| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,310 |
$15,775 |
4.7× |
| Abdomen 2 views (74019) |
$482.80 |
$1,207 |
4.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$966.80 |
$2,417 |
2.5× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,910 |
$7,275 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,411.20 |
$8,528 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$1,990.80 |
$4,977 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$1,589.60 |
$3,974 |
0.5× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,862.40 |
$4,656 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,123.80 |
$5,309.50 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,516.80 |
$3,792 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,454.20 |
$3,635.50 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,395.20 |
$5,988 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,219.80 |
$3,049.50 |
0.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,273.20 |
$5,683 |
0.7× |
| Ankle 2 views (73600) |
$336.40 |
$841 |
4.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$972.40 |
$2,431 |
2.9× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,809.20 |
$4,523 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,101.60 |
$10,254 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$3,936 |
$9,840 |
1.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,140.80 |
$5,352 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,941.60 |
$4,854 |
0.6× |
| Arthrogram elbow (73085) |
$977.40 |
$2,443.50 |
2.9× |
| Arthrogram hip (73525) |
$967.60 |
$2,419 |
2.9× |
| Arthrogram shoulder (73040) |
$1,008.40 |
$2,521 |
3.0× |
| Arthrogram wrist (73115) |
$804.80 |
$2,012 |
2.4× |
| Arthrography knee lt (73580) |
$988.40 |
$2,471 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$622 |
$1,555 |
4.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,187.20 |
$2,968 |
3.1× |
| Bone &/joint imaging whole body (78306) |
$2,144.80 |
$5,362 |
5.6× |
| Bone age studies (77072) |
$292.40 |
$731 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,783.20 |
$4,458 |
4.6× |
| Bone survey complete (77075) |
$1,143.20 |
$2,858 |
11.4× |
| Brain image w/flow 4 + views (78606) |
$2,508 |
$6,270 |
4.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,938.80 |
$4,847 |
3.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,527.20 |
$6,318 |
1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$787.60 |
$1,969 |
1.5× |
| Cervical spine 2 or 3 views (72040) |
$438.80 |
$1,097 |
5.2× |
| Chest 1 view (71045) |
$288 |
$720 |
3.4× |
| Chest 3 views (71047) |
$473.60 |
$1,184 |
5.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$630.40 |
$1,576 |
3.7× |
| Clavicle complete (73000) |
$339.20 |
$848 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$649.60 |
$1,624 |
6.5× |
| Continuing medical physics consltj pr wk (77336) |
$826.80 |
$2,067 |
6.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$6,157.20 |
$15,393 |
18.4× |
| CT abdomen and pelvis without contrast (74176) |
$4,176.80 |
$10,442 |
18.2× |
| CT abdomen w contrast (74160) |
$2,626.80 |
$6,567 |
15.6× |
| CT abdomen w wo contrast (74170) |
$3,586.20 |
$8,965.50 |
21.3× |
| CT abdomen w/o contrast (74150) |
$2,151.40 |
$5,378.50 |
21.4× |
| CT angio hrt w/3d image (75574) |
$2,556.40 |
$6,391 |
7.6× |
| CT angiography upper extremity lt (73206) |
$2,093.20 |
$5,233 |
12.4× |
| CT c-spine w/o contrast (72125) |
$1,948.20 |
$4,870.50 |
19.4× |
| CT cervical spine w&w/o contrast (72127) |
$4,458 |
$11,145 |
26.4× |
| CT cervical spine with contrast (72126) |
$3,429.60 |
$8,574 |
10.2× |
| CT chest w/wo contrast (71270) |
$5,036.80 |
$12,592 |
29.9× |
| CT chest with contrast (71260) |
$3,786 |
$9,465 |
22.4× |
| CT colonography w/dye (74262) |
$939.60 |
$2,349 |
5.6× |
| CT colonography w/o cntrst (74261) |
$939.60 |
$2,349 |
9.3× |
| CT head/brain with contrast (70460) |
$2,638.40 |
$6,596 |
15.6× |
