| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,273.75 |
$8,365 |
3.8× |
| Abdomen 2 views (74019) |
$621.75 |
$829 |
5.0× |
| Acute gi blood loss imaging (78278) |
$2,706 |
$3,608 |
5.6× |
| Angio Adrenal Bilat Select (75733) |
$17,713.50 |
$23,618 |
4.7× |
| Angiography extremity bilateral rs&i (75716) |
$9,109.50 |
$12,146 |
2.4× |
| Angiography extremity unilateral rs&i (75710) |
$12,981.75 |
$17,309 |
3.4× |
| Angiography internal mammary rs&i (75756) |
$7,624.50 |
$10,166 |
2.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$10,509.75 |
$14,013 |
1.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$8,290.50 |
$11,054 |
2.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$10,281.38 |
$13,708.50 |
2.7× |
| Angiography Spinal Selective Rs&I (75705) |
$12,364.50 |
$16,486 |
1.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$14,123.25 |
$18,831 |
2.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$5,313.38 |
$7,084.50 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$6,455.25 |
$8,607 |
1.7× |
| Ankle 2 views (73600) |
$978 |
$1,304 |
9.4× |
| Aortogram thoracic (75605) |
$10,549.88 |
$14,066.50 |
1.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$12,911.62 |
$17,215.50 |
3.4× |
| Aortography abdominal serialography rs&i (75625) |
$9,956.25 |
$13,275 |
2.6× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$9,851.25 |
$13,135 |
2.6× |
| Arthrogram ankle (73615) |
$2,624.25 |
$3,499 |
6.3× |
| Arthrogram elbow (73085) |
$3,107.25 |
$4,143 |
7.4× |
| Arthrogram hip (73525) |
$2,212.12 |
$2,949.50 |
5.3× |
| Arthrogram knee (73580) |
$2,280.75 |
$3,041 |
5.5× |
| Arthrogram shoulder (73040) |
$1,834.50 |
$2,446 |
4.4× |
| Arthrogram wrist (73115) |
$2,212.50 |
$2,950 |
5.3× |
| Basic dosimetry (77300) |
$496.50 |
$662 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,944 |
$2,592 |
4.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$3,163.50 |
$4,218 |
6.6× |
| Bone &/joint imaging whole body (78306) |
$3,850.50 |
$5,134 |
8.0× |
| Bone age studies (77072) |
$471 |
$628 |
3.8× |
| Bone Imaging 3 Phase (78315) |
$3,644.25 |
$4,859 |
7.6× |
| Bone survey complete (77075) |
$1,204.50 |
$1,606 |
9.6× |
| Bone survey infant (77076) |
$860.25 |
$1,147 |
6.9× |
| Bowel imaging (78290) |
$1,723.50 |
$2,298 |
3.6× |
| Brachytx isodose complex (77318) |
$3,167.25 |
$4,223 |
7.1× |
| Brachytx isodose intermed (77317) |
$4,323.75 |
$5,765 |
9.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,554 |
$2,072 |
3.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$2,280 |
$3,040 |
3.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$7,504.50 |
$10,006 |
4.4× |
| Brain Imaging Vascular Flow Only (78610) |
$2,649.75 |
$3,533 |
4.1× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$4,261.50 |
$5,682 |
8.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$6,522 |
$8,696 |
15.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,161.50 |
$2,882 |
3.3× |
| Cervical spine 2 or 3 views (72040) |
$1,597.50 |
$2,130 |
15.3× |
| Chest 1 view (71045) |
$444.75 |
$593 |
4.3× |
| Chest xray 3 views (71047) |
$334.50 |
$446 |
3.2× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$830.25 |
$1,107 |
3.9× |
| Clavicle complete (73000) |
$1,039.50 |
$1,386 |
10.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$300 |
$400 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$951.75 |
$1,269 |
5.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,863 |
$10,484 |
18.8× |
| CT abdomen and pelvis without contrast (74176) |
$5,550 |
$7,400 |
19.4× |
| CT abdomen w contrast (74160) |
$3,078 |
$4,104 |
14.6× |
| CT abdomen w wo contrast (74170) |
$2,382 |
$3,176 |
11.3× |
| CT abdomen w/o contrast (74150) |
$2,061 |
$2,748 |
16.4× |
| CT angio hrt w/3d image (75574) |
