| 3-D radiotherapy plan dose-volume histograms (77295) |
$8,612 |
$8,612 |
5.2× |
| Abdomen 2 views (74019) |
$399 |
$399 |
3.2× |
| Angiography extremity bilateral rs&i (75716) |
$8,678 |
$8,678 |
2.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,422 |
$3,422 |
0.9× |
| Ankle 2 views (73600) |
$217 |
$217 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$437 |
$437 |
2.7× |
| Bone age studies (77072) |
$399 |
$399 |
3.2× |
| Bone survey complete (77075) |
$399 |
$399 |
3.2× |
| Cervical spine 2 or 3 views (72040) |
$217 |
$217 |
2.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$399 |
$399 |
1.9× |
| Clavicle complete (73000) |
$217 |
$217 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$677 |
$677 |
5.4× |
| Continuing medical physics consltj pr wk (77336) |
$1,787 |
$1,787 |
11.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,140 |
$3,140 |
7.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,278 |
$1,278 |
4.5× |
| CT abdomen w wo contrast (74170) |
$2,475 |
$2,475 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,022 |
$1,022 |
8.2× |
| CT angio hrt w/3d image (75574) |
$3,220 |
$3,220 |
7.7× |
| CT angiography upper extremity lt (73206) |
$2,726 |
$2,726 |
13.0× |
| CT cervical spine w&w/o contrast (72127) |
$1,749 |
$1,749 |
8.3× |
| CT cervical spine with contrast (72126) |
$1,410 |
$1,410 |
3.4× |
| CT chest w/wo contrast (71270) |
$1,756 |
$1,756 |
8.4× |
| CT colonography screening (74263) |
$967 |
$967 |
3.4× |
| CT colonography w/o cntrst (74261) |
$4,041 |
$4,041 |
32.2× |
| CT head/brain with contrast (70460) |
$1,201 |
$1,201 |
5.7× |
| CT lower ext w/o (73700) |
$1,037 |
$1,037 |
8.3× |
| CT lower extremity with contrast (73701) |
$1,418 |
$1,418 |
6.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,749 |
$1,749 |
8.3× |
| CT lumbar spine w/o contrast (72131) |
$1,037 |
$1,037 |
8.3× |
| CT lumbar spine with contrast (72132) |
$1,410 |
$1,410 |
3.4× |
| CT maxillofacial w contrast (70487) |
$1,255 |
$1,255 |
6.0× |
| CT maxillofacial w/o contrast (70486) |
$1,099 |
$1,099 |
8.8× |
| CT maxillofacial w/wo contrast (70488) |
$1,597 |
$1,597 |
7.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,938 |
$1,938 |
9.2× |
| CT orbits w/o contrast (70480) |
$1,239 |
$1,239 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,033 |
$1,033 |
8.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,865 |
$1,865 |
8.9× |
| CT thoracic spine w/contrast (72129) |
$1,422 |
$1,422 |
6.8× |
| CT thoracic spine w/o contrast (72128) |
$1,041 |
$1,041 |
8.3× |
| CT thorax w/o contrast (71250) |
$1,689.90 |
$1,689.90 |
13.5× |
| CT unlisted procedure (76497) |
$99 |
$99 |
0.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,479 |
$2,479 |
11.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,473 |
$1,473 |
11.8× |
| CT upper extremity with contrast (73201) |
$1,881 |
$1,881 |
4.5× |
| CTA abdomen pelvis (74174) |
$3,465 |
$3,465 |
8.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,987 |
$2,987 |
14.2× |
| Cta Neck (70498) |
$2,405 |
$2,405 |
11.4× |
| Cta Pelvis (72191) |
$2,751 |
$2,751 |
13.1× |
| Cystography minimum 3 views rs&i (74430) |
$880 |
$880 |
2.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$399 |
$399 |
3.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$399 |
$399 |
3.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$399 |
$399 |
3.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$399 |
$399 |
3.2× |
| Dxa bone density study axial skeleton (77085) |
$400 |
$400 |
3.2× |
| Echo exam of fetal heart (76825) |
$1,695 |
$1,695 |
2.6× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$809 |
$809 |
2.8× |
| Esophagus (74220) |
$880 |
$880 |
4.2× |
| Fetal biophysical profile non-stress testing (76818) |
$418 |
$418 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,017 |
$1,017 |
8.1× |
| Fluoroscopy up to 1 hr (76000) |
$809 |
$809 |
2.8× |
| Foot 2 views (73620) |
$217 |
$217 |
2.1× |
| Forearm 2 views (73090) |
$217 |
$217 |
2.1× |
| Hand 2 views (73120) |
$348 |
$348 |
2.8× |
| Hand 3 views (73130) |
$406 |
$406 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,486 |
$2,486 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,540 |
$1,540 |
3.2× |
| Ht muscle image spect sing (78451) |
$4,187 |
$4,187 |
2.7× |
| Humerus Min 2 Views Left (73060) |
$217 |
$217 |
2.1× |
| Hysterosalpingogram (74740) |
$809 |
$809 |
2.8× |
| Knee 3 views (73562) |
$217 |
$217 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,125 |
$1,125 |
2.5× |
| MRA head w/o contrast (70544) |
$1,853 |
$1,853 |
6.5× |
| MRA head with contrast (70545) |
$1,982 |
$1,982 |
4.7× |
| MRA neck w contrast (70548) |
$2,028 |
$2,028 |
4.8× |
| MRI abdomen w contrast (74182) |
