| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,101.14 |
$7,729 |
3.8× |
| Abdomen 1 View (74018) |
$310.86 |
$471 |
3.7× |
| Abdomen 2 views (74019) |
$332.64 |
$504 |
3.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,316.70 |
$1,995 |
3.4× |
| Angio internal mammary (75756) |
$3,635.28 |
$5,508 |
1.2× |
| Angio pulmonary bilat (75743) |
$3,635.28 |
$5,508 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,283.96 |
$8,006 |
1.7× |
| Angiography extremity bilateral rs&i (75716) |
$3,635.28 |
$5,508 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,161.40 |
$4,790 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,635.28 |
$5,508 |
1.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,635.28 |
$5,508 |
1.2× |
| Ankle 2 views (73600) |
$315.48 |
$478 |
3.7× |
| Aortography thoracic serialography rs&i (75605) |
$6,243.60 |
$9,460 |
1.2× |
| Artery X-Rays Abdomen (75726) |
$5,429.16 |
$8,226 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,635.28 |
$5,508 |
1.2× |
| Artery X-Rays Pelvis (75736) |
$6,243.60 |
$9,460 |
1.2× |
| Artery X-Rays Spine (75705) |
$6,243.60 |
$9,460 |
1.2× |
| Arthrogram ankle (73615) |
$1,242.78 |
$1,883 |
3.7× |
| Arthrogram hip (73525) |
$1,657.92 |
$2,512 |
4.9× |
| Arthrogram Wrist (73115) |
$830.94 |
$1,259 |
2.5× |
| Basic radiation dosimetry calculation (77300) |
$599.94 |
$909 |
4.6× |
| Bone age studies (77072) |
$506.22 |
$767 |
5.0× |
| Bone Imaging 3 Phase (78315) |
$1,665.18 |
$2,523 |
4.3× |
| Bone Imaging Limited Area (78300) |
$951.06 |
$1,441 |
2.4× |
| Bone Imaging Multiple Areas (78305) |
$1,170.18 |
$1,773 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,389.96 |
$2,106 |
3.6× |
| Bone marrow imaging; whole body (78104) |
$951.06 |
$1,441 |
2.4× |
| Bone survey infant (77076) |
$391.38 |
$593 |
3.9× |
| Brachytx isodose complex (77318) |
$1,283.04 |
$1,944 |
3.5× |
| Brachytx isodose intermed (77317) |
$1,131.90 |
$1,715 |
3.1× |
| Brachytx Isodose Plan Simple (77316) |
$641.52 |
$972 |
1.8× |
| Brain Image W/Flow < 4 Views (78601) |
$1,535.82 |
$2,327 |
4.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,901.82 |
$7,427 |
3.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,913.90 |
$4,415 |
8.6× |
| Cat Scan Follow-Up Study (76380) |
$769.56 |
$1,166 |
9.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$951.06 |
$1,441 |
1.8× |
| Cerebrospinal Fluid Scan (78630) |
$1,828.86 |
$2,771 |
3.5× |
| Chest 1 view (71045) |
$259.38 |
$393 |
3.1× |
| Chest 2 views (71046) |
$275.88 |
$418 |
3.3× |
| Chest 3 views (71047) |
$275.88 |
$418 |
3.3× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$335.94 |
$509 |
3.3× |
| Clavicle complete (73000) |
$333.96 |
$506 |
4.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$769.56 |
$1,166 |
7.6× |
| Continuing medical physics consltj pr wk (77336) |
$646.80 |
$980 |
5.0× |
| Contrast Exam Abdominl Aorta (75625) |
$3,833.94 |
$5,809 |
1.3× |
| Contrast X-Ray Bladder (74430) |
$785.40 |
$1,190 |
2.3× |
| Contrast X-Ray Of Elbow (73085) |
$900.90 |
$1,365 |
2.7× |
| Contrast X-Ray Of Knee Joint (73580) |
$955.68 |
$1,448 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,550.14 |
$5,379 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,544.96 |
$3,856 |
11.0× |
| CT abdomen w contrast (74160) |
$1,750.32 |
$2,652 |
10.3× |
| CT abdomen w wo contrast (74170) |
$2,091.54 |
$3,169 |
12.3× |
| CT abdomen w/o contrast (74150) |
$1,259.28 |
$1,908 |
12.4× |
| CT Angio Abdomen and Pelvis (74174) |
$3,358.08 |
$5,088 |
9.9× |
| CT Angio Chest (71275) |
$1,859.88 |
$2,818 |
10.9× |
| CT Angio Head (70496) |
$2,091.54 |
$3,169 |
12.3× |
| CT angio hrt w/3d image (75574) |
$1,259.28 |
$1,908 |
3.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,002.44 |
$3,034 |
11.8× |