| CT head/brain without and with contrast (70470) |
$3,690.40 |
$9,226 |
21.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,504.80 |
$6,262 |
7.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,090.80 |
$2,727 |
13.0× |
| CT hrt w/3d image congen (75573) |
$3,061.20 |
$7,653 |
9.1× |
| CT iac w contrast (70481) |
$3,097.20 |
$7,743 |
18.4× |
| CT lower ext w/o (73700) |
$2,129.60 |
$5,324 |
21.2× |
| CT lower extremity w wo contrast (73702) |
$5,190 |
$12,975 |
30.8× |
| CT lower extremity with contrast (73701) |
$2,929.60 |
$7,324 |
17.4× |
| CT lumbar spine w & w/o contrast (72133) |
$5,194.80 |
$12,987 |
30.8× |
| CT lumbar spine w/o contrast (72131) |
$2,906.80 |
$7,267 |
28.9× |
| CT lumbar spine with contrast (72132) |
$4,467.20 |
$11,168 |
13.3× |
| CT maxillofacial w contrast (70487) |
$3,168.40 |
$7,921 |
18.8× |
| CT maxillofacial w/o contrast (70486) |
$1,640.60 |
$4,101.50 |
16.3× |
| CT maxillofacial w/wo contrast (70488) |
$3,354.40 |
$8,386 |
19.9× |
| CT neck soft tissue w contrast (70491) |
$2,453.20 |
$6,133 |
14.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$3,363.20 |
$8,408 |
19.9× |
| CT orbits w/o contrast (70480) |
$2,091.60 |
$5,229 |
20.8× |
| CT pelvis w & w/o contrast (72194) |
$1,950.80 |
$4,877 |
11.6× |
| CT pelvis w/o contrast (72192) |
$1,794.40 |
$4,486 |
17.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$4,098 |
$10,245 |
24.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,500.80 |
$3,752 |
14.9× |
| CT thoracic spine w/contrast (72129) |
$3,429.60 |
$8,574 |
20.3× |
| CT thoracic spine w/o contrast (72128) |
$1,637.80 |
$4,094.50 |
16.3× |
| CT thoracic spine w/wo contrast (72130) |
$4,549.60 |
$11,374 |
27.0× |
| CT thorax w/o contrast (71250) |
$2,023.40 |
$5,058.50 |
20.1× |
| CT unlisted procedure (76497) |
$278.80 |
$697 |
3.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$5,296.80 |
$13,242 |
31.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,129.60 |
$5,324 |
21.2× |
| CT upper extremity with contrast (73201) |
$2,783.20 |
$6,958 |
8.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,747.20 |
$4,368 |
10.4× |
| Cta Abdomen (74175) |
$1,676 |
$4,190 |
9.9× |
| CTA abdomen pelvis (74174) |
$2,825.60 |
$7,064 |
8.4× |
| CTA chest (71275) |
$1,554.80 |
$3,887 |
9.2× |
| Cta Head (70496) |
$1,157 |
$2,892.50 |
6.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,124.80 |
$2,812 |
6.7× |
| Cta Neck (70498) |
$1,124.80 |
$2,812 |
6.7× |
| Cta Pelvis (72191) |
$1,635.60 |
$4,089 |
9.7× |
| Cystography minimum 3 views rs&i (74430) |
$881.20 |
$2,203 |
2.6× |
| Diskogram cervical (72285) |
$799.60 |
$1,999 |
0.4× |
| Diskography lumbar (72295) |
$4,106.40 |
$10,266 |
2.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$725.20 |
$1,813 |
7.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$78.80 |
$197 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$200 |
$500 |
2.0× |
| Echoencephalography real time imaging (76506) |
$804.80 |
$2,012 |
8.0× |
| Esophagus (74220) |
$722.80 |
$1,807 |
4.3× |
| Fetal biophysical profile non-stress testing (76818) |
$398.80 |
$997 |
4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$384 |
$960 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$764 |
$1,910 |
3.3× |
| Foot 2 views (73620) |
$353.20 |
$883 |
4.2× |
| Forearm 2 views (73090) |
$354 |
$885 |
4.2× |
| Gated Heart Planar Single (78472) |
$2,235.60 |
$5,589 |
5.8× |
| Hand 2 views (73120) |
$325.60 |
$814 |
3.2× |
| Hand 3 views (73130) |
$366 |
$915 |
4.4× |
| Heart Infarct Image (78466) |
$1,931.60 |
$4,829 |
5.0× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,593.40 |
$3,983.50 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,165.20 |
$5,413 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,346 |
$3,365 |
3.5× |
| Ht muscle image spect sing (78451) |
$2,061.20 |
$5,153 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$348 |
$870 |
4.2× |
| Hysterosalpingogram (74740) |
$737.60 |
$1,844 |