$2,654 |
$2,654 |
6.3× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,826 |
$2,826 |
6.8× |
| MRI breast w/o contrast bilateral (77047) |
$1,720 |
$1,720 |
6.0× |
| MRI chest w/o & w/contrast material (71552) |
$4,430 |
$4,430 |
10.6× |
| MRI chest w/o contrast (71550) |
$3,245 |
$3,245 |
11.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,227 |
$2,227 |
5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,909 |
$1,909 |
6.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,297 |
$2,297 |
5.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,819 |
$2,819 |
6.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,462 |
$3,462 |
8.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,452 |
$3,452 |
8.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,539 |
$2,539 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,546 |
$2,546 |
6.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,622 |
$1,622 |
5.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,738 |
$3,738 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,882 |
$2,882 |
10.1× |
| Myocardial Spect Multiple Studies (78452) |
$4,187 |
$4,187 |
2.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,393 |
$2,393 |
2.3× |
| Neck soft tissue (70360) |
$217 |
$217 |
2.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,324 |
$8,324 |
5.0× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$4,795 |
$4,795 |
2.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$399 |
$399 |
3.2× |
| Osseous survey infant (77076) |
$399 |
$399 |
3.2× |
| Parathyrd planar w/spect&CT (78072) |
$1,578 |
$1,578 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$399 |
$399 |
3.2× |
| PET image w/CT, skull-thigh (78815) |
$4,795 |
$4,795 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,795 |
$4,795 |
2.8× |
| PET imaging for CT attenuation whole body (78816) |
$4,795 |
$4,795 |
2.8× |
| PET whole body (78813) |
$4,795 |
$4,795 |
2.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,840 |
$2,840 |
6.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$809 |
$809 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$217 |
$217 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$399 |
$399 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$399 |
$399 |
3.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$399 |
$399 |
3.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$399 |
$399 |
3.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$25,739 |
$25,739 |
2.9× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$766 |
$766 |
1.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,163 |
$1,163 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$399 |
$399 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$217 |
$217 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$399 |
$399 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$880 |
$880 |
4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$632 |
$632 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$880 |
$880 |
4.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$880 |
$880 |
4.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$217 |
$217 |
2.1× |
| Radiological examination surgical specimen (76098) |
$1,695 |
$1,695 |
2.6× |
| Ribs bilateral 3 views (71110) |
$399 |
$399 |
3.2× |
| Sacroiliac Joints < 3 Views (72200) |
$399 |
$399 |
3.2× |
| Scanogram (77073) |
$399 |
$399 |
3.2× |
| Scapula complete (73010) |
$399 |
$399 |
3.2× |
| Screening digital breast tomosynthesis (77063) |
$57 |
$57 |
2.4× |
| Small bowel series (74250) |
$399 |
$399 |
1.9× |
| Spec medical radj physics consltj (77370) |
$437 |
$437 |
2.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,462 |
$1,462 |
3.3× |
| Special dosimetry (77331) |
$557 |
$557 |
3.5× |
| Special treatment procedure (77470) |
$3,327 |
$3,327 |
5.0× |
| Spine thoracic 3 views (72072) |
$399 |
$399 |
3.2× |
| Stereotactic body radiation delivery (77373) |
$12,972 |
$12,972 |
6.1× |
| Superior sagittal sinus venogram (75870) |
$8,585 |
$8,585 |
2.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$4,033 |
$4,033 |
9.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,186 |
$2,186 |
4.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,078 |
$1,078 |
6.7× |
| Thoracolumbar 2 views (72080) |
$217 |
$217 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,578 |
$1,578 |
2.4× |
| Tmj unilateral (70328) |
$387 |
$387 |
3.7× |
| Treatment devices simple (77332) |
$437 |
$437 |
2.7× |
| Tx devices design & construction complex (77334) |
$1,285 |
$1,285 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$399 |
$399 |
3.2× |
| Umbilical-artery Doppler (OB) (76820) |
$399 |
$399 |
3.2× |
| Unlisted magnetic resonance procedure (76498) |
