| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,404.24 |
$7,340.40 |
3.2× |
| Abdomen 2 views (74019) |
$245.40 |
$409 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$667.68 |
$1,112.80 |
1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,183.98 |
$1,973.30 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,817.40 |
$3,029 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,817.40 |
$3,029 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$854.34 |
$1,423.90 |
0.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,112.40 |
$6,854 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,817.40 |
$3,029 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$948.54 |
$1,580.90 |
0.3× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$862.56 |
$1,437.60 |
0.2× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,112.40 |
$6,854 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$341.58 |
$569.30 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$854.34 |
$1,423.90 |
0.3× |
| Ankle 2 views (73600) |
$156.87 |
$261.45 |
1.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$238.50 |
$397.50 |
0.7× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,817.40 |
$3,029 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,802 |
$4,670 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$1,817.40 |
$3,029 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,817.40 |
$3,029 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$1,817.40 |
$3,029 |
0.6× |
| Arthrogram elbow (73085) |
$469.92 |
$783.20 |
1.3× |
| Arthrogram hip (73525) |
$649.14 |
$1,081.90 |
1.9× |
| Arthrogram shoulder (73040) |
$415.68 |
$692.80 |
1.2× |
| Arthrogram wrist (73115) |
$563.88 |
$939.80 |
1.6× |
| Arthrography knee lt (73580) |
$376.86 |
$628.10 |
1.1× |
| Basic radiation dosimetry calculation (77300) |
$486 |
$810 |
3.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$610.92 |
$1,018.20 |
1.5× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$783.30 |
$1,305.50 |
2.0× |
| Bone &/joint imaging whole body (78306) |
$821.10 |
$1,368.50 |
2.1× |
| Bone age studies (77072) |
$249.36 |
$415.60 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$920.22 |
$1,533.70 |
2.3× |
| Bone survey complete (77075) |
$322.32 |
$537.20 |
3.1× |
| Brachytx isodose complex (77318) |
$1,174.80 |
$1,958 |
3.1× |
| Brachytx isodose intermed (77317) |
$704.28 |
$1,173.80 |
1.9× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$629.70 |
$1,049.50 |
1.7× |
| Brain image w/flow 4 + views (78606) |
$601.44 |
$1,002.40 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$447.18 |
$745.30 |
1.1× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,868 |
$4,780 |
2.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,196.40 |
$1,994 |
3.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$458.46 |
$764.10 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$261.93 |
$436.55 |
3.0× |
| Chest 1 view (71045) |
$137.28 |
$228.80 |
1.6× |
| Chest 3 views (71047) |
$152.40 |
$254 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$309.66 |
$516.10 |
1.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$591.90 |
$986.50 |
0.8× |
| Clavicle complete (73000) |
$130.98 |
$218.30 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,080.84 |
$1,801.40 |
10.3× |
| Continuing medical physics consltj pr wk (77336) |
$617.76 |
$1,029.60 |
4.6× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$196.86 |
$328.10 |
1.1× |
| Corpora cavernosography (74445) |
$680.70 |
$1,134.50 |
6.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,998.98 |
$4,998.30 |
8.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,178.24 |
$3,630.40 |
9.1× |
| CT abdomen w contrast (74160) |
$1,240.32 |
$2,067.20 |
7.1× |
| CT abdomen w wo contrast (74170) |
$1,596.78 |
$2,661.30 |
9.1× |
| CT abdomen w/o contrast (74150) |
$1,164.30 |
$1,940.50 |
11.1× |
| CT angio hrt w/3d image (75574) |
$1,500 |
$2,500 |
4.3× |
| CT angiography upper extremity lt (73206) |
$913.68 |
$1,522.80 |
5.2× |
| CT c-spine w/o contrast (72125) |
$1,226.34 |
$2,043.90 |
11.7× |
| CT cervical spine w&w/o contrast (72127) |
$1,509.48 |
$2,515.80 |
8.6× |
| CT cervical spine with contrast (72126) |
$1,245 |
$2,075 |