3.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,931.60 |
$4,829 |
3.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,106.40 |
$5,266 |
4.0× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$2,648.80 |
$6,622 |
5.1× |
| Knee 3 views (73562) |
$432.80 |
$1,082 |
5.2× |
| Liver & spleen imaging static only (78215) |
$1,641.20 |
$4,103 |
4.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,970.40 |
$4,926 |
5.1× |
| Lung perfusion differential (78597) |
$724.80 |
$1,812 |
1.9× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$838 |
$2,095 |
0.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$1,047.20 |
$2,618 |
1.7× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$838 |
$2,095 |
0.6× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$1,047.20 |
$2,618 |
0.3× |
| Lymphoscintigraphy (78195) |
$1,976 |
$4,940 |
3.8× |
| Mammary ductogram or galactogram multiple (77054) |
$625.60 |
$1,564 |
2.7× |
| Meckels Diverticulum (78290) |
$968.80 |
$2,422 |
2.5× |
| MRA head w & w/o contrast (70546) |
$3,638.40 |
$9,096 |
10.8× |
| MRA head w/o contrast (70544) |
$2,581.20 |
$6,453 |
11.2× |
| MRA head with contrast (70545) |
$3,482.80 |
$8,707 |
10.4× |
| MRA neck w contrast (70548) |
$2,817.20 |
$7,043 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,508 |
$8,770 |
10.5× |
| MRA neck w/o contrast (70547) |
$2,677.80 |
$6,694.50 |
11.7× |
| MRI abdomen w contrast (74182) |
$2,784 |
$6,960 |
8.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,208.80 |
$10,522 |
12.5× |
| MRI abdomen w/o contrast (74181) |
$3,740 |
$9,350 |
16.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,987.60 |
$4,969 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,987.60 |
$4,969 |
2.6× |
| MRI breast w/o contrast bilateral (77047) |
$3,103.60 |
$7,759 |
13.5× |
| MRI breast w/o contrast unilat (77046) |
$1,352.80 |
$3,382 |
5.9× |
| MRI c-spine with contrast (72142) |
$3,025.20 |
$7,563 |
9.0× |
| MRI cervical spine w/o contrast (72141) |
$2,581.60 |
$6,454 |
11.2× |
| MRI chest w/o & w/contrast material (71552) |
$2,972.40 |
$7,431 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,161.60 |
$5,404 |
9.4× |
| MRI chest with contrast (71551) |
$2,906.40 |
$7,266 |
3.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,890.40 |
$9,726 |
11.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,841.20 |
$9,603 |
11.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,600 |
$6,500 |
11.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,100 |
$5,250 |
9.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,913.80 |
$7,284.50 |
8.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,554.60 |
$6,386.50 |
7.6× |
| MRI pelvis w contrast (72196) |
$2,937.20 |
$7,343 |
8.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,832.40 |
$7,081 |
8.4× |
| MRI pelvis w/o contrast (72195) |
$2,145.60 |
$5,364 |
9.3× |
| MRI scan of arm joint before and after contrast (73223) |
$2,953.40 |
$7,383.50 |
8.8× |
| MRI scan of leg joint before and after contrast (73723) |
$2,877.60 |
$7,194 |
8.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$4,930 |
$12,325 |
14.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,124.60 |
$7,811.50 |
9.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,156.40 |
$10,391 |
12.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,156.40 |
$7,891 |
9.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$4,196.40 |
$10,491 |
12.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,652 |
$6,630 |
11.6× |
| MRI tmj (70336) |
$1,704.80 |
$4,262 |
7.4× |
| MRI upper ext joint w/o contrast (73221) |
$3,263.60 |
$8,159 |
14.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$4,658 |
$11,645 |
13.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,970.40 |
$9,926 |
17.3× |
| Myelogram Cervical (72240) |
$1,937.20 |
$4,843 |
2.6× |
| Myelogram Lumbar (72265) |
$1,855.20 |
$4,638 |
2.5× |
| Myelogram thoracic (72255) |
$1,855.20 |
$4,638 |
2.5× |
| Myelography 2 or more regions (72270) |
