| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,356.50 |
$11,142 |
5.8× |
| Abdomen 2 views (74019) |
$987.75 |
$1,317 |
9.0× |
| Acute gi blood loss imaging (78278) |
$1,215 |
$1,620 |
2.9× |
| Angiography extremity bilateral rs&i (75716) |
$5,913 |
$7,884 |
1.8× |
| Angiography extremity unilateral rs&i (75710) |
$7,349.62 |
$9,799.50 |
2.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,678.25 |
$11,571 |
1.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,556 |
$11,408 |
2.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,214.50 |
$8,286 |
1.9× |
| Angiography Spinal Selective Rs&I (75705) |
$10,537.50 |
$14,050 |
1.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,548.25 |
$12,731 |
1.6× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,425.25 |
$4,567 |
1.0× |
| Ankle 2 views (73600) |
$783.38 |
$1,044.50 |
8.6× |
| Aortogram thoracic (75605) |
$8,060.25 |
$10,747 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$5,468.25 |
$7,291 |
1.7× |
| Arthrogram ankle (73615) |
$1,232.25 |
$1,643 |
3.4× |
| Arthrogram elbow (73085) |
$1,818 |
$2,424 |
5.0× |
| Arthrogram hip (73525) |
$1,911 |
$2,548 |
5.2× |
| Arthrogram knee (73580) |
$3,159.75 |
$4,213 |
8.7× |
| Arthrogram shoulder (73040) |
$1,686 |
$2,248 |
4.6× |
| Basic dosimetry (77300) |
$1,803.75 |
$2,405 |
12.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,919.75 |
$3,893 |
7.0× |
| Bone &/joint imaging whole body (78306) |
$2,472.75 |
$3,297 |
5.9× |
| Bone age studies (77072) |
$564 |
$752 |
5.2× |
| Bone Imaging 3 Phase (78315) |
$3,270.75 |
$4,361 |
7.8× |
| Bone survey complete (77075) |
$2,518.12 |
$3,357.50 |
23.1× |
| Bone survey infant (77076) |
$2,818.12 |
$3,757.50 |
25.8× |
| Bowel imaging (78290) |
$1,072.50 |
$1,430 |
2.6× |
| Brachytx isodose complex (77318) |
$3,960.75 |
$5,281 |
10.1× |
| Brachytx isodose intermed (77317) |
$2,671.50 |
$3,562 |
6.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$2,286 |
$3,048 |
5.8× |
| Brain Imaging Vascular Flow Only (78610) |
$1,244.25 |
$1,659 |
2.2× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$2,745 |
$3,660 |
6.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$7,773 |
$10,364 |
21.3× |
| Cervical spine 2 or 3 views (72040) |
$852 |
$1,136 |
9.4× |
| Chest 1 view (71045) |
$413.25 |
$551 |
4.5× |
| Chest xray 3 views (71047) |
$736.50 |
$982 |
8.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,344.75 |
$1,793 |
7.3× |
| Clavicle complete (73000) |
$795 |
$1,060 |
8.7× |
| Continuing medical physics consltj pr wk (77336) |
$1,427.25 |
$1,903 |
10.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$11,114.25 |
$14,819 |
30.5× |
| CT abdomen and pelvis without contrast (74176) |
$10,377.75 |
$13,837 |
41.6× |
| CT abdomen w contrast (74160) |
$5,242.50 |
$6,990 |
28.6× |
| CT abdomen w wo contrast (74170) |
$6,689.25 |
$8,919 |
36.5× |
| CT abdomen w/o contrast (74150) |
$5,263.12 |
$7,017.50 |
48.2× |
| CT angio hrt w/3d image (75574) |
$2,195.25 |
$2,927 |
6.0× |
| CT angio lwr extr w/o&w/dye (73706) |
$6,792.75 |
$9,057 |
37.1× |
| CT angiography upper extremity lt (73206) |
$8,266.50 |
$11,022 |
45.1× |
| CT c-spine w/contrast (72126) |
$6,601.50 |
$8,802 |
18.1× |
| CT c-spine w/o contrast (72125) |
$6,202.50 |
$8,270 |
56.8× |
| CT cervical spine w&w/o contrast (72127) |
$8,181 |
$10,908 |
44.7× |
| CT chest w contrast (71260) |
$7,484.25 |
$9,979 |
40.9× |
| CT chest w/wo contrast (71270) |
$8,773.50 |
$11,698 |
47.9× |
| CT head/brain with contrast (70460) |
$5,621.25 |
$7,495 |
30.7× |
| CT head/brain without and with contrast (70470) |
$5,778.38 |
$7,704.50 |
31.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,897.50 |
$2,530 |
5.2× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$634.50 |
$846 |
7.0× |
| CT hrt w/3d image congen (75573) |
$2,389.50 |
$3,186 |
6.6× |
| CT iac w contrast (70481) |