| CT Angio Neck (70498) |
$1,126.62 |
$1,707 |
6.6× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,818.96 |
$2,756 |
10.7× |
| CT cervical spine w/ contrast (72126) |
$1,539.12 |
$2,332 |
4.5× |
| CT cervical spine w/o contrast (72125) |
$1,357.62 |
$2,057 |
13.4× |
| CT cervical spine w/wo cont (72127) |
$1,818.96 |
$2,756 |
10.7× |
| CT chest w contrast (71260) |
$1,539.12 |
$2,332 |
9.0× |
| CT chest w/wo contrast (71270) |
$1,818.96 |
$2,756 |
10.7× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,119.36 |
$1,696 |
11.0× |
| CT head/brain with contrast (70460) |
$1,770.12 |
$2,682 |
10.4× |
| CT head/brain without and with contrast (70470) |
$1,818.96 |
$2,756 |
10.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,448.04 |
$2,194 |
4.3× |
| CT hrt w/3d image congen (75573) |
$1,259.28 |
$1,908 |
3.7× |
| CT iac w contrast (70481) |
$1,770.12 |
$2,682 |
10.4× |
| CT l-spine w&w/o contrast (72133) |
$1,818.96 |
$2,756 |
10.7× |
| CT lower ext w/o (73700) |
$1,430.88 |
$2,168 |
14.1× |
| CT lower extremity w/contrast material (73701) |
$1,574.76 |
$2,386 |
9.2× |
| CT lumbar spine w contrast (72132) |
$1,562.88 |
$2,368 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$1,359.60 |
$2,060 |
13.4× |
| CT maxillofacial w contrast (70487) |
$1,624.92 |
$2,462 |
9.5× |
| CT maxillofacial wo contrast (70486) |
$1,271.16 |
$1,926 |
12.5× |
| CT neck tissue combo (70492) |
$2,091.54 |
$3,169 |
12.3× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,818.96 |
$2,756 |
10.7× |
| CT orbits w/o contrast (70480) |
$1,351.02 |
$2,047 |
13.3× |
| CT pelvis w&w/o contrast (72194) |
$1,818.96 |
$2,756 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,259.28 |
$1,908 |
12.4× |
| CT scan of leg combo (73702) |
$1,818.96 |
$2,756 |
10.7× |
| CT scans face/jaw combo (70488) |
$1,679.04 |
$2,544 |
9.9× |
| CT soft tissue neck w contrast (70491) |
$1,595.22 |
$2,417 |
9.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,259.28 |
$1,908 |
12.4× |
| CT thoracic spine w contrast (72129) |
$1,539.12 |
$2,332 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,448.04 |
$2,194 |
14.3× |
| CT thoracic spine w/wo cont (72130) |
$1,818.96 |
$2,756 |
10.7× |
| CT thorax w/o contrast (71250) |
$1,264.56 |
$1,916 |
12.5× |
| CT unlisted procedure (76497) |
$331.98 |
$503 |
3.9× |
| CT upper ext wo (73200) |
$1,335.18 |
$2,023 |
13.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,846.68 |
$2,798 |
10.8× |
| CT upper extremity with contrast (73201) |
$1,770.12 |
$2,682 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,907.40 |
$2,890 |
11.2× |
| Cta Abdomen (74175) |
$1,994.52 |
$3,022 |
11.7× |
| CTA pelvis (72191) |
$1,818.96 |
$2,756 |
10.7× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$576.84 |
$874 |
2.5× |
| Dilation ureters/urethra rs&i (74485) |
$2,366.10 |
$3,585 |
1.2× |
| Discography Cerv/Thor Spine (72285) |
$1,911.36 |
$2,896 |
1.0× |
| Diskography lumbar (72295) |
$2,484.90 |
$3,765 |
1.3× |
| Dxa Bone Density Axial (77080) |
$592.02 |
$897 |
5.8× |
| Echo exam uterus (76831) |
$489.72 |
$742 |
2.1× |
| Echo Guide For Artery Repair (76936) |
$880.44 |
$1,334 |
4.2× |
| Echograp Trans R Pros Study (76873) |
$482.46 |
$731 |
4.8× |
| Esophagram (74220) |
$516.12 |
$782 |
3.0× |
| Fetal Biophys Profile W/Nst (76818) |
$489.72 |
$742 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$398.64 |
$604 |
3.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,233.44 |
$3,384 |
9.6× |
| Fluoroscopy up to 1 hr (76000) |
$517.44 |
$784 |
2.2× |
| Follow-Up Angiography (75898) |
$3,161.40 |
$4,790 |
1.0× |
| Foot 2 views (73620) |
$319.44 |
$484 |
3.8× |
| Forearm 2 views (73090) |
$315.48 |
$478 |
3.7× |
| Gastric emptying imaging study (78264) |
$1,302.84 |
$1,974 |
3.4× |
| Gastroesophageal Reflux Exam (78262) |