$2,318.40 |
$5,796 |
3.1× |
| Myocardial infarct spect (78469) |
$2,578 |
$6,445 |
4.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,358.60 |
$8,396.50 |
2.7× |
| Neck soft tissue (70360) |
$299.40 |
$748.50 |
3.6× |
| Nm cisternogram (78630) |
$1,176.40 |
$2,941 |
2.3× |
| Nm csf leak detection (78650) |
$2,592.80 |
$6,482 |
2.1× |
| Nm gastric emptying study (78264) |
$1,122.80 |
$2,807 |
2.9× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,527.20 |
$6,318 |
1.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$762.40 |
$1,906 |
2.0× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$770.80 |
$1,927 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$1,457.60 |
$3,644 |
6.5× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$451.20 |
$1,128 |
4.5× |
| Osseous survey infant (77076) |
$556.80 |
$1,392 |
5.5× |
| Osseous survey limited (77074) |
$724.40 |
$1,811 |
7.2× |
| Parathyrd planar w/spect&CT (78072) |
$1,081.60 |
$2,704 |
2.1× |
| Parathyrd planar w/wo subtrj (78071) |
$1,081.60 |
$2,704 |
2.8× |
| Parathyroid imaging (78070) |
$1,192 |
$2,980 |
3.1× |
| Pelvis 1 or 2 views (72170) |
$417.60 |
$1,044 |
4.2× |
| Perineogram (74775) |
$779.60 |
$1,949 |
3.4× |
| PET image w/CT, skull-thigh (78815) |
$3,544 |
$8,860 |
2.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,527.20 |
$6,318 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,579.20 |
$6,448 |
1.9× |
| PET imaging limited area chest head/neck (78811) |
$2,527.20 |
$6,318 |
2.0× |
| PET whole body (78813) |
$2,527.20 |
$6,318 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$4,705.60 |
$11,764 |
14.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,338.80 |
$5,847 |
0.8× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,724.40 |
$4,311 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,977.60 |
$4,944 |
5.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,853.20 |
$7,133 |
5.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$460.80 |
$1,152 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$504 |
$1,260 |
5.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$711.20 |
$1,778 |
7.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$570.40 |
$1,426 |
5.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$751.60 |
$1,879 |
7.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$555.60 |
$1,389 |
5.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$328 |
$820 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$633 |
$1,582.50 |
6.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$315.60 |
$789 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$835.40 |
$2,088.50 |
5.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$985.20 |
$2,463 |
5.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$960.80 |
$2,402 |
5.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$431.20 |
$1,078 |
5.2× |
| Radiological examination surgical specimen (76098) |
$504 |
$1,260 |
1.0× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,328.40 |
$5,821 |
0.8× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,659.20 |
$4,148 |
0.5× |
| Ribs bilateral 3 views (71110) |
$516.40 |
$1,291 |
5.1× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,742.80 |
$4,357 |
3.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,738 |
$6,845 |
5.2× |
| Sacroiliac Joints < 3 Views (72200) |
$256.80 |
$642 |
2.6× |
| Scanogram (77073) |
$191.60 |
$479 |
1.9× |
| Scapula complete (73010) |
$430 |
$1,075 |
4.3× |
| Screening digital breast tomosynthesis (77063) |
$145.80 |
$364.50 |
6.2× |
| Sella turcica (70240) |
$290.80 |
$727 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$388 |
$970 |
3.9× |
| Sialogram (70390) |
$456 |
$1,140 |
2.0× |
| Small bowel series (74250) |
$616 |
$1,540 |
3.7× |
| Spec medical radj physics consltj (77370) |
$864.80 |
$2,162 |
6.7× |
| Special dosimetry (77331) |
$568.80 |
$1,422 |
4.4× |
| Special treatment procedure (77470) |
$1,124.40 |