$2,239.50 |
$2,986 |
5.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$3,541.88 |
$4,722.50 |
16.8× |
| CT angiography upper extremity lt (73206) |
$4,522.88 |
$6,030.50 |
21.5× |
| CT c-spine w/contrast (72126) |
$3,582 |
$4,776 |
8.6× |
| CT c-spine w/o contrast (72125) |
$3,248.25 |
$4,331 |
25.9× |
| CT cervical spine w&w/o contrast (72127) |
$7,481.25 |
$9,975 |
35.6× |
| CT chest w contrast (71260) |
$3,990 |
$5,320 |
19.0× |
| CT chest w/wo contrast (71270) |
$2,382 |
$3,176 |
11.3× |
| CT head/brain with contrast (70460) |
$1,434 |
$1,912 |
6.8× |
| CT head/brain without and with contrast (70470) |
$3,624.75 |
$4,833 |
17.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,498.75 |
$4,665 |
8.4× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$291.75 |
$389 |
2.8× |
| CT hrt w/3d image congen (75573) |
$2,441.25 |
$3,255 |
5.8× |
| CT iac w contrast (70481) |
$2,692.50 |
$3,590 |
12.8× |
| CT limited/localized follow up study (76380) |
$3,026.25 |
$4,035 |
29.0× |
| CT lower ext w/o (73700) |
$3,609 |
$4,812 |
28.8× |
| CT lower extremity w wo contrast (73702) |
$2,772.75 |
$3,697 |
13.2× |
| CT lower extremity w/contrast material (73701) |
$3,203.25 |
$4,271 |
15.2× |
| CT lumbar spine w & w/o contrast (72133) |
$6,093 |
$8,124 |
29.0× |
| CT lumbar spine w/contrast (72132) |
$3,488.25 |
$4,651 |
8.3× |
| CT lumbar spine w/o contrast (72131) |
$4,456.50 |
$5,942 |
35.6× |
| CT maxillofacial w contrast (70487) |
$2,424.75 |
$3,233 |
11.5× |
| CT maxillofacial w/wo contrast (70488) |
$5,487.75 |
$7,317 |
26.1× |
| CT maxillofacial wo contrast (70486) |
$1,949.62 |
$2,599.50 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$7,763.25 |
$10,351 |
36.9× |
| CT orbits w/o contrast (70480) |
$2,628.75 |
$3,505 |
21.0× |
| CT pelvis w/o contrast (72192) |
$2,154.75 |
$2,873 |
17.2× |
| CT pelvis w/wo contrast (72194) |
$2,598 |
$3,464 |
12.4× |
| CT scan of arm combo (73202) |
$4,578 |
$6,104 |
21.8× |
| CT soft tissue neck w contrast (70491) |
$4,361.25 |
$5,815 |
20.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,273 |
$4,364 |
15.6× |
| CT soft tissue neck w/o contrast (70490) |
$2,429.25 |
$3,239 |
19.4× |
| CT thoracic spine w/contrast (72129) |
$3,975 |
$5,300 |
18.9× |
| CT thoracic spine w/o contrast (72128) |
$1,833 |
$2,444 |
14.6× |
| CT thoracic spine w/wo contrast (72130) |
$4,458 |
$5,944 |
21.2× |
| CT thorax w/o contrast (71250) |
$3,367.50 |
$4,490 |
26.9× |
| CT unlisted procedure (76497) |
$2,562.75 |
$3,417 |
24.6× |
| CT upper ext wo (73200) |
$3,178.50 |
$4,238 |
25.4× |
| CT upper extremity with contrast (73201) |
$2,714.25 |
$3,619 |
6.5× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,541.75 |
$3,389 |
12.1× |
| Cta Abdomen (74175) |
$3,114.38 |
$4,152.50 |
14.8× |
| CTA abdomen pelvis (74174) |
$4,458.38 |
$5,944.50 |
10.7× |
| CTA chest (71275) |
$4,120.50 |
$5,494 |
19.6× |
| Cta Head (70496) |
$3,825.75 |
$5,101 |
18.2× |
| Cta Neck (70498) |
$2,707.12 |
$3,609.50 |
12.9× |
| Cta Pelvis (72191) |
$5,984.25 |
$7,979 |
28.5× |
| Cystography minimum 3 views rs&i (74430) |
$2,307.75 |
$3,077 |
5.5× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$4,193.25 |
$5,591 |
1.7× |
| Diskography lumbar (72295) |
$10,802.25 |
$14,403 |
4.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$1,086 |
$1,448 |
8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$1,641.75 |
$2,189 |
13.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$703.50 |
$938 |
5.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,692 |
$2,256 |
13.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$1,039.50 |
$1,386 |
10.0× |
| Dxa bone density study axial skeleton (77085) |
$192 |
$256 |
1.5× |
| Echo exam of eye (76529) |
$924.75 |
$1,233 |
8.9× |