3.6× |
| CT chest w/wo contrast (71270) |
$1,535.58 |
$2,559.30 |
8.7× |
| CT chest with contrast (71260) |
$1,285.80 |
$2,143 |
7.3× |
| CT colonography screening (74263) |
$748.62 |
$1,247.70 |
3.1× |
| CT colonography w/dye (74262) |
$1,497.18 |
$2,495.30 |
8.5× |
| CT colonography w/o cntrst (74261) |
$748.62 |
$1,247.70 |
7.1× |
| CT head/brain with contrast (70460) |
$1,019.70 |
$1,699.50 |
5.8× |
| CT head/brain without and with contrast (70470) |
$1,206.36 |
$2,010.60 |
6.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$550.92 |
$918.20 |
1.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$75 |
$125 |
0.9× |
| CT iac w contrast (70481) |
$1,010.76 |
$1,684.60 |
5.8× |
| CT limited/localized follow up study (76380) |
$589.50 |
$982.50 |
6.8× |
| CT lower ext w/o (73700) |
$948 |
$1,580 |
9.1× |
| CT lower extremity w wo contrast (73702) |
$1,112.40 |
$1,854 |
6.3× |
| CT lower extremity with contrast (73701) |
$1,106.34 |
$1,843.90 |
6.3× |
| CT lumbar spine w & w/o contrast (72133) |
$1,297.80 |
$2,163 |
7.4× |
| CT lumbar spine w/o contrast (72131) |
$1,110.24 |
$1,850.40 |
10.6× |
| CT lumbar spine with contrast (72132) |
$1,285.14 |
$2,141.90 |
3.7× |
| CT maxillofacial w contrast (70487) |
$1,062.72 |
$1,771.20 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$1,013.70 |
$1,689.50 |
9.7× |
| CT maxillofacial w/wo contrast (70488) |
$1,152.24 |
$1,920.40 |
6.6× |
| CT neck soft tissue w contrast (70491) |
$1,082.28 |
$1,803.80 |
6.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,132.38 |
$1,887.30 |
6.4× |
| CT orbits w/o contrast (70480) |
$915.42 |
$1,525.70 |
8.7× |
| CT pelvis w & w/o contrast (72194) |
$1,402.26 |
$2,337.10 |
8.0× |
| CT pelvis w/o contrast (72192) |
$1,013.94 |
$1,689.90 |
9.7× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$156.81 |
$261.35 |
1.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,315.38 |
$2,192.30 |
7.5× |
| CT soft tissue neck w/o contrast (70490) |
$917.88 |
$1,529.80 |
8.8× |
| CT thoracic spine w/contrast (72129) |
$1,286.64 |
$2,144.40 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$1,090.50 |
$1,817.50 |
10.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,579.38 |
$2,632.30 |
9.0× |
| CT thorax w/o contrast (71250) |
$1,080.84 |
$1,801.40 |
10.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,050.60 |
$1,751 |
6.0× |
| CT upper extremity w/o contrast rt (73200) |
$946.62 |
$1,577.70 |
9.0× |
| CT upper extremity with contrast (73201) |
$1,007.88 |
$1,679.80 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,723.74 |
$2,872.90 |
9.8× |
| Cta Abdomen (74175) |
$2,044.98 |
$3,408.30 |
11.6× |
| CTA abdomen pelvis (74174) |
$3,407.76 |
$5,679.60 |
9.8× |
| CTA chest (71275) |
$1,304.04 |
$2,173.40 |
7.4× |
| Cta Head (70496) |
$1,287.60 |
$2,146 |
7.3× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,772.90 |
$4,621.50 |
7.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,173.78 |
$1,956.30 |
6.7× |
| Cta Neck (70498) |
$1,485.30 |
$2,475.50 |
8.5× |
| Cta Pelvis (72191) |
$1,362.84 |
$2,271.40 |
7.8× |
| Cystography minimum 3 views rs&i (74430) |
$256.98 |
$428.30 |
0.7× |
| Dacryocystography (70170) |
$308.04 |
$513.40 |
1.3× |
| Diskogram cervical (72285) |
$1,059.12 |
$1,765.20 |
0.5× |
| Diskography lumbar (72295) |
$1,059.12 |
$1,765.20 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$80.85 |
$134.75 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$139.09 |
$231.82 |
1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$110.52 |
$184.20 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$231.84 |
$386.40 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$80.97 |
$134.95 |
0.9× |
| Echo exam of fetal heart (76825) |
$439.63 |
$732.72 |
0.8× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$197.48 |
$329.14 |
0.8× |
| Echoencephalography real time imaging (76506) |
$319.74 |
$532.90 |
3.1× |
| Esophagus (74220) |
$270.42 |
$450.70 |
1.5× |
| Fetal biophysical profile non-stress testing (76818) |
$184.20 |
$307 |
1.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$104.16 |
$173.60 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$295.74 |
$492.90 |
1.2× |
| Foot 2 views (73620) |
$174.99 |
$291.65 |
2.0× |