$7,265.25 |
$9,687 |
39.7× |
| CT limited/localized follow up study (76380) |
$873.75 |
$1,165 |
9.6× |
| CT lower ext w/o (73700) |
$4,581 |
$6,108 |
42.0× |
| CT lower extremity w wo contrast (73702) |
$5,757 |
$7,676 |
31.4× |
| CT lower extremity w/contrast material (73701) |
$5,374.88 |
$7,166.50 |
29.3× |
| CT lumbar spine w & w/o contrast (72133) |
$6,522.75 |
$8,697 |
35.6× |
| CT lumbar spine w/contrast (72132) |
$5,899.88 |
$7,866.50 |
16.2× |
| CT lumbar spine w/o contrast (72131) |
$5,355.38 |
$7,140.50 |
49.1× |
| CT maxillofacial w contrast (70487) |
$4,726.12 |
$6,301.50 |
25.8× |
| CT maxillofacial w/wo contrast (70488) |
$5,769.75 |
$7,693 |
31.5× |
| CT maxillofacial wo contrast (70486) |
$4,642.12 |
$6,189.50 |
42.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$9,222.38 |
$12,296.50 |
50.3× |
| CT orbits w/o contrast (70480) |
$7,332.38 |
$9,776.50 |
67.2× |
| CT pelvis w/o contrast (72192) |
$4,712.62 |
$6,283.50 |
43.2× |
| CT pelvis w/wo contrast (72194) |
$5,850.75 |
$7,801 |
31.9× |
| CT scan of arm combo (73202) |
$7,944 |
$10,592 |
43.4× |
| CT soft tissue neck w contrast (70491) |
$5,168.25 |
$6,891 |
28.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$5,865 |
$7,820 |
32.0× |
| CT soft tissue neck w/o contrast (70490) |
$5,400.38 |
$7,200.50 |
49.5× |
| CT thoracic spine w/contrast (72129) |
$7,371 |
$9,828 |
40.2× |
| CT thoracic spine w/o contrast (72128) |
$6,886.50 |
$9,182 |
63.1× |
| CT thoracic spine w/wo contrast (72130) |
$7,902 |
$10,536 |
43.1× |
| CT thorax w/o contrast (71250) |
$6,088.88 |
$8,118.50 |
55.8× |
| CT upper ext wo (73200) |
$5,195.25 |
$6,927 |
47.6× |
| CT upper extremity with contrast (73201) |
$6,594.38 |
$8,792.50 |
18.1× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$5,734.50 |
$7,646 |
31.3× |
| Cta Abdomen (74175) |
$7,362.75 |
$9,817 |
40.2× |
| CTA abdomen pelvis (74174) |
$7,929 |
$10,572 |
21.8× |
| CTA chest (71275) |
$9,662.25 |
$12,883 |
52.8× |
| Cta Head (70496) |
$7,542 |
$10,056 |
41.2× |
| Cta Neck (70498) |
$5,389.50 |
$7,186 |
29.4× |
| Cta Pelvis (72191) |
$6,676.88 |
$8,902.50 |
36.5× |
| Cystography minimum 3 views rs&i (74430) |
$841.12 |
$1,121.50 |
2.3× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,188 |
$5,584 |
1.9× |
| Diskography lumbar (72295) |
$3,191.25 |
$4,255 |
1.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,069.50 |
$1,426 |
9.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,026 |
$1,368 |
9.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$1,468.50 |
$1,958 |
5.9× |
| Esophagus (74220) |
$1,183.50 |
$1,578 |
6.5× |
| Facial bones min 3 views (70150) |
$946.88 |
$1,262.50 |
8.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,716 |
$2,288 |
15.7× |
| Fetal Echo (76825) |
$3,345.75 |
$4,461 |
5.9× |
| Fluoroscopy up to 1 hr (76000) |
$1,759.50 |
$2,346 |
7.1× |
| Foot 2 views (73620) |
$829.50 |
$1,106 |
9.1× |
| Forearm 2 views (73090) |
$971.62 |
$1,295.50 |
10.7× |
| Functional MRI brain by tech (70554) |
$2,761.50 |
$3,682 |
11.1× |
| Hand 2 views (73120) |
$540 |
$720 |
4.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$10,827 |
$14,436 |
14.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$10,827 |
$14,436 |
14.9× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$10,827 |
$14,436 |
14.9× |
| Heart Infarct Image (78466) |
$1,175.25 |
$1,567 |
2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,654.50 |
$6,206 |
1.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$3,273.75 |
$4,365 |
5.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$3,649.50 |
$4,866 |
8.7× |
| Hysterosalpingogram (74740) |
$2,330.25 |
$3,107 |
9.4× |
| Interstitial radiation source applic complex (77778) |
$6,954 |
$9,272 |
9.6× |
| Kidney imaging morphology (78700) |
$2,464.50 |
$3,286 |
5.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,832.50 |
$5,110 |