| Esophagus (74220) |
$1,588.50 |
$2,118 |
7.6× |
| Facial bones min 3 views (70150) |
$890.25 |
$1,187 |
7.1× |
| Fetal biophysical profile non-stress testing (76818) |
$1,687.50 |
$2,250 |
13.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,529.25 |
$2,039 |
12.2× |
| Fluoroscopy up to 1 hr (76000) |
$708.75 |
$945 |
2.5× |
| Foot 2 views (73620) |
$744 |
$992 |
7.1× |
| Forearm 2 views (73090) |
$1,036.50 |
$1,382 |
9.9× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$4,359.75 |
$5,813 |
9.1× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$5,784 |
$7,712 |
8.9× |
| Hand 2 views (73120) |
$887.25 |
$1,183 |
7.1× |
| Heart Infarct Image (78466) |
$4,672.50 |
$6,230 |
9.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$7,166.25 |
$9,555 |
1.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$13,273.50 |
$17,698 |
3.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,492.50 |
$5,990 |
6.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,354.25 |
$3,139 |
4.9× |
| Hysterosalpingogram (74740) |
$2,723.25 |
$3,631 |
9.5× |
| Interstitial radiation source applic complex (77778) |
$3,671.25 |
$4,895 |
4.4× |
| Kidney imaging morphology (78700) |
$1,623.75 |
$2,165 |
3.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,549.75 |
$4,733 |
5.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,820.50 |
$5,094 |
5.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,578.75 |
$2,105 |
2.4× |
| Knee 3 views (73562) |
$1,073.25 |
$1,431 |
10.3× |
| Liver & spleen imaging static only (78215) |
$2,703.75 |
$3,605 |
5.6× |
| Liver imaging static only (78201) |
$4,363.50 |
$5,818 |
6.7× |
| Lung perf&ventilat diferentl (78598) |
$2,182.50 |
$2,910 |
3.4× |
| Lung perfusion differential (78597) |
$1,797 |
$2,396 |
3.8× |
| Lung ventilation imaging (78579) |
$1,604.25 |
$2,139 |
3.3× |
| Lymphoscintigraphy (78195) |
$4,437.75 |
$5,917 |
6.8× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$6,804.75 |
$9,073 |
7.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$9,723 |
$12,964 |
23.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$6,721.50 |
$8,962 |
16.1× |
| Mammary ductogram or galactogram multiple (77054) |
$1,516.50 |
$2,022 |
5.3× |
| Mammary ductogram or galactogram single (77053) |
$1,921.50 |
$2,562 |
6.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,390.50 |
$1,854 |
3.1× |
| Mr safety determination physician/other qhp (76016) |
$360 |
$480 |
3.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$99.75 |
$133 |
2.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$375 |
$500 |
3.3× |
| Mr safety implt pos&/immoblj (76019) |
$243 |
$324 |
3.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$987.75 |
$1,317 |
3.5× |
| MRA head w & w/o contrast (70546) |
$5,155.50 |
$6,874 |
12.3× |
| MRA head w/o contrast (70544) |
$4,718.25 |
$6,291 |
16.5× |
| MRA head with contrast (70545) |
$2,427.75 |
$3,237 |
5.8× |
| MRA neck w contrast (70548) |
$2,427.75 |
$3,237 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$5,155.50 |
$6,874 |
12.3× |
| MRA neck w/o contrast (70547) |
$4,184.25 |
$5,579 |
14.6× |
| MRI abdomen w contrast (74182) |
$6,868.50 |
$9,158 |
16.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$11,900.25 |
$15,867 |
28.5× |
| MRI abdomen w/o contrast (74181) |
$8,108.25 |
$10,811 |
28.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$7,279.50 |
$9,706 |
7.7× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$8,351.25 |
$11,135 |
20.0× |
| MRI breast w/o contrast bilateral (77047) |
$10,817.25 |
$14,423 |
37.8× |
| MRI breast wo contrast unilateral (77046) |
$11,128.50 |
$14,838 |
38.9× |
| MRI c-spine with contrast (72142) |
$6,405 |
$8,540 |
15.3× |
| MRI cervical spine w/o contrast (72141) |
$5,655.75 |
$7,541 |