$731.28 |
$1,108 |
1.9× |
| Gated Heart Planar Single (78472) |
$1,620.96 |
$2,456 |
4.2× |
| Hand 2 views (73120) |
$310.20 |
$470 |
3.1× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$3,018.84 |
$4,574 |
4.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,868.36 |
$4,346 |
4.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,641.32 |
$4,002 |
3.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$6,076.62 |
$9,207 |
2.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,139.42 |
$7,787 |
1.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,587.96 |
$2,406 |
3.0× |
| Hepatobiliary System Imaging (78226) |
$1,663.20 |
$2,520 |
4.3× |
| Ht Muscle Image Spect Sing (78451) |
$3,072.96 |
$4,656 |
2.4× |
| Hysterosalpingogram (74740) |
$626.34 |
$949 |
2.7× |
| Image fusion (77399) |
$196.02 |
$297 |
1.5× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$377.52 |
$572 |
4.5× |
| Interstitial radiation source applic complex (77778) |
$4,075.50 |
$6,175 |
6.0× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,509.42 |
$2,287 |
2.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,358.28 |
$2,058 |
2.5× |
| Intracavitary radiation source applic simple (77761) |
$1,207.14 |
$1,829 |
2.2× |
| Joint Survey Single View (77077) |
$151.14 |
$229 |
1.5× |
| K Flow/Funct Image Multiple (78709) |
$1,682.34 |
$2,549 |
3.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,722.60 |
$2,610 |
3.3× |
| K Flow/Funct Image W/O Drug (78707) |
$1,682.34 |
$2,549 |
3.2× |
| Kidney Imaging Morphol (78700) |
$1,170.18 |
$1,773 |
3.0× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,170.18 |
$1,773 |
3.0× |
| Knee 3 Views (73562) |
$327.36 |
$496 |
3.9× |
| Liver & Spleen Imaging Static Only (78215) |
$951.06 |
$1,441 |
2.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,243.44 |
$1,884 |
3.2× |
| Liver imaging w/vascular flow (78202) |
$2,070.42 |
$3,137 |
3.9× |
| Lung perfusion differential (78597) |
$841.50 |
$1,275 |
2.2× |
| Lymph System Imaging (78195) |
$1,463.22 |
$2,217 |
2.8× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$2,072.40 |
$3,140 |
1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,635.28 |
$5,508 |
1.2× |
| Magnetic Image Jaw Joint (70336) |
$3,107.94 |
$4,709 |
13.4× |
| Magnetic Resonance Elastography (76391) |
$1,535.16 |
$2,326 |
6.6× |
| Mammary ductogram or galactogram multiple (77054) |
$691.68 |
$1,048 |
3.0× |
| Mammary ductogram or galactogram single (77053) |
$691.68 |
$1,048 |
3.0× |
| Meckels Divert Exam (78290) |
$1,243.44 |
$1,884 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,045.34 |
$3,099 |
5.6× |
| Mr safety determination physician/other qhp (76016) |
$203.94 |
$309 |
2.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$65.34 |
$99 |
2.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$239.58 |
$363 |
2.6× |
| Mr safety implt pos&/immoblj (76019) |
$143.22 |
$217 |
2.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$718.08 |
$1,088 |
3.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,667.72 |
$4,042 |
7.9× |
| MRA head w/o contrast (70544) |
$2,310 |
$3,500 |
10.0× |
| MRA head with contrast (70545) |
$2,425.50 |
$3,675 |
7.2× |
| MRA neck w contrast (70548) |
$1,801.80 |
$2,730 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,080.98 |
$3,153 |
6.1× |
| MRA neck w/o contrast (70547) |
$1,716 |
$2,600 |
7.4× |
| MRI abdomen w contrast (74182) |
$2,789.16 |
$4,226 |
8.2× |
| MRI abdomen w/o contrast (74181) |
$2,656.50 |
$4,025 |
11.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,542.32 |
$3,852 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,669.70 |
$4,045 |
7.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,542.32 |
$3,852 |
3.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,656.50 |