6.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$4,147.50 |
$5,530 |
7.3× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$5,136 |
$6,848 |
9.1× |
| Knee 3 views (73562) |
$844.12 |
$1,125.50 |
9.3× |
| Liver & spleen imaging static only (78215) |
$3,321 |
$4,428 |
8.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,800 |
$2,400 |
4.3× |
| Liver imaging static only (78201) |
$3,785.25 |
$5,047 |
6.7× |
| Liver imaging w/vascular flow (78202) |
$4,419.75 |
$5,893 |
7.8× |
| Lung perfusion differential (78597) |
$2,127 |
$2,836 |
5.1× |
| Lymphoscintigraphy (78195) |
$2,957.25 |
$3,943 |
5.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$7,581 |
$10,108 |
9.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$7,179 |
$9,572 |
19.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$7,548.75 |
$10,065 |
20.7× |
| Mammary ductogram or galactogram multiple (77054) |
$1,453.50 |
$1,938 |
5.8× |
| Mammary ductogram or galactogram single (77053) |
$1,398 |
$1,864 |
5.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,577 |
$3,436 |
6.6× |
| Mr safety determination physician/other qhp (76016) |
$360 |
$480 |
4.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$99.75 |
$133 |
3.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$375 |
$500 |
3.8× |
| Mr safety implt pos&/immoblj (76019) |
$243 |
$324 |
3.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$987.75 |
$1,317 |
4.0× |
| MRA head w & w/o contrast (70546) |
$8,385 |
$11,180 |
23.0× |
| MRA head w/o contrast (70544) |
$7,563.75 |
$10,085 |
30.4× |
| MRA head with contrast (70545) |
$7,752 |
$10,336 |
21.3× |
| MRA neck w contrast (70548) |
$7,245.75 |
$9,661 |
19.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$8,467.50 |
$11,290 |
23.2× |
| MRA neck w/o contrast (70547) |
$5,848.50 |
$7,798 |
23.5× |
| MRI abdomen w contrast (74182) |
$5,499 |
$7,332 |
15.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,576.75 |
$4,769 |
9.8× |
| MRI abdomen w/o contrast (74181) |
$3,339 |
$4,452 |
13.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$7,071 |
$9,428 |
8.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$7,518.75 |
$10,025 |
20.6× |
| MRI breast w/o contrast bilateral (77047) |
$6,403.50 |
$8,538 |
25.7× |
| MRI breast wo contrast unilateral (77046) |
$5,544 |
$7,392 |
22.2× |
| MRI c-spine with contrast (72142) |
$8,984.25 |
$11,979 |
24.7× |
| MRI cardiac w/o contrast (75557) |
$4,821 |
$6,428 |
19.3× |
| MRI cervical spine w/o contrast (72141) |
$10,710 |
$14,280 |
43.0× |
| MRI chest w/o & w/contrast material (71552) |
$7,263 |
$9,684 |
19.9× |
| MRI chest w/o contrast (71550) |
$6,273 |
$8,364 |
25.2× |
| MRI chest with contrast (71551) |
$8,181 |
$10,908 |
10.0× |
| MRI fetal sngl/1st gestation (74712) |
$7,098 |
$9,464 |
28.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,867 |
$5,156 |
10.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$8,952.75 |
$11,937 |
24.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$5,035.50 |
$6,714 |
20.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$6,613.50 |
$8,818 |
26.5× |
| MRI orbit face neck w contrast (70542) |
$8,262 |
$11,016 |
22.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$8,082.75 |
$10,777 |
22.2× |
| MRI pelvis w/contrast (72196) |
$9,250.50 |
$12,334 |
25.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$6,973.50 |
$9,298 |
19.1× |
| MRI pelvis w/o contrast (72195) |
$8,892 |
$11,856 |
35.7× |
| MRI spectroscopy (76390) |
$393.75 |
$525 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$9,567.75 |
$12,757 |
26.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$7,713 |
$10,284 |
21.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$7,260 |
$9,680 |
19.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$8,993.25 |
$11,991 |
24.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,260 |
$9,680 |