19.8× |
| MRI chest w/o & w/contrast material (71552) |
$3,770.25 |
$5,027 |
9.0× |
| MRI chest w/o contrast (71550) |
$4,108.50 |
$5,478 |
14.4× |
| MRI chest with contrast (71551) |
$6,756.75 |
$9,009 |
7.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$10,835.25 |
$14,447 |
25.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$10,093.50 |
$13,458 |
24.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,931.50 |
$9,242 |
24.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,357.75 |
$4,477 |
11.7× |
| MRI orbit face neck w contrast (70542) |
$5,742.75 |
$7,657 |
13.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$6,824.25 |
$9,099 |
16.3× |
| MRI pelvis w/contrast (72196) |
$8,226.75 |
$10,969 |
19.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$8,067 |
$10,756 |
19.3× |
| MRI pelvis w/o contrast (72195) |
$6,234.75 |
$8,313 |
21.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$6,786 |
$9,048 |
16.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,532 |
$7,376 |
13.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$15,123.75 |
$20,165 |
36.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$8,958 |
$11,944 |
21.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,523.25 |
$10,031 |
18.0× |
| MRI temporomandibular joint (70336) |
$2,833.50 |
$3,778 |
9.9× |
| MRI thoracic spine w/o contrast (72146) |
$5,800.50 |
$7,734 |
20.3× |
| MRI up ext w/o contrast (73218) |
$4,897.50 |
$6,530 |
17.1× |
| MRI upper ext joint w/o contrast (73221) |
$12,876.75 |
$17,169 |
45.0× |
| MRI, joint upper extrem combo (73223) |
$5,671.50 |
$7,562 |
13.6× |
| Myelogram Cervical (72240) |
$1,899.75 |
$2,533 |
2.0× |
| Myelogram Lumbar (72265) |
$1,859.25 |
$2,479 |
2.0× |
| Myelogram thoracic (72255) |
$2,589.75 |
$3,453 |
2.8× |
| Myelography 2 or more regions (72270) |
$5,813.25 |
$7,751 |
6.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$4,488 |
$5,984 |
2.9× |
| Myocardial Perfusion Planar Multiple Studies (78454) |
$5,746.50 |
$7,662 |
3.7× |
| Myocardial Spect Multiple Studies (78452) |
$8,033.25 |
$10,711 |
5.2× |
| Myocardial spect single study at rest or stress (78451) |
$4,653.75 |
$6,205 |
3.0× |
| Neck soft tissue (70360) |
$811.50 |
$1,082 |
7.8× |
| Nm adrenal scan (78075) |
$4,864.50 |
$6,486 |
3.1× |
| Nm bone marrow wb (78104) |
$2,076.75 |
$2,769 |
4.3× |
| Nm cardiac blood pool multiple (78473) |
$3,829.50 |
$5,106 |
8.0× |
| Nm cisternogram (78630) |
$2,814 |
$3,752 |
4.3× |
| Nm csf leak detection (78650) |
$2,109.75 |
$2,813 |
1.4× |
| Nm gastric emptying study (78264) |
$1,419 |
$1,892 |
3.0× |
| Nm gastroesophageal reflux study (78262) |
$1,725 |
$2,300 |
3.6× |
| Nm kidney scan w/flow (78701) |
$1,862.25 |
$2,483 |
3.9× |
| Nm peritoneal-venous shunt patency (78291) |
$2,350.50 |
$3,134 |
4.9× |
| Noncardiac Vascular Flow Imaging (78445) |
$2,518.50 |
$3,358 |
5.3× |
| Nonvascular shunt X-ray (75809) |
$1,514.25 |
$2,019 |
12.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,205.25 |
$5,607 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$1,650.75 |
$2,201 |
5.9× |
| Ob us nuchal meas 1 gest (76813) |
$1,597.50 |
$2,130 |
12.8× |
| Osseous survey limited (77074) |
$1,233 |
$1,644 |
9.8× |
| Parathyroid Planar Imaging (78070) |
$2,027.25 |
$2,703 |
4.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$4,692 |
$6,256 |
9.8× |
| Pelvis 1 or 2 views (72170) |
$837.75 |
$1,117 |
6.7× |
| PET image w/CT, skull-thigh (78815) |
$8,530.50 |
$11,374 |
5.0× |
| PET imaging CT for attenuation limited area (78814) |
$8,349.75 |
$11,133 |
4.9× |
| PET imaging for CT attenuation whole body (78816) |
$8,995.50 |
$11,994 |
5.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$7,166.25 |
$9,555 |
1.9× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$6,900.75 |