$4,025 |
11.5× |
| MRI cardiac w/o contrast (75557) |
$2,913.90 |
$4,415 |
12.6× |
| MRI cervical spine w contrast (72142) |
$1,906.08 |
$2,888 |
5.6× |
| MRI cervical spine w/o cont (72141) |
$1,815 |
$2,750 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,656.50 |
$4,025 |
11.5× |
| MRI chest with contrast (71551) |
$2,845.92 |
$4,312 |
3.7× |
| MRI chest wo w contrast (71552) |
$3,036 |
$4,600 |
9.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,311.32 |
$3,502 |
6.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,669.70 |
$4,045 |
7.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,420.88 |
$3,668 |
10.4× |
| MRI lumbar spine w contrast (72149) |
$2,571.36 |
$3,896 |
7.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,001.12 |
$3,032 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,310 |
$3,500 |
10.0× |
| MRI orbit face neck w contrast (70542) |
$2,425.50 |
$3,675 |
7.2× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,934.36 |
$4,446 |
8.7× |
| MRI pelvis w contrast (72196) |
$2,504.70 |
$3,795 |
7.4× |
| MRI pelvis w/o & w contrast (72197) |
$2,893.44 |
$4,384 |
8.5× |
| MRI pelvis w/o contrast (72195) |
$2,277 |
$3,450 |
9.8× |
| MRI spectroscopy (76390) |
$2,352.24 |
$3,564 |
27.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,295.48 |
$3,478 |
9.9× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,542.32 |
$3,852 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,410.98 |
$3,653 |
10.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,669.70 |
$4,045 |
7.9× |
| MRI, abdomen, combo (74183) |
$3,375.24 |
$5,114 |
10.0× |
| MRI, dorsal spine combo (72157) |
$2,651.88 |
$4,018 |
7.8× |
| MRI, dorsal spine contrast (72147) |
$2,410.98 |
$3,653 |
7.1× |
| MRI, joint upper extrem (73221) |
$2,420.88 |
$3,668 |
10.4× |
| MRI, joint upper extrem combo (73223) |
$2,669.70 |
$4,045 |
7.9× |
| MRI, lumbar spine combo (72158) |
$2,700.06 |
$4,091 |
8.0× |
| Myelogram Lumbar (72265) |
$1,922.58 |
$2,913 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,365.34 |
$5,099 |
2.7× |
| N-invas est c ffr sw aly CTA (75580) |
$3,977.16 |
$6,026 |
4.8× |
| Neck soft tissue (70360) |
$316.80 |
$480 |
3.7× |
| Nm csf leak detection (78650) |
$1,828.86 |
$2,771 |
1.5× |
| Nonvascular Shunt X-Ray (75809) |
$522.72 |
$792 |
5.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,513.08 |
$6,838 |
3.4× |
| Nuclear Rx Intra-Arterial (79445) |
$669.24 |
$1,014 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$951.06 |
$1,441 |
4.2× |
| Ob us nuchal meas 1 gest (76813) |
$293.70 |
$445 |
2.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$169.62 |
$257 |
2.0× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$222.42 |
$337 |
2.2× |
| Optic foramina (70190) |
$315.48 |
$478 |
3.7× |
| Panoramic X-ray of jaws (70355) |
$315.48 |
$478 |
3.7× |
| Parathyroid Planar Imaging (78070) |
$1,170.18 |
$1,773 |
3.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,609.74 |
$2,439 |
4.1× |
| Pelvis 1 or 2 views (72170) |
$326.04 |
$494 |
3.2× |
| Perineogram (74775) |
$747.78 |
$1,133 |
3.2× |
| Peritoneogram Rs&I (74190) |
$551.76 |
$836 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$4,901.82 |
$7,427 |
3.5× |
| PET image w/CT, full body (78816) |
$5,121.60 |
$7,760 |
3.7× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$5,121.60 |
$7,760 |
3.7× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$5,155.92 |
$7,812 |
4.1× |
| Platelet survival study Non-Facility (78191) |
$585.42 |
$887 |
1.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,635.28 |
$5,508 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,226.28 |
$1,858 |
3.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$391.38 |
$593 |
3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$687.72 |