$2,811 |
2.1× |
| Spine thoracic 3 views (72072) |
$500.40 |
$1,251 |
5.0× |
| Splenoportograpy rs&i (75810) |
$2,401.20 |
$6,003 |
0.8× |
| Superior sagittal sinus venogram (75870) |
$1,551.60 |
$3,879 |
0.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$732 |
$1,830 |
2.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$789.20 |
$1,973 |
2.2× |
| Testicular Imaging With Vascular Flow (78761) |
$1,219.60 |
$3,049 |
3.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,008.40 |
$5,021 |
5.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$926.80 |
$2,317 |
7.2× |
| Thoracolumbar 2 views (72080) |
$466.40 |
$1,166 |
5.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$703.20 |
$1,758 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$506.40 |
$1,266 |
1.3× |
| Thyroid uptake measurement (78012) |
$542.40 |
$1,356 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,134.80 |
$2,837 |
3.0× |
| Tmj unilateral (70328) |
$150 |
$375 |
1.8× |
| Tomogram (76100) |
$558 |
$1,395 |
5.5× |
| Treatment devices simple (77332) |
$455.20 |
$1,138 |
3.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,633.60 |
$6,584 |
5.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$838 |
$2,095 |
2.2× |
| Tx devices design & construction complex (77334) |
$1,302.80 |
$3,257 |
3.6× |
| Ultrasound, abdomen limited (76705) |
$734 |
$1,835 |
7.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$129.20 |
$323 |
1.5× |
| Unlisted magnetic resonance procedure (76498) |
$966.80 |
$2,417 |
11.6× |
| Unlisted Ultrasound Procedure (76999) |
$447.60 |
$1,119 |
5.3× |
| Upper Extremity Infant (73092) |
$270 |
$675 |
2.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$873.60 |
$2,184 |
2.3× |
| Urethrocystography retrograde rs&i (74450) |
$732 |
$1,830 |
3.2× |
| Urethrocystography voiding (74455) |
$818 |
$2,045 |
3.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$1,114.80 |
$2,787 |
6.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$777.60 |
$1,944 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$205.20 |
$513 |
2.0× |
| Us breast unilateral complete (76641) |
$831.40 |
$2,078.50 |
8.3× |
| Us breast unilateral limited (76642) |
$409.60 |
$1,024 |
4.9× |
| Us chest (76604) |
$754.40 |
$1,886 |
7.5× |
| Us compl joint r-t w/image documentation (76881) |
$820.80 |
$2,052 |
8.2× |
| Us infant hips dynamic (76885) |
$466.40 |
$1,166 |
5.6× |
| Us kidney transplant (76776) |
$1,012.40 |
$2,531 |
10.1× |
| Us ob detailed single fetus (76811) |
$542 |
$1,355 |
2.4× |
| Us ob transvaginal (76817) |
$584 |
$1,460 |
5.8× |
| Us pelvic non ob complete (76856) |
$930.40 |
$2,326 |
9.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$735.20 |
$1,838 |
7.3× |
| Us pregnancy ltd (76815) |
$668.20 |
$1,670.50 |
6.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$793.60 |
$1,984 |
7.9× |
| Us retroperitoneal complete (76770) |
$827.60 |
$2,069 |
8.2× |
| Us retroperitoneal limited (76775) |
$524.60 |
$1,311.50 |
5.2× |
| Us scrotum and contents (76870) |
$479.20 |
$1,198 |
4.8× |
| Us soft tissue head/neck (76536) |
$674.80 |
$1,687 |
6.7× |
| Us spinal canal and contents (76800) |
$709.20 |
$1,773 |
7.1× |
| Us transrectal (76872) |
$362.40 |
$906 |
3.6× |
| Us xtr non-vasc lmtd (76882) |
$495.40 |
$1,238.50 |
4.9× |
| Venogram extremity bilateral (75822) |
$1,275.20 |
$3,188 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$1,946.40 |
$4,866 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$2,068 |
$5,170 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$1,048.80 |
$2,622 |
0.7× |
| Venography Renal Bilateral (75833) |
$2,015.60 |
$5,039 |
0.7× |
| Venography renal unilateral selective rs&i (75831) |
$2,494.80 |
$6,237 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,551.60 |
$3,879 |
0.5× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,486.40 |
$6,216 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$200 |
$500 |
2.4× |
| Wrist 2 views (73100) |
$288 |
$720 |