$9,201 |
1.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,521 |
$2,028 |
3.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,883 |
$3,844 |
4.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,513.88 |
$2,018.50 |
2.3× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$1,307.25 |
$1,743 |
12.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$672 |
$896 |
6.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$1,125.75 |
$1,501 |
10.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$337.50 |
$450 |
3.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$500.25 |
$667 |
4.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$1,419 |
$1,892 |
11.3× |
| Radex fingr minimum 2 views (73140) |
$783.75 |
$1,045 |
7.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$1,180.50 |
$1,574 |
11.3× |
| Radex Hand Minimum 3 Views (73130) |
$1,255.50 |
$1,674 |
12.0× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$492.75 |
$657 |
4.7× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$733.50 |
$978 |
5.9× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$735 |
$980 |
5.9× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$1,185.75 |
$1,581 |
9.5× |
| Radex Humerus Minimum 2 Views (73060) |
$1,226.25 |
$1,635 |
11.8× |
| Radex Kne 1/2 Views (73560) |
$1,071.75 |
$1,429 |
10.3× |
| Radex Kne Compl 4/More Views (73564) |
$1,062 |
$1,416 |
8.5× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$911.25 |
$1,215 |
7.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$695.25 |
$927 |
6.7× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$809.25 |
$1,079 |
6.5× |
| Radex Sho Compl Minimum 2 Views (73030) |
$1,231.50 |
$1,642 |
11.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$605.25 |
$807 |
5.8× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$350.25 |
$467 |
2.8× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$362.25 |
$483 |
3.5× |
| Radex Toe Minimum 2 Views (73660) |
$350.25 |
$467 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$941.25 |
$1,255 |
7.5× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$1,086 |
$1,448 |
10.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$1,036.50 |
$1,382 |
8.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$51,601.50 |
$68,802 |
5.8× |
| Radiation treatment delivery level 1 (77402) |
$1,005.75 |
$1,341 |
8.2× |
| Radiation treatment delivery level 2 (77407) |
$1,617.75 |
$2,157 |
3.5× |
| Radiation treatment delivery level 3 (77412) |
$3,381 |
$4,508 |
5.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$489 |
$652 |
4.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$569.25 |
$759 |
4.5× |
| Radiologic exam chest 2 views (71046) |
$450.75 |
$601 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$1,080.75 |
$1,441 |
5.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$154.50 |
$206 |
0.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,944 |
$2,592 |
9.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,151 |
$2,868 |
10.2× |
| Radiologic examination femur 1 view (73551) |
$337.50 |
$450 |
3.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$1,096.50 |
$1,462 |
10.5× |
| Radiological examination surgical specimen (76098) |
$1,882.50 |
$2,510 |
2.9× |
| Ribs bilateral 3 views (71110) |
$855.75 |
$1,141 |
6.8× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$1,674 |
$2,232 |
3.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,913.75 |
$3,885 |
6.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$7,109.25 |
$9,479 |
10.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$9,162.75 |
$12,217 |
14.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,549.25 |
$3,399 |
3.9× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,936 |