$1,042 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$315.48 |
$478 |
3.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$316.80 |
$480 |
3.7× |
| Radex elbow complete minimum 3 views (73080) |
$337.92 |
$512 |
4.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$391.38 |
$593 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$315.48 |
$478 |
3.7× |
| Radex foot complete minimum 3 views (73630) |
$335.94 |
$509 |
4.0× |
| Radex Hand Minimum 3 Views (73130) |
$388.74 |
$589 |
4.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$315.48 |
$478 |
3.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$315.48 |
$478 |
3.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$315.48 |
$478 |
3.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$616.44 |
$934 |
7.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$322.74 |
$489 |
3.8× |
| Radex shoulder complete minimum 2 views (73030) |
$315.48 |
$478 |
3.7× |
| Radex Sinuses Paransl < 3 Views (70210) |
$315.48 |
$478 |
3.7× |
| Radex Spine 1 View Specify Level (72020) |
$333.96 |
$506 |
4.0× |
| Radex Sternum Minimum 2 Views (71120) |
$333.96 |
$506 |
4.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$315.48 |
$478 |
3.7× |
Radex Toe Minimum 2 Views (73660)
range across 2 matching MRF lines |
$315.48–$478 |
$478 |
varies |
| Radex upper extremity infant minimum 2 views (73092) |
$315.48 |
$478 |
3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$318.78 |
$483 |
3.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$365.64 |
$554 |
3.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$7,677.78 |
$11,633 |
1.1× |
| Radiation treatment delivery level 1 (77402) |
$693.66 |
$1,051 |
7.0× |
| Radiation treatment delivery level 2 (77407) |
$867.24 |
$1,314 |
2.3× |
| Radiation treatment delivery level 3 (77412) |
$1,097.58 |
$1,663 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$391.38 |
$593 |
3.9× |
| Radiologic exam colon double contrast study (74280) |
$916.08 |
$1,388 |
5.4× |
| Radiologic exam colon single contrast study (74270) |
$636.24 |
$964 |
3.7× |
| Radiologic exam knee complete 4/more views (73564) |
$363 |
$550 |
3.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$394.68 |
$598 |
3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$597.96 |
$906 |
3.5× |
| Radiologic exam swallow function contrast study (74230) |
$523.38 |
$793 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$798.60 |
$1,210 |
4.7× |
| Radiologic examination femur 1 view (73551) |
$315.48 |
$478 |
3.7× |
| Radiologic examination femur minimum 2 views (73552) |
$322.74 |
$489 |
3.8× |
| Radiologic examination knee 1/2 views (73560) |
$315.48 |
$478 |
3.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$391.38 |
$593 |
3.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$330 |
$500 |
3.9× |
| Radiopharm Dacryocystography (78660) |
$1,316.70 |
$1,995 |
3.4× |
| Renal Cyst Study (74470) |
$633.60 |
$960 |
1.2× |
| Ribs bilateral 3 views (71110) |
$391.38 |
$593 |
3.9× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$877.80 |
$1,330 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,535.82 |
$2,327 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,584 |
$2,400 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,508.10 |
$2,285 |
2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,682.34 |
$2,549 |
3.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,791.90 |
$2,715 |
1.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,026.20 |
$3,070 |
1.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,791.90 |
$2,715 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,283.04 |
$1,944 |
5.7× |
| Rp Therapy Intravenous Administration (79101) |
$1,097.58 |
$1,663 |
4.8× |
| Salivary Gland Imaging Serial Images (78231) |