19.9× |
| MRI temporomandibular joint (70336) |
$6,505.50 |
$8,674 |
26.1× |
| MRI thoracic spine w/o contrast (72146) |
$7,810.50 |
$10,414 |
31.3× |
| MRI up ext w/o contrast (73218) |
$6,586.50 |
$8,782 |
26.4× |
| MRI upper ext joint w/o contrast (73221) |
$7,678.50 |
$10,238 |
30.8× |
| MRI, joint upper extrem combo (73223) |
$8,542.50 |
$11,390 |
23.4× |
| Myelogram Cervical (72240) |
$3,258 |
$4,344 |
4.0× |
| Myelogram Lumbar (72265) |
$3,358.50 |
$4,478 |
4.1× |
| Myelogram thoracic (72255) |
$1,758.75 |
$2,345 |
2.1× |
| Myelography 2 or more regions (72270) |
$5,206.50 |
$6,942 |
6.4× |
| Myocardial Spect Multiple Studies (78452) |
$4,728.75 |
$6,305 |
3.5× |
| Neck soft tissue (70360) |
$849.75 |
$1,133 |
9.4× |
| Nm bone marrow multi (78103) |
$3,667.50 |
$4,890 |
8.8× |
| Nm cisternogram (78630) |
$1,356 |
$1,808 |
2.4× |
| Nm gastric emptying study (78264) |
$3,171 |
$4,228 |
7.6× |
| Nm gastroesophageal reflux study (78262) |
$2,007 |
$2,676 |
4.8× |
| Nm peritoneal-venous shunt patency (78291) |
$1,623 |
$2,164 |
3.9× |
| Nonvascular shunt X-ray (75809) |
$1,345.50 |
$1,794 |
12.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,891.75 |
$5,189 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$2,468.25 |
$3,291 |
10.1× |
| Orthopantogram (70355) |
$755.25 |
$1,007 |
8.3× |
| Osseous survey limited (77074) |
$401.25 |
$535 |
3.7× |
| Parathyroid Planar Imaging (78070) |
$3,535.50 |
$4,714 |
8.5× |
| Pelvis 1 or 2 views (72170) |
$999.38 |
$1,332.50 |
9.2× |
| Perineogram (74775) |
$2,211 |
$2,948 |
8.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,904.25 |
$6,539 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,423.25 |
$3,231 |
5.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$4,388.25 |
$5,851 |
7.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$978 |
$1,304 |
1.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$960.38 |
$1,280.50 |
10.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$668.25 |
$891 |
7.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,038.75 |
$1,385 |
11.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$457.12 |
$609.50 |
5.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$1,136.62 |
$1,515.50 |
10.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,442.25 |
$1,923 |
13.2× |
| Radex fingr minimum 2 views (73140) |
$750 |
$1,000 |
8.3× |
| Radex Foot Compl Minimum 3 Views (73630) |
$594.38 |
$792.50 |
6.5× |
| Radex Hand Minimum 3 Views (73130) |
$961.50 |
$1,282 |
10.6× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$956.62 |
$1,275.50 |
10.5× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$743.62 |
$991.50 |
6.8× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,378.50 |
$1,838 |
12.6× |
| Radex Humerus Minimum 2 Views (73060) |
$793.88 |
$1,058.50 |
8.7× |
| Radex Kne 1/2 Views (73560) |
$698.62 |
$931.50 |
7.7× |
| Radex Kne Compl 4/More Views (73564) |
$860.25 |
$1,147 |
7.9× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$930 |
$1,240 |
8.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$707.62 |
$943.50 |
7.8× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$1,477.50 |
$1,970 |
13.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$721.88 |
$962.50 |
7.9× |
| Radex Sinuses Paransl < 3 Views (70210) |
$644.62 |
$859.50 |
7.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$750 |
$1,000 |
6.9× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$963.75 |
$1,285 |
10.6× |
| Radex Toe Minimum 2 Views (73660) |
$761.25 |
$1,015 |
8.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$448.50 |
$598 |
4.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$889.88 |
$1,186.50 |
9.8× |
| Radiation treatment delivery level 1 (77402) |
$659.25 |
$879 |
6.2× |
| Radiation treatment delivery level 2 (77407) |
$659.25 |
$879 |
1.6× |
| Radiation treatment delivery level 3 (77412) |