$5,248 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,830.75 |
$2,441 |
6.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,743 |
$2,324 |
6.2× |
| Sacroiliac Joints < 3 Views (72200) |
$416.25 |
$555 |
3.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$2,016.75 |
$2,689 |
7.1× |
| Scapula (73010) |
$1,365 |
$1,820 |
10.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$547.50 |
$730 |
23.4× |
| Shoulder 1 view (73020) |
$470.25 |
$627 |
4.5× |
| Sialogram (70390) |
$1,136.25 |
$1,515 |
4.0× |
| Simulation intermediate (77285) |
$2,260.50 |
$3,014 |
5.0× |
| Small bowel series (74250) |
$812.25 |
$1,083 |
3.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,908.50 |
$3,878 |
6.5× |
| Special dosimetry (77331) |
$396 |
$528 |
2.5× |
| Special Physics Consult (77370) |
$1,165.88 |
$1,554.50 |
7.2× |
| Special treatment procedure (77470) |
$3,526.12 |
$4,701.50 |
5.3× |
| Spine thoracic 3 views (72072) |
$1,071.75 |
$1,429 |
8.6× |
| Spleen imaging only (78185) |
$1,869.75 |
$2,493 |
3.9× |
| Stereotactic Body Radiation Delivery (77373) |
$20,670.75 |
$27,561 |
9.6× |
| Superior sagittal sinus venogram (75870) |
$3,115.50 |
$4,154 |
0.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,185 |
$5,580 |
9.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,097.75 |
$2,797 |
4.7× |
| Testicular Imaging With Vascular Flow (78761) |
$2,049.75 |
$2,733 |
4.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$5,593.50 |
$7,458 |
12.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,388.25 |
$1,851 |
8.6× |
| Thoracolumbar 2 views (72080) |
$843 |
$1,124 |
8.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,681.50 |
$2,242 |
2.6× |
| Thyroid imaging w/blood flow (78013) |
$660.75 |
$881 |
1.4× |
| Thyroid uptake measurement (78012) |
$975.75 |
$1,301 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,445 |
$3,260 |
5.1× |
| Treatment device complex (77334) |
$2,592 |
$3,456 |
5.8× |
| Treatment device intermediate (77333) |
$1,707 |
$2,276 |
10.6× |
| Treatment devices simple (77332) |
$1,045.50 |
$1,394 |
6.5× |
| Ultrasound breast complete (76641) |
$981 |
$1,308 |
7.8× |
| Ultrasound Exam Aaa Screen (76706) |
$1,997.62 |
$2,663.50 |
15.9× |
| Ultrasound, abdomen limited (76705) |
$2,709.75 |
$3,613 |
21.6× |
| Umbilical-artery Doppler (OB) (76820) |
$996.75 |
$1,329 |
8.0× |
| Unlisted magnetic resonance procedure (76498) |
$4,152 |
$5,536 |
39.8× |
| Ureteral reflux study (78740) |
$1,311.75 |
$1,749 |
2.7× |
| Urethrocystogram voiding (74455) |
$2,061 |
$2,748 |
7.2× |
| Urethrocystography retrograde rs&i (74450) |
$1,742.62 |
$2,323.50 |
6.1× |
| Us breast unilateral limited (76642) |
$1,446.75 |
$1,929 |
13.9× |
| Us chest (76604) |
$649.50 |
$866 |
5.2× |
| Us compl joint r-t w/image documentation (76881) |
$701.25 |
$935 |
5.6× |
| Us encephalogram (76506) |
$922.50 |
$1,230 |
7.4× |
| Us infant hips w manipulation (76885) |
$900.75 |
$1,201 |
8.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$1,111.12 |
$1,481.50 |
8.9× |
| Us ob detailed single fetus (76811) |
$3,604.50 |
$4,806 |
12.6× |
| Us ob limited (76815) |
$1,430.25 |
$1,907 |
11.4× |
| Us ob transvaginal (76817) |
$755.25 |
$1,007 |
6.0× |
| Us pelvic non ob complete (76856) |
$3,071.25 |
$4,095 |
24.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$694.88 |
$926.50 |
5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$458.25 |
$611 |
3.7× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$697.50 |
$930 |
5.6× |
| Us retroperitoneal complete (76770) |
$2,543.25 |
$3,391 |
20.3× |
| Us retroperitoneal limited (76775) |
$735 |
$980 |
5.9× |
| Us scrotum and contents (76870) |
$1,308.75 |
$1,745 |
10.4× |
| Us soft tissue head/neck (76536) |
$1,461 |
$1,948 |
11.7× |
| Us spinal canal and contents (76800) |
