| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,716.50 |
$5,433 |
1.9× |
| Abdomen 1 View (74018) |
$106 |
$212 |
1.2× |
| Abdomen 2 views (74019) |
$201.50 |
$403 |
1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$397 |
$794 |
1.0× |
| Angio internal mammary (75756) |
$3,800.50 |
$7,601 |
1.2× |
| Angio pulmonary bilat (75743) |
$2,110.50 |
$4,221 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,110.50 |
$4,221 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$2,110.50 |
$4,221 |
0.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,110.50 |
$4,221 |
0.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,755.50 |
$7,511 |
1.1× |
| Ankle 2 views (73600) |
$206.50 |
$413 |
2.3× |
| Aortography thoracic serialography rs&i (75605) |
$5,155.50 |
$10,311 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$5,155.50 |
$10,311 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,237 |
$4,474 |
0.7× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$1,862.50 |
$3,725 |
0.3× |
| Artery X-Rays Spine (75705) |
$7,146 |
$14,292 |
1.2× |
| Arthrogram hip (73525) |
$619.50 |
$1,239 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$306 |
$612 |
2.2× |
| Bone age studies (77072) |
$198 |
$396 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$996.50 |
$1,993 |
2.4× |
| Bone Imaging Limited Area (78300) |
$634.50 |
$1,269 |
1.5× |
| Bone Imaging Multiple Areas (78305) |
$779.50 |
$1,559 |
1.9× |
| Bone Imaging Whole Body (78306) |
$996.50 |
$1,993 |
2.4× |
| Bone marrow imaging limited area (78102) |
$668.50 |
$1,337 |
1.6× |
| Bone survey infant (77076) |
$172.50 |
$345 |
1.6× |
| Brachytx isodose complex (77318) |
$433.50 |
$867 |
1.1× |
| Brachytx isodose intermed (77317) |
$433.50 |
$867 |
1.1× |
| Brachytx Isodose Plan Simple (77316) |
$156 |
$312 |
0.4× |
| Brain Image W/Flow < 4 Views (78601) |
$208.50 |
$417 |
0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,844.50 |
$3,689 |
5.1× |
| Cat Scan Follow-Up Study (76380) |
$467.50 |
$935 |
5.2× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$414.50 |
$829 |
0.7× |
| Chest 1 view (71045) |
$106 |
$212 |
1.2× |
| Chest 2 views (71046) |
$106 |
$212 |
1.2× |
| Chest 3 views (71047) |
$106 |
$212 |
1.2× |
| Chest 4 or more views (71048) |
$201.50 |
$403 |
1.9× |
| Cisternography Positive Contrast Rs&I (70015) |
$598 |
$1,196 |
0.7× |
| Clavicle complete (73000) |
$235 |
$470 |
2.6× |
| Continuing medical physics consltj pr wk (77336) |
$303.50 |
$607 |
2.2× |
| Contrast Exam Abdominl Aorta (75625) |
$5,938 |
$11,876 |
1.8× |
| Contrast X-Ray Bladder (74430) |
$644 |
$1,288 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,588 |
$5,176 |
7.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,068.50 |
$2,137 |
4.3× |
| CT abdomen w contrast (74160) |
$1,110.50 |
$2,221 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,802 |
$3,604 |
9.9× |
| CT abdomen w/o contrast (74150) |
$1,020.50 |
$2,041 |
9.4× |
| CT Angio Abdomen and Pelvis (74174) |
$1,727 |
$3,454 |
4.8× |
| CT Angio Chest (71275) |
$1,290.50 |
$2,581 |
7.1× |
| CT Angio Head (70496) |
$1,322 |
$2,644 |
7.3× |
| CT angio hrt w/3d image (75574) |
$800.50 |
$1,601 |
2.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,520.50 |
$3,041 |
8.4× |
| CT Angio Neck (70498) |
$1,241 |
$2,482 |
6.8× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,162.50 |
$4,325 |
11.9× |
| CT cervical spine w/ contrast (72126) |
$1,115.50 |
$2,231 |
3.1× |
| CT cervical spine w/o contrast (72125) |
$1,094 |
$2,188 |
10.1× |
| CT chest w contrast (71260) |
$1,151 |
$2,302 |
6.3× |
| CT chest w/wo contrast (71270) |
$1,221 |
$2,442 |
6.7× |
| CT head/brain with contrast (70460) |