| Forearm 2 views (73090) |
$140.52 |
$234.20 |
1.6× |
| Gastric mucosa imaging (78261) |
$341.64 |
$569.40 |
0.9× |
| Gated Heart Planar Single (78472) |
$746.46 |
$1,244.10 |
1.9× |
| Hand 2 views (73120) |
$231.54 |
$385.90 |
2.2× |
| Hand 3 views (73130) |
$191.85 |
$319.75 |
2.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,117.20 |
$6,862 |
5.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,579.92 |
$7,633.20 |
6.6× |
| Heart Infarct Image (78466) |
$501.60 |
$836 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$909.03 |
$1,515.05 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$851.70 |
$1,419.50 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$851.70 |
$1,419.50 |
2.1× |
| Ht muscle image spect sing (78451) |
$1,178.04 |
$1,963.40 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$162.39 |
$270.65 |
1.9× |
| Hysterosalpingogram (74740) |
$379.80 |
$633 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$3,473.40 |
$5,789 |
5.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$606.48 |
$1,010.80 |
0.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$583.02 |
$971.70 |
1.1× |
| Intracavitary radiation source applic simple (77761) |
$590.58 |
$984.30 |
1.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$322.32 |
$537.20 |
3.1× |
| Kidney imaging morphology (78700) |
$315 |
$525 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$864.24 |
$1,440.40 |
1.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$957.60 |
$1,596 |
1.8× |
| Knee 3 views (73562) |
$196.20 |
$327 |
2.3× |
| Liver & spleen imaging static only (78215) |
$830.82 |
$1,384.70 |
2.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$498.54 |
$830.90 |
1.2× |
| Liver imaging static only (78201) |
$734.10 |
$1,223.50 |
1.3× |
| Liver imaging w/vascular flow (78202) |
$486.78 |
$811.30 |
0.9× |
| Lung perf&ventilat diferentl (78598) |
$1,052.04 |
$1,753.40 |
1.9× |
| Lung perfusion differential (78597) |
$1,052.04 |
$1,753.40 |
2.6× |
| Lung Ventilation Imaging (78579) |
$297.84 |
$496.40 |
0.7× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,640.40 |
$2,734 |
0.5× |
| Lymphoscintigraphy (78195) |
$771 |
$1,285 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$248.70 |
$414.50 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$281.46 |
$469.10 |
1.2× |
| Meckels Diverticulum (78290) |
$405.84 |
$676.40 |
1.0× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$180.62 |
$301.03 |
0.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$6,642.12 |
$11,070.20 |
17.7× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$89.10 |
$148.50 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.75 |
$61.25 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$154.21 |
$257.01 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$362.58 |
$604.30 |
1.5× |
| MRA head w & w/o contrast (70546) |
$1,552.92 |
$2,588.20 |
4.4× |
| MRA head w/o contrast (70544) |
$1,243.44 |
$2,072.40 |
5.2× |
| MRA head with contrast (70545) |
$1,441.02 |
$2,401.70 |
4.1× |
| MRA neck w contrast (70548) |
$1,545 |
$2,575 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,617.36 |
$2,695.60 |
4.6× |
| MRA neck w/o contrast (70547) |
$1,521.90 |
$2,536.50 |
6.4× |
| MRI abdomen w contrast (74182) |
$2,163 |
$3,605 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,420.22 |
$4,033.70 |
6.9× |
| MRI abdomen w/o contrast (74181) |
$1,535.28 |
$2,558.80 |
6.4× |
| MRI any jnt lwr ext with con lt (73722) |
$1,516.44 |
$2,527.40 |
1.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,559.34 |
$2,598.90 |
2.0× |
| MRI bone marrow blood supply (77084) |
$795.66 |
$1,326.10 |
3.3× |
| MRI breast w/o contrast bilateral (77047) |
$1,088.82 |
$1,814.70 |
4.6× |
| MRI breast w/o contrast unilat (77046) |
$674.10 |
$1,123.50 |
2.8× |
| MRI c-spine with contrast (72142) |
$2,200.26 |
$3,667.10 |
6.3× |
| MRI cardiac w/o cont stress (75559) |
$609.12 |
$1,015.20 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$754.32 |
$1,257.20 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$1,752.48 |
$2,920.80 |
7.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,092.26 |
$3,487.10 |
6.0× |
| MRI chest w/o contrast (71550) |
$1,514.52 |
$2,524.20 |
6.3× |