$1,958 |
$1,958 |
18.8× |
| Urethrocystography retrograde rs&i (74450) |
$809 |
$809 |
2.8× |
| Urethrocystography voiding (74455) |
$809 |
$809 |
2.8× |
| Us abdl aorta screen aaa (76706) |
$399 |
$399 |
3.2× |
| Us breast unilateral complete (76641) |
$548.50 |
$548.50 |
4.4× |
| Us breast unilateral limited (76642) |
$597 |
$597 |
5.7× |
| Us compl joint r-t w/image documentation (76881) |
$399 |
$399 |
3.2× |
| Us elastography parenchyma (76981) |
$1,041 |
$1,041 |
8.3× |
| Us fetal nuchal translucency 1st gestation (76813) |
$405 |
$405 |
3.2× |
| Us kidney transplant (76776) |
$399 |
$399 |
3.2× |
| Us ob detailed single fetus (76811) |
$399 |
$399 |
1.4× |
| Us ob transvaginal (76817) |
$399 |
$399 |
3.2× |
| Us pelvic non ob complete (76856) |
$399 |
$399 |
3.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$399 |
$399 |
3.2× |
| Us pregnancy ltd (76815) |
$399 |
$399 |
3.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$399 |
$399 |
3.2× |
| Us retroperitoneal complete (76770) |
$399 |
$399 |
3.2× |
| Us retroperitoneal limited (76775) |
$399 |
$399 |
3.2× |
| Us scrotum and contents (76870) |
$399 |
$399 |
3.2× |
| Us soft tissue head/neck (76536) |
$399 |
$399 |
3.2× |
| Us xtr non-vasc lmtd (76882) |
$399 |
$399 |
3.2× |
| Us, eye b-scan (76512) |
$388 |
$388 |
3.1× |
| Venography extremity unilateral rs&i (75820) |
$2,133 |
$2,133 |
1.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$8,678 |
$8,678 |
2.3× |
| Wrist 2 views (73100) |
$217 |
$217 |
2.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$400 |
$400 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$217 |
$217 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$880 |
$880 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$217 |
$217 |
2.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$217 |
$217 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$217 |
$217 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$217 |
$217 |
2.1× |
| X-ray exam hip uni 4/> views (73503) |
$399 |
$399 |
3.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$399 |
$399 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$399 |
$399 |
3.2× |
| X-ray exam of femur 1 (73551) |
$217 |
$217 |
2.1× |
| X-ray eye for foreign body (70030) |
$217 |
$217 |
2.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$399 |
$399 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$277 |
$277 |
2.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$217 |
$217 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$217 |
$217 |
2.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$277 |
$277 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$388 |
$388 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$217 |
$217 |
2.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$399 |
$399 |
3.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$399 |
$399 |
3.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$399 |
$399 |
3.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$217 |
$217 |
2.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$217 |
$217 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$399 |
$399 |
3.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$399 |
$399 |
3.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,589 |
$1,589 |
3.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$217 |
$217 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$399 |
$399 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$399 |
$399 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$399 |
$399 |
3.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$217 |
$217 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$217 |
$217 |
2.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$217 |
$217 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$399 |
$399 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$399 |
$399 |
3.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$217 |
$217 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$217 |
$217 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$399 |
$399 |
3.2× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$375 |
$375 |
3.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$217 |
$217 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$217 |
$217 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$399 |
$399 |
3.2× |
| Xr finger(s) 2+ views (73140) |
$217 |
$217 |
2.1× |
| Xr shoulder 1 view (73020) |
$217 |
$217 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$399 |
$399 |
3.2× |
| Xr tibia/fibula 2 views (73590) |
$217 |
$217 |
2.1× |
| Xr tmj bilateral (70330) |
$217 |
$217 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$300 |
$300 |
2.9× |