$1,023.66 |
$1,551 |
2.6× |
| Scapula (73010) |
$353.10 |
$535 |
3.5× |
| Shoulder 1 view (73020) |
$315.48 |
$478 |
3.7× |
| Shoulder Arthrography (73040) |
$1,657.92 |
$2,512 |
4.9× |
| Sialogram (70390) |
$519.42 |
$787 |
2.2× |
| Skull less than 4 views (70250) |
$326.70 |
$495 |
3.2× |
| Special dosimetry (77331) |
$422.40 |
$640 |
3.2× |
| Special Physics Consult (77370) |
$1,056 |
$1,600 |
8.1× |
| Special teletherapy port plan (77321) |
$1,358.28 |
$2,058 |
3.7× |
| Special treatment procedure (77470) |
$1,909.38 |
$2,893 |
3.6× |
| Speech evaluation, complex (70371) |
$551.76 |
$836 |
2.4× |
| Stereotactic Body Radiation Delivery (77373) |
$7,421.70 |
$11,245 |
4.3× |
| Sternoclavicular joints (71130) |
$315.48 |
$478 |
3.7× |
| Superior sagittal sinus venogram (75870) |
$3,635.28 |
$5,508 |
1.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$414.48 |
$628 |
4.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,457.84 |
$3,724 |
6.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$580.80 |
$880 |
1.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,221.56 |
$3,366 |
6.1× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,056 |
$1,600 |
2.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$867.24 |
$1,314 |
6.6× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$704.22 |
$1,067 |
4.1× |
| Thoracic spine 2 views (72070) |
$329.34 |
$499 |
3.2× |
| Thoracic spine 3 views (72072) |
$380.82 |
$577 |
3.8× |
| Thoracolumbar 2 views (72080) |
$432.96 |
$656 |
5.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$694.98 |
$1,053 |
1.8× |
| Thyroid Met Imaging Body (78018) |
$1,493.58 |
$2,263 |
2.8× |
| Thyroid Uptake Measurement (78012) |
$463.98 |
$703 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,097.58 |
$1,663 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,512.72 |
$2,292 |
4.2× |
| Tx devices design & construction intermediate (77333) |
$754.38 |
$1,143 |
5.8× |
| Tx devices design & construction simple (77332) |
$581.46 |
$881 |
4.5× |
| Ultrasound Breast Limited (76642) |
$392.70 |
$595 |
4.6× |
| Ultrasound Exam Aaa Screen (76706) |
$386.76 |
$586 |
3.8× |
| Ultrasound, abdomen limited (76705) |
$578.16 |
$876 |
5.7× |
| Umbilical-artery Doppler (OB) (76820) |
$292.38 |
$443 |
2.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$258.72 |
$392 |
3.1× |
| Unlisted fluoroscopic procedure (76496) |
$704.22 |
$1,067 |
8.3× |
| Unlisted magnetic resonance procedure (76498) |
$2,233.44 |
$3,384 |
26.4× |
Unlisted Procedure Clinical Brachytherapy (77799)
range across 3 matching MRF lines |
$256.74–$1,358.28 |
$389–$2,058 |
varies |
| Unlisted us procedure (76999) |
$293.70 |
$445 |
3.5× |
| Upper gi w/o kub (74240) |
$514.14 |
$779 |
3.0× |
| Ureteral Reflux Study (78740) |
$1,023.66 |
$1,551 |
2.6× |
| Urethrocystogram voiding (74455) |
$747.78 |
$1,133 |
3.2× |
| Urethrocystography retrograde (74450) |
$747.78 |
$1,133 |
3.2× |
| Us breast unilateral complete (76641) |
$546.48 |
$828 |
5.4× |
| Us chest (76604) |
$405.24 |
$614 |
4.0× |
| Us complete joint (76881) |
$566.28 |
$858 |
5.6× |
| Us exam, pelvic, limited (76857) |
$482.46 |
$731 |
4.8× |
| Us head (76506) |
$629.64 |
$954 |
6.2× |
| Us kidney transplant (76776) |
$573.54 |
$869 |
5.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$384.78 |
$583 |
3.8× |
| Us ob detailed single fetus (76811) |
$650.10 |
$985 |
2.8× |
| Us ob limited 1 or more fetuses (76815) |
$335.28 |
$508 |
3.3× |
| Us ob transvaginal (76817) |
$440.22 |
$667 |
4.3× |
| Us pelvic non ob complete (76856) |
$615.12 |
$932 |
6.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$454.74 |
$689 |
4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$321.42 |
$487 |
3.2× |
| Us retroperitoneal complete (76770) |
$566.28 |
$858 |