| MRI chest with contrast (71551) |
$1,734.78 |
$2,891.30 |
2.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,421.40 |
$2,369 |
4.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,483.20 |
$2,472 |
4.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,419 |
$2,365 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,702.98 |
$2,838.30 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,273.76 |
$3,789.60 |
6.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,082.60 |
$3,471 |
6.0× |
| MRI pelvis w contrast (72196) |
$1,737.78 |
$2,896.30 |
5.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,374.02 |
$3,956.70 |
6.8× |
| MRI pelvis w/o contrast (72195) |
$1,655.58 |
$2,759.30 |
6.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,968.42 |
$3,280.70 |
5.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,809.96 |
$3,016.60 |
5.2× |
| MRI spectroscopy (76390) |
$920.22 |
$1,533.70 |
10.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,423.28 |
$4,038.80 |
6.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,348.40 |
$3,914 |
6.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,529 |
$4,215 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,378.82 |
$3,964.70 |
6.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,451.54 |
$4,085.90 |
7.0× |
| MRI thoracic spine w/o contrast (72146) |
$1,721.88 |
$2,869.80 |
7.2× |
| MRI tmj (70336) |
$1,497.12 |
$2,495.20 |
6.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,483.20 |
$2,472 |
6.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,620.84 |
$2,701.40 |
4.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,330.74 |
$2,217.90 |
5.6× |
| Myocardial Spect Multiple Studies (78452) |
$2,043 |
$3,405 |
1.6× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,068.80 |
$3,448 |
1.4× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,068.80 |
$3,448 |
1.4× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,225.60 |
$5,376 |
1.5× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,097.20 |
$5,162 |
1.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,495.83 |
$2,493.05 |
1.7× |
| Neck soft tissue (70360) |
$119.46 |
$199.10 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$530.40 |
$884 |
1.3× |
| Nm cisternogram (78630) |
$793.50 |
$1,322.50 |
1.5× |
| Nm csf leak detection (78650) |
$532.92 |
$888.20 |
0.4× |
| Nm gastric emptying study (78264) |
$763.98 |
$1,273.30 |
1.9× |
| Nm gastroesophageal reflux study (78262) |
$341.64 |
$569.40 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$695.82 |
$1,159.70 |
1.7× |
| Nm red cell sequestration (78140) |
$565.68 |
$942.80 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,099.60 |
$10,166 |
4.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$844.08 |
$1,406.80 |
0.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$939.87 |
$1,566.45 |
0.7× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$664.14 |
$1,106.90 |
0.5× |
| Nuclear medicine study of kidney and blood flow (78701) |
$339 |
$565 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$552 |
$920 |
2.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$51.60 |
$86 |
0.5× |
| Orthopantogram (70355) |
$172.20 |
$287 |
2.0× |
| Osseous survey infant (77076) |
$187.14 |
$311.90 |
1.8× |
| Osseous survey limited (77074) |
$280.32 |
$467.20 |
2.7× |
| Parathyrd planar w/spect&CT (78072) |
$1,152 |
$1,920 |
2.1× |
| Parathyrd planar w/wo subtrj (78071) |
$1,152 |
$1,920 |
2.9× |
| Parathyroid imaging (78070) |
$508.68 |
$847.80 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$156.18 |
$260.30 |
1.5× |
| Perineogram (74775) |
$256.98 |
$428.30 |
1.1× |
| Peritoneogram rs&i (74190) |
$721.41 |
$1,202.35 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$3,480 |
$5,800 |
2.4× |
| PET imaging CT for attenuation limited area (78814) |
$3,480 |
$5,800 |
2.4× |
| PET imaging for CT attenuation whole body (78816) |
$3,480 |
$5,800 |
2.4× |
| PET imaging limited area chest head/neck (78811) |
$1,060.77 |
$1,767.95 |
0.8× |
| PET whole body (78813) |
$942.57 |
$1,570.95 |
0.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,794.60 |
$2,991 |
5.1× |
| Pr red cell survival study (78130) |
$730.20 |
$1,217 |
1.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,817.40 |