$1,588.50 |
$2,118 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$620.25 |
$827 |
6.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$834 |
$1,112 |
7.6× |
| Radiologic exam chest 2 views (71046) |
$576 |
$768 |
6.3× |
| Radiologic exam colon single contrast study (74270) |
$1,336.50 |
$1,782 |
7.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,934.25 |
$2,579 |
10.6× |
| Radiologic examination femur 1 view (73551) |
$633 |
$844 |
7.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$982.88 |
$1,310.50 |
10.8× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Non-Facility (70370) |
$1,576.50 |
$2,102 |
17.3× |
| Radiological examination surgical specimen (76098) |
$834.75 |
$1,113 |
1.5× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$6,355.50 |
$8,474 |
11.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,592.75 |
$3,457 |
4.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$6,373.50 |
$8,498 |
11.2× |
| Rp Therapy Intravenous Administration (79101) |
$3,157.50 |
$4,210 |
13.0× |
| Sacroiliac Joints < 3 Views (72200) |
$502.50 |
$670 |
4.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,722 |
$2,296 |
6.9× |
| Salivary gland function study (78232) |
$2,613.75 |
$3,485 |
6.3× |
| Salivary gland imaging; with serial images Non-Facility (78231) |
$2,201.25 |
$2,935 |
5.3× |
| Scapula (73010) |
$671.62 |
$895.50 |
6.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$154.50 |
$206 |
6.6× |
| Sella turcica (70240) |
$585 |
$780 |
6.4× |
| Shoulder 1 view (73020) |
$760.88 |
$1,014.50 |
8.4× |
| Simulation intermediate (77285) |
$2,915.25 |
$3,887 |
7.5× |
| Small bowel series (74250) |
$1,045.50 |
$1,394 |
5.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,367.75 |
$3,157 |
6.1× |
| Special dosimetry (77331) |
$1,770 |
$2,360 |
12.6× |
| Special Physics Consult (77370) |
$3,403.50 |
$4,538 |
24.2× |
| Special treatment procedure (77470) |
$3,602.25 |
$4,803 |
6.2× |
| Spine thoracic 3 views (72072) |
$1,134.38 |
$1,512.50 |
10.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$789 |
$1,052 |
7.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,016.50 |
$4,022 |
7.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,243.50 |
$1,658 |
3.2× |
| Testicular Imaging With Vascular Flow (78761) |
$2,377.50 |
$3,170 |
5.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,664.75 |
$3,553 |
6.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,299.75 |
$1,733 |
9.3× |
| Thoracolumbar 2 views (72080) |
$525.75 |
$701 |
5.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$4,224.75 |
$5,633 |
7.5× |
| Thyroid imaging w/blood flow (78013) |
$1,919.25 |
$2,559 |
4.6× |
| Thyroid uptake measurement (78012) |
$1,652.25 |
$2,203 |
4.0× |
| Tomogram (76100) |
$1,751.25 |
$2,335 |
16.0× |
| Treatment device complex (77334) |
$2,414.25 |
$3,219 |
6.2× |
| Treatment device intermediate (77333) |
$2,398.50 |
$3,198 |
17.1× |
| Treatment devices simple (77332) |
$1,366.50 |
$1,822 |
9.7× |
| Ultrasound breast complete (76641) |
$736.50 |
$982 |
6.7× |
| Ultrasound, abdomen limited (76705) |
$1,558.50 |
$2,078 |
14.3× |
| Umbilical-artery Doppler (OB) (76820) |
$1,102.50 |
$1,470 |
10.1× |
| Ureteral reflux study (78740) |
$4,763.25 |
$6,351 |
11.4× |
| Urethrocystogram voiding (74455) |
$2,097 |
$2,796 |
8.4× |
| Urethrocystography retrograde rs&i (74450) |
$969.75 |
$1,293 |
3.9× |
| Urography, infusion, drip technique and/or bolus technique; Non-Facility (74410) |
$2,208 |
$2,944 |
12.1× |
| Urography, infusion, drip technique and/or bolus technique; with nephrotomography Non-Facility (74415) |
$2,803.50 |
$3,738 |
15.3× |
| Us chest (76604) |
$771 |
$1,028 |
7.1× |
| Us Cmprn Rpr Artl Pseudoarysm/Arven Fstl (76936) |
$1,872 |
$2,496 |
8.3× |
| Us encephalogram (76506) |
$1,199.25 |
$1,599 |
11.0× |
| Us infant hips w manipulation (76885) |
$1,092 |