3.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$597.60 |
$1,494 |
5.9× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$348.80 |
$872 |
4.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$400.40 |
$1,001 |
4.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,082.40 |
$2,706 |
6.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$326 |
$815 |
3.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$419.60 |
$1,049 |
5.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$575.60 |
$1,439 |
5.7× |
| X-ray exam hip uni 1 view (73501) |
$316.80 |
$792 |
3.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$447.60 |
$1,119 |
5.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$488.20 |
$1,220.50 |
4.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$604.80 |
$1,512 |
6.0× |
| X-ray eye for foreign body (70030) |
$228.40 |
$571 |
2.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$627.20 |
$1,568 |
6.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$316.40 |
$791 |
3.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$413.20 |
$1,033 |
4.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$336.80 |
$842 |
4.0× |
| X-ray IV pyelogram+drip infusn (74410) |
$714.80 |
$1,787 |
4.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$414.40 |
$1,036 |
5.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$465.20 |
$1,163 |
4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$374.80 |
$937 |
4.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$337.20 |
$843 |
4.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$543.60 |
$1,359 |
5.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$655.60 |
$1,639 |
6.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$415.60 |
$1,039 |
4.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$406.80 |
$1,017 |
4.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$256.80 |
$642 |
3.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$272 |
$680 |
2.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$684.80 |
$1,712 |
6.8× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$1,047.20 |
$2,618 |
2.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,163.20 |
$2,908 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$396.40 |
$991 |
4.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$571.20 |
$1,428 |
5.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$756 |
$1,890 |
7.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$256.80 |
$642 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$319.20 |
$798 |
3.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$463.60 |
$1,159 |
5.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$570 |
$1,425 |
6.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$387.20 |
$968 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$544 |
$1,360 |
5.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$355.60 |
$889 |
3.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$368 |
$920 |
4.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$440.80 |
$1,102 |
5.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$440.80 |
$1,102 |
5.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$502.40 |
$1,256 |
5.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$496 |
$1,240 |
4.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$256.80 |
$642 |
3.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$378.40 |
$946 |
4.5× |
| Xr c-spine 6 or more views (72052) |
$623.20 |
$1,558 |
6.2× |
| Xr chest 4+ views (71048) |
$468.80 |
$1,172 |
4.7× |
| Xr finger(s) 2+ views (73140) |
$318.80 |
$797 |
3.8× |
| XR Mastoids < 3 Views Bilateral (70120) |
$290.80 |
$727 |
2.9× |
| Xr shoulder 1 view (73020) |
$421.60 |
$1,054 |
5.0× |
| Xr spine cervical 4 or 5 views (72050) |
$644.80 |
$1,612 |
6.4× |
| Xr tibia/fibula 2 views (73590) |
$425.20 |
$1,063 |
5.1× |
| Xr tmj bilateral (70330) |
$571.20 |
$1,428 |
6.8× |
| Xray knee 1 or 2 views rt (73560) |
$371.60 |
$929 |
4.4× |