |
| Us ob limited 1 or more fetuses (76815) |
$852.48 |
$1,184 |
7.6× |
| Us ob transvaginal (76817) |
$1,316.16 |
$1,828 |
11.7× |
| Us pelvic non ob complete (76856) |
$1,104.48 |
$1,534 |
9.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,145.52 |
$1,591 |
10.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$761.76 |
$1,058 |
6.8× |
| Us retroperitoneal complete (76770) |
$1,712.16 |
$2,378 |
15.3× |
| Us retroperitoneal limited (76775) |
$1,026.72 |
$1,426 |
9.2× |
| Us scrotum and contents (76870) |
$1,023.84 |
$1,422 |
9.1× |
| Us spinal canal and contents (76800) |
$1,187.28 |
$1,649 |
10.6× |
| Us thyroid (76536) |
$878.40 |
$1,220 |
7.8× |
| Us transrectal (76872) |
$1,058.40 |
$1,470 |
9.4× |
| Vein X-Ray Chest (75827) |
$3,355.20 |
$4,660 |
2.0× |
| Venogram Sinus/Jugular (75860) |
$6,798.24 |
$9,442 |
2.0× |
| Venography Adrenal Unilateral (75840) |
$6,798.24 |
$9,442 |
2.0× |
| Venography caval inferior serialography rs&i (75825) |
$6,798.24 |
$9,442 |
2.0× |
| Venography extremity bilateral rs&i (75822) |
$5,059.44 |
$7,027 |
3.0× |
| Venography extremity unilateral rs&i (75820) |
$3,710.16 |
$5,153 |
2.2× |
| Venography Renal Bilateral (75833) |
$6,798.24 |
$9,442 |
2.0× |
| Venography Renal Unilateral (75831) |
$5,911.92 |
$8,211 |
1.7× |
| Venous sampling by catheter (75893) |
$11,676.24 |
$16,217 |
2.0× |
| Wrist 2 views (73100) |
$488.16 |
$678 |
5.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$722.16 |
$1,003 |
7.7× |
| X-ray antegrade pyelogram tube (74425) |
$1,021.68 |
$1,419 |
2.7× |
| X-Ray Aorta Leg Arteries (75630) |
$6,798.24 |
$9,442 |
2.0× |
| X-Ray Bend Only L-S Spine (72120) |
$550.80 |
$765 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$488.16 |
$678 |
5.2× |
| X-Ray Exam Breast Specimen (76098) |
$1,029.60 |
$1,430 |
1.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$269.28 |
$374 |
2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$511.20 |
$710 |
4.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$649.44 |
$902 |
5.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$269.28 |
$374 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$511.20 |
$710 |
5.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$628.56 |
$873 |
5.6× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$571.68 |
$794 |
5.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$638.64 |
$887 |
5.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$832.32 |
$1,156 |
7.4× |
| X-Ray Exam L-S Spine Bending (72114) |
$936 |
$1,300 |
8.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$667.44 |
$927 |
7.2× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$995.76 |
$1,383 |
8.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$594 |
$825 |
5.3× |
| X-ray eye for foreign body (70030) |
$203.76 |
$283 |
2.2× |
| X-ray humerus (73060) |
$509.04 |
$707 |
5.5× |
| X-ray IV pyelogram (ivp) (74400) |
$1,087.20 |
$1,510 |
5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$270.72 |
$376 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$528.48 |
$734 |
5.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$666 |
$925 |
5.9× |
| X-ray nose-rectum child f.b. (76010) |
$394.56 |
$548 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$732.24 |
$1,017 |
6.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$451.44 |
$627 |
4.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$312.48 |
$434 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$555.84 |
$772 |
6.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$751.68 |
$1,044 |
8.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$706.32 |
$981 |
6.3× |
| X-Ray Stress View (77071) |
$527.04 |
$732 |
5.7× |
| X-ray thoracic spine 4 vw (72074) |
$690.48 |
$959 |
6.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$945.36 |
$1,313 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$586.80 |
$815 |
5.2× |
| X-Rays Bone Survey Complete (77075) |
$1,035.36 |
$1,438 |
9.2× |
| Xr c-spine 4 or 5 views (72050) |
$748.08 |
$1,039 |
6.7× |
| Xr facial bones less than 3 views (70140) |
$357.84 |
$497 |
3.8× |
| Xr orbits complete 4 views (70200) |
$485.28 |
$674 |
4.3× |