5.6× |
| Us retroperitoneal limited (76775) |
$517.44 |
$784 |
5.1× |
| Us scrotum and contents (76870) |
$578.16 |
$876 |
5.7× |
| Us spinal canal and contents (76800) |
$349.80 |
$530 |
3.4× |
| Us thyroid (76536) |
$552.42 |
$837 |
5.4× |
| Us transrectal (76872) |
$228.36 |
$346 |
2.2× |
| Vein X-Ray Chest (75827) |
$2,383.26 |
$3,611 |
1.6× |
| Vein X-Ray Skull Epidural (75872) |
$2,176.02 |
$3,297 |
3.6× |
| Vein X-Ray Spleen/Liver (75810) |
$3,635.28 |
$5,508 |
1.2× |
| Venogram Sinus/Jugular (75860) |
$3,635.28 |
$5,508 |
1.2× |
| Venography Adrenal Unilateral (75840) |
$3,635.28 |
$5,508 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$3,635.28 |
$5,508 |
1.2× |
| Venography extremity bilateral rs&i (75822) |
$1,794.54 |
$2,719 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,794.54 |
$2,719 |
1.2× |
| Venography Orbital Rs&I (75880) |
$1,346.40 |
$2,040 |
2.2× |
| Venography Renal Bilateral (75833) |
$3,635.28 |
$5,508 |
1.2× |
| Venography Renal Unilateral (75831) |
$3,635.28 |
$5,508 |
1.2× |
| Venous sampling by catheter (75893) |
$6,243.60 |
$9,460 |
1.2× |
| Wrist 2 views (73100) |
$315.48 |
$478 |
3.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$315.48 |
$478 |
3.7× |
| X-ray antegrade pyelogram tube (74425) |
$616.44 |
$934 |
1.8× |
| X-Ray Aorta Leg Arteries (75630) |
$4,041.18 |
$6,123 |
1.3× |
| X-Ray Bend Only L-S Spine (72120) |
$582.78 |
$883 |
5.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$315.48 |
$478 |
3.7× |
| X-Ray Exam Breast Specimen (76098) |
$397.98 |
$603 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$315.48 |
$478 |
3.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$380.82 |
$577 |
3.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$347.82 |
$527 |
3.4× |
| X-Ray Exam Hip Uni 1 View (73501) |
$363 |
$550 |
4.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$363.66 |
$551 |
4.3× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$391.38 |
$593 |
3.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$391.38 |
$593 |
3.9× |
X-Ray Exam Hips Bi 3-4 Views (73522)
range across 2 matching MRF lines |
$236.28–$494.34 |
$358–$749 |
varies |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$515.46 |
$781 |
5.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$582.78 |
$883 |
5.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$420.42 |
$637 |
5.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$582.78 |
$883 |
5.7× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$477.18 |
$723 |
4.7× |
| X-ray eye for foreign body (70030) |
$268.62 |
$407 |
3.2× |
| X-ray humerus (73060) |
$315.48 |
$478 |
3.7× |
| X-ray IV pyelogram (ivp) (74400) |
$747.78 |
$1,133 |
4.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$315.48 |
$478 |
3.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$315.48 |
$478 |
3.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$363.66 |
$551 |
3.6× |
| X-ray nose-rectum child f.b. (76010) |
$279.84 |
$424 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$498.30 |
$755 |
4.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$363 |
$550 |
3.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$330 |
$500 |
3.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$391.38 |
$593 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$391.38 |
$593 |
3.9× |
| X-ray thoracic spine 4 vw (72074) |
$347.82 |
$527 |
3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$708.84 |
$1,074 |
2.1× |
| X-Rays Bone Length Studies (77073) |
$450.12 |
$682 |
4.4× |
| X-Rays Bone Survey Complete (77075) |
$516.12 |
$782 |
5.1× |
| Xr c-spine 4 or 5 views (72050) |
$467.28 |
$708 |
4.6× |
| Xr facial bones less than 3 views (70140) |
$315.48 |
$478 |
3.7× |
| Xr orbits complete 4 views (70200) |
$391.38 |
$593 |
3.9× |