$3,029 |
0.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,932.36 |
$3,220.60 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$596.16 |
$993.60 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,156.14 |
$1,926.90 |
2.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$330 |
$550 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$85.80 |
$143 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$142.20 |
$237 |
1.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$215.22 |
$358.70 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$56.19 |
$93.65 |
0.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$270.60 |
$451 |
2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,280 |
$23,800 |
1.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$845.28 |
$1,408.80 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$346.80 |
$578 |
3.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$579.48 |
$965.80 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$170.34 |
$283.90 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$145.80 |
$243 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$137.88 |
$229.80 |
1.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$127.50 |
$212.50 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$424.20 |
$707 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$261 |
$435 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$410.16 |
$683.60 |
2.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$385.80 |
$643 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$147 |
$245 |
1.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$90.60 |
$151 |
1.0× |
| Radiological examination surgical specimen (76098) |
$168 |
$280 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$948.54 |
$1,580.90 |
0.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,817.40 |
$3,029 |
0.6× |
| Ribs bilateral 3 views (71110) |
$303.78 |
$506.30 |
2.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$367.98 |
$613.30 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$988.02 |
$1,646.70 |
1.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,823.40 |
$3,039 |
3.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,908 |
$3,180 |
1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$810 |
$1,350 |
3.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$356.10 |
$593.50 |
1.5× |
| Rp Therapy Intravenous Administration (79101) |
$720 |
$1,200 |
3.1× |
| Sacroiliac Joints < 3 Views (72200) |
$84.36 |
$140.60 |
0.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$763.98 |
$1,273.30 |
3.2× |
| Salivary gland function study (78232) |
$524.16 |
$873.60 |
1.3× |
| Scanogram (77073) |
$102.78 |
$171.30 |
1.0× |
| Scapula complete (73010) |
$174.12 |
$290.20 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$42 |
$70 |
1.8× |
| Sella turcica (70240) |
$122.04 |
$203.40 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$346.98 |
$578.30 |
3.3× |
| Sialogram (70390) |
$367.98 |
$613.30 |
1.5× |
| Simulation intermediate (77285) |
$1,119.72 |
$1,866.20 |
3.0× |
| Small bowel series (74250) |
$285.60 |
$476 |
1.6× |
| Spec medical radj physics consltj (77370) |
$918 |
$1,530 |
6.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$748.20 |
$1,247 |
2.0× |
| Special dosimetry (77331) |
$336 |
$560 |
2.5× |
| Special treatment procedure (77470) |
$2,044.08 |
$3,406.80 |
3.7× |
| Speech evaluation complex (70371) |
$146.46 |
$244.10 |
0.6× |
| Spine thoracic 3 views (72072) |
$236.28 |
$393.80 |
2.3× |
| Spleen imaging only (78185) |
$565.68 |
$942.80 |
1.4× |
| Splenoportograpy rs&i (75810) |
$854.34 |
$1,423.90 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$8,161.80 |
$13,603 |
4.6× |
| Superior sagittal sinus venogram (75870) |
$854.34 |
$1,423.90 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,243.60 |
$5,406 |
8.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,567.68 |
$2,612.80 |
4.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$649.14 |
$1,081.90 |
2.7× |
| Testicular Imaging With Vascular Flow (78761) |
$451.68 |
$752.80 |
1.1× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,680.60 |
$2,801 |
4.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$769.20 |