$603 |
$804 |
4.8× |
| Us transrectal (76872) |
$1,229.25 |
$1,639 |
9.8× |
| Us transrectal prostate volume (76873) |
$1,263 |
$1,684 |
10.1× |
| Us, eye b-scan (76512) |
$1,089 |
$1,452 |
8.7× |
| Us,transplanted kidney, real time/ doppler (76776) |
$1,116.75 |
$1,489 |
8.9× |
| Venogram adrenal unilat (75840) |
$17,044.50 |
$22,726 |
4.5× |
| Venogram extremity bilateral (75822) |
$4,078.50 |
$5,438 |
2.2× |
| Venogram Extremity Unilateral (75820) |
$3,612.38 |
$4,816.50 |
1.9× |
| Venography caval inferior serialography rs&i (75825) |
$7,578.75 |
$10,105 |
2.0× |
| Venography caval superior serialography rs&i (75827) |
$4,411.88 |
$5,882.50 |
2.3× |
| Venography Renal Bilateral (75833) |
$11,285.25 |
$15,047 |
3.0× |
| Venography renal unilateral selective rs&i (75831) |
$10,264.50 |
$13,686 |
2.7× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,606.75 |
$4,809 |
1.0× |
| Venography, epidural, radiological supervision and interpretation Non-Facility (75872) |
$2,783.25 |
$3,711 |
3.7× |
| Venous sampling by catheter (75893) |
$10,369.50 |
$13,826 |
1.6× |
| Venous thrombosis imaging, venogram; unilateral Non-Facility (78457) |
$2,004 |
$2,672 |
3.1× |
| Wrist 2 views (73100) |
$900.75 |
$1,201 |
8.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$1,137 |
$1,516 |
9.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$561 |
$748 |
5.4× |
| X-ray b.e. reductn intuss (74283) |
$3,711 |
$4,948 |
17.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,155.75 |
$1,541 |
5.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,158.75 |
$1,545 |
11.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$727.88 |
$970.50 |
7.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$687.75 |
$917 |
5.5× |
| X-ray exam of femur 2/> (73552) |
$492.75 |
$657 |
4.7× |
| X-ray eye for foreign body (70030) |
$594 |
$792 |
5.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$687.75 |
$917 |
6.6× |
| X-ray IV pyelogram (ivp) (74400) |
$2,599.50 |
$3,466 |
12.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$863.25 |
$1,151 |
8.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$879 |
$1,172 |
8.4× |
| X-ray leg, infant (73592) |
$474.75 |
$633 |
4.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$1,807.50 |
$2,410 |
14.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,481.25 |
$1,975 |
11.8× |
| X-ray nose-rectum child f.b. (76010) |
$789.75 |
$1,053 |
7.6× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,162.50 |
$1,550 |
9.3× |
| X-ray retrograde pyelogram (74420) |
$1,260.75 |
$1,681 |
3.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$784.50 |
$1,046 |
7.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,558.50 |
$2,078 |
12.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,086.75 |
$1,449 |
8.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$789.75 |
$1,053 |
6.3× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$990 |
$1,320 |
9.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$742.50 |
$990 |
7.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,024.50 |
$1,366 |
8.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$745.50 |
$994 |
6.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$643.50 |
$858 |
6.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$366 |
$488 |
3.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$794.25 |
$1,059 |
7.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,388.25 |
$1,851 |
11.1× |
| Xr bone length studies (77073) |
$520.50 |
$694 |
4.2× |
| Xr c-spine 4 or 5 views (72050) |
$1,515 |
$2,020 |
12.1× |
| Xr c-spine 6 or more views (72052) |
$799.50 |
$1,066 |
6.4× |
| Xr chest 4+ views (71048) |
$607.50 |
$810 |
4.8× |
| Xr urogram antegrade (74425) |
$2,046.38 |
$2,728.50 |
4.9× |