$1,456 |
12.0× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,155.75 |
$1,541 |
10.6× |
| Us ob limited (76815) |
$1,409.62 |
$1,879.50 |
12.9× |
| Us ob transvaginal (76817) |
$1,179.75 |
$1,573 |
10.8× |
| Us pelvic non ob complete (76856) |
$1,989 |
$2,652 |
18.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$454.50 |
$606 |
4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,176.75 |
$1,569 |
10.8× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$489 |
$652 |
4.5× |
| Us retroperitoneal complete (76770) |
$1,554.75 |
$2,073 |
14.2× |
| Us retroperitoneal limited (76775) |
$1,534.50 |
$2,046 |
14.1× |
| Us scrotum and contents (76870) |
$1,288.50 |
$1,718 |
11.8× |
| Us soft tissue head/neck (76536) |
$1,432.50 |
$1,910 |
13.1× |
| Us spinal canal and contents (76800) |
$1,660.50 |
$2,214 |
15.2× |
| Us transrectal (76872) |
$1,759.50 |
$2,346 |
16.1× |
| Us transrectal prostate volume (76873) |
$1,658.25 |
$2,211 |
15.2× |
| Venogram extremity bilateral (75822) |
$5,530.88 |
$7,374.50 |
3.4× |
| Venogram Extremity Unilateral (75820) |
$5,176.12 |
$6,901.50 |
3.1× |
| Venography caval inferior serialography rs&i (75825) |
$4,447.50 |
$5,930 |
1.3× |
| Venography caval superior serialography rs&i (75827) |
$3,650.25 |
$4,867 |
2.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$6,986.25 |
$9,315 |
2.1× |
| Venous sampling by catheter (75893) |
$9,069 |
$12,092 |
1.6× |
| Wrist 2 views (73100) |
$901.12 |
$1,201.50 |
9.9× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,406.25 |
$1,875 |
12.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$924.75 |
$1,233 |
10.2× |
| X-ray b.e. reductn intuss (74283) |
$1,845 |
$2,460 |
10.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,554.75 |
$2,073 |
8.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$828 |
$1,104 |
9.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$1,048.50 |
$1,398 |
11.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$2,577 |
$3,436 |
23.6× |
| X-ray exam of femur 2/> (73552) |
$949.88 |
$1,266.50 |
10.5× |
| X-ray eye for foreign body (70030) |
$725.25 |
$967 |
8.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$756.38 |
$1,008.50 |
8.3× |
| X-ray IV pyelogram (ivp) (74400) |
$1,842.75 |
$2,457 |
10.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$702.75 |
$937 |
7.7× |
| X-ray leg, infant (73592) |
$448.50 |
$598 |
4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$741 |
$988 |
6.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,258.12 |
$1,677.50 |
11.5× |
| X-ray nose-rectum child f.b. (76010) |
$423 |
$564 |
4.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$921.75 |
$1,229 |
8.4× |
| X-ray retrograde pyelogram (74420) |
$1,104.75 |
$1,473 |
3.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,117.50 |
$1,490 |
10.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,040.62 |
$1,387.50 |
9.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$341.25 |
$455 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$733.88 |
$978.50 |
8.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$986.62 |
$1,315.50 |
10.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,313.25 |
$1,751 |
12.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$960 |
$1,280 |
8.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$865.12 |
$1,153.50 |
9.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$799.50 |
$1,066 |
8.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$724.12 |
$965.50 |
8.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$660 |
$880 |
6.0× |
| Xr bone length studies (77073) |
$861.38 |
$1,148.50 |
7.9× |
| Xr c-spine 4 or 5 views (72050) |
$1,540.50 |
$2,054 |
14.1× |
| Xr c-spine 6 or more views (72052) |
$1,647.75 |
$2,197 |
15.1× |
| Xr chest 4+ views (71048) |
$759 |
$1,012 |
7.0× |
| Xr urogram antegrade (74425) |
$1,054.12 |
$1,405.50 |
2.9× |