$1,282 |
5.7× |
| Thoracolumbar 2 views (72080) |
$193.80 |
$323 |
2.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$799.26 |
$1,332.10 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$449.94 |
$749.90 |
1.1× |
| Thyroid uptake measurement (78012) |
$258 |
$430 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$679.86 |
$1,133.10 |
1.7× |
| Tmj unilateral (70328) |
$157.80 |
$263 |
1.8× |
| Tomogram (76100) |
$219.66 |
$366.10 |
2.1× |
| Treatment device intermediate (77333) |
$480.60 |
$801 |
3.6× |
| Treatment devices simple (77332) |
$511.92 |
$853.20 |
3.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,114.20 |
$1,857 |
2.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$432.48 |
$720.80 |
1.1× |
| Tx devices design & construction complex (77334) |
$1,283.76 |
$2,139.60 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$439.14 |
$731.90 |
4.2× |
| Umbilical-artery Doppler (OB) (76820) |
$105.12 |
$175.20 |
1.0× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$145.92 |
$243.20 |
1.7× |
| Unlisted magnetic resonance procedure (76498) |
$954 |
$1,590 |
10.9× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$707.70 |
$1,179.50 |
6.9× |
| Unlisted Ultrasound Procedure (76999) |
$151.68 |
$252.80 |
1.7× |
| Upper Extremity Infant (73092) |
$137.88 |
$229.80 |
1.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$339 |
$565 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$348.60 |
$581 |
1.5× |
| Urethrocystography voiding (74455) |
$420.42 |
$700.70 |
1.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$374.22 |
$623.70 |
2.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$554.28 |
$923.80 |
3.2× |
| Us abdl aorta screen aaa (76706) |
$145.62 |
$242.70 |
1.4× |
| Us breast unilateral complete (76641) |
$489 |
$815 |
4.7× |
| Us breast unilateral limited (76642) |
$373.80 |
$623 |
4.3× |
| Us chest (76604) |
$415.74 |
$692.90 |
4.0× |
| Us compl joint r-t w/image documentation (76881) |
$370.32 |
$617.20 |
3.5× |
| Us elastography parenchyma (76981) |
$192 |
$320 |
1.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$115.71 |
$192.85 |
1.1× |
| Us guided compression repair (76936) |
$257.16 |
$428.60 |
1.2× |
| Us infant hips dynamic (76885) |
$148.59 |
$247.65 |
1.7× |
| Us infant hips limited static (76886) |
$200.28 |
$333.80 |
2.3× |
| Us kidney transplant (76776) |
$272.22 |
$453.70 |
2.6× |
| Us ob detailed single fetus (76811) |
$189.36 |
$315.60 |
0.8× |
| Us ob transvaginal (76817) |
$111.15 |
$185.25 |
1.1× |
| Us pelvic non ob complete (76856) |
$588.96 |
$981.60 |
5.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$318.72 |
$531.20 |
3.0× |
| Us pregnancy ltd (76815) |
$259.74 |
$432.90 |
2.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$466.80 |
$778 |
4.5× |
| Us retroperitoneal complete (76770) |
$563.04 |
$938.40 |
5.4× |
| Us retroperitoneal limited (76775) |
$463.20 |
$772 |
4.4× |
| Us scrotum and contents (76870) |
$549.72 |
$916.20 |
5.2× |
| Us soft tissue head/neck (76536) |
$403.74 |
$672.90 |
3.9× |
| Us spinal canal and contents (76800) |
$195.90 |
$326.50 |
1.9× |
| Us transrectal (76872) |
$293.28 |
$488.80 |
2.8× |
| Us transrectal prostate volume (76873) |
$566.82 |
$944.70 |
5.4× |
| Us xtr non-vasc lmtd (76882) |
$272.82 |
$454.70 |
2.6× |
| Vasogram (74440) |
$256.98 |
$428.30 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,239.09 |
$2,065.15 |
0.8× |
| Venogram orbital (75880) |
$791.37 |
$1,318.95 |
1.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,447.08 |
$2,411.80 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,519.44 |
$2,532.40 |
1.0× |
| Venography epidural rs&i (75872) |
$854.34 |
$1,423.90 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,301.10 |
$2,168.50 |
0.8× |
| Venography Renal Bilateral (75833) |
$1,162.11 |
$1,936.85 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$948.60 |
$1,581 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,301.10 |
$2,168.50 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$993.12 |
$1,655.20 |
0.2× |
| Wrist 2 views (73100) |
$124.68 |
$207.80 |
1.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$273.72 |
$456.20 |
2.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$117.60 |
$196 |
1.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$224.10 |
$373.50 |
2.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$566.76 |
$944.60 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$148.29 |
$247.15 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$213.30 |
$355.50 |
2.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$270.60 |
$451 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$174.81 |
$291.35 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$189.75 |
$316.25 |
2.2× |
| X-ray exam hip uni 4/> views (73503) |
$324 |
$540 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$260.55 |
$434.25 |
2.5× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$252 |
$420 |
2.4× |
| X-ray exam of femur 1 (73551) |
$119.46 |
$199.10 |
1.4× |
| X-ray eye for foreign body (70030) |
$29.37 |
$48.95 |
0.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$195 |
$325 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$119.46 |
$199.10 |
1.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$206.70 |
$344.50 |
2.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,380 |
$2,300 |
0.7× |
| X-ray head for orthodontia (70350) |
$24.06 |
$40.11 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$130.98 |
$218.30 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$195.84 |
$326.40 |
2.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$259.68 |
$432.80 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$209.46 |
$349.10 |
2.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$137.88 |
$229.80 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$200.04 |
$333.40 |
1.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$432.72 |
$721.20 |
4.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$91.56 |
$152.60 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$117.60 |
$196 |
1.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$111.66 |
$186.10 |
1.3× |
| X-ray of voice box or throat (70370) |
$124.14 |
$206.90 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$228.60 |
$381 |
2.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$146.76 |
$244.60 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$298.68 |
$497.80 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$594 |
$990 |
1.7× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$210 |
$350 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$242.46 |
$404.10 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$309.24 |
$515.40 |
3.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$169.56 |
$282.60 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$130.98 |
$218.30 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$240.30 |
$400.50 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$224.04 |
$373.40 |
2.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$143.34 |
$238.90 |
1.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$245.10 |
$408.50 |
2.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$199.86 |
$333.10 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$199.20 |
$332 |
2.3× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$187.14 |
$311.90 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$137.88 |
$229.80 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$193.38 |
$322.30 |
1.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$236.58 |
$394.30 |
2.3× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$142.08 |
$236.80 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$211.59 |
$352.65 |
2.4× |
| Xr arthrogram ankle (73615) |
$498.78 |
$831.30 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$337.44 |
$562.40 |
3.2× |
| Xr chest 4+ views (71048) |
$81.18 |
$135.30 |
0.8× |
| Xr Cholecystography Oral Contrast (74290) |
$53.19 |
$88.65 |
0.3× |
| Xr finger(s) 2+ views (73140) |
$147.48 |
$245.80 |
1.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$41.31 |
$68.85 |
0.4× |
| Xr shoulder 1 view (73020) |
$83.46 |
$139.10 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$403.92 |
$673.20 |
3.9× |
| Xr tibia/fibula 2 views (73590) |
$224.37 |
$373.95 |
2.6× |
| Xr tmj bilateral (70330) |
$301.44 |
$502.40 |
3.5× |
| Xray knee 1 or 2 views rt (73560) |
$166.14 |
$276.90 |
1.9× |