$1,097.50 |
$2,195 |
6.0× |
| CT head/brain without and with contrast (70470) |
$1,230 |
$2,460 |
6.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$539 |
$1,078 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$199 |
$398 |
2.2× |
| CT iac w contrast (70481) |
$1,279 |
$2,558 |
7.0× |
| CT l-spine w&w/o contrast (72133) |
$2,250 |
$4,500 |
12.4× |
| CT lower ext w/o (73700) |
$983.50 |
$1,967 |
9.1× |
| CT lower extremity w/contrast material (73701) |
$1,330.50 |
$2,661 |
7.3× |
| CT lumbar spine w contrast (72132) |
$1,227 |
$2,454 |
3.4× |
| CT lumbar spine w/o contrast (72131) |
$1,113.50 |
$2,227 |
10.3× |
| CT maxillofacial w contrast (70487) |
$953 |
$1,906 |
5.3× |
| CT maxillofacial wo contrast (70486) |
$942.50 |
$1,885 |
8.7× |
| CT neck tissue combo (70492) |
$641.50 |
$1,283 |
3.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$983.50 |
$1,967 |
5.4× |
| CT orbits w/o contrast (70480) |
$1,162.50 |
$2,325 |
10.7× |
| CT pelvis w&w/o contrast (72194) |
$1,509.50 |
$3,019 |
8.3× |
| CT pelvis w/o contrast (72192) |
$942 |
$1,884 |
8.7× |
| CT soft tissue neck w contrast (70491) |
$1,049 |
$2,098 |
5.8× |
| CT soft tissue neck w/o contrast (70490) |
$770 |
$1,540 |
7.1× |
| CT thoracic spine w contrast (72129) |
$1,115.50 |
$2,231 |
6.1× |
| CT thoracic spine w/o contrast (72128) |
$944 |
$1,888 |
8.7× |
| CT thorax w/o contrast (71250) |
$565.50 |
$1,131 |
5.2× |
| CT upper ext wo (73200) |
$1,056.50 |
$2,113 |
9.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$654.50 |
$1,309 |
3.6× |
| CT upper extremity with contrast (73201) |
$1,082.50 |
$2,165 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,233 |
$4,466 |
12.3× |
| Cta Abdomen (74175) |
$2,641 |
$5,282 |
14.6× |
| CTA pelvis (72191) |
$1,891.50 |
$3,783 |
10.4× |
| Dilation ureters/urethra rs&i (74485) |
$1,275.50 |
$2,551 |
0.6× |
| Diskography lumbar (72295) |
$2,738 |
$5,476 |
1.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$286.50 |
$573 |
2.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$180 |
$360 |
1.7× |
| Dxa Bone Density Axial (77080) |
$358.50 |
$717 |
3.3× |
| Echo exam of fetal heart (76825) |
$629.50 |
$1,259 |
1.1× |
| Echo Guide For Artery Repair (76936) |
$369 |
$738 |
1.7× |
| Echograp Trans R Pros Study (76873) |
$274 |
$548 |
2.5× |
| Esophagram (74220) |
$682 |
$1,364 |
3.8× |
| Fetal Biophys Profile W/Nst (76818) |
$529.50 |
$1,059 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$310 |
$620 |
2.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$540.50 |
$1,081 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$469 |
$938 |
1.9× |
| Follow-Up Angiography (75898) |
$661.50 |
$1,323 |
0.2× |
| Foot 2 views (73620) |
$206.50 |
$413 |
2.3× |
| Forearm 2 views (73090) |
$294 |
$588 |
3.3× |
| Gastric emptying imaging study (78264) |
$1,390 |
$2,780 |
3.4× |
| Gated Heart Planar Single (78472) |
$540.50 |
$1,081 |
1.3× |
| Gated Heart, Multiple (78473) |
$847 |
$1,694 |
2.0× |
| Hand 2 views (73120) |
$206.50 |
$413 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,291 |
$2,582 |
1.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$896.50 |
$1,793 |
1.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$1,450.50 |
$2,901 |
0.4× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,800.50 |
$7,601 |
1.2× |
| Hepatobil Syst Image W/Drug (78227) |
$835 |
$1,670 |
1.5× |
| Hepatobiliary System Imaging (78226) |
$835 |
$1,670 |
2.0× |
| Ht Muscle Image Spect Sing (78451) |
$2,079.50 |
$4,159 |
1.6× |
| Hysterosalpingogram (74740) |
$1,008 |
$2,016 |
4.1× |
| Image fusion (77399) |
$159 |
$318 |
1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$189.50 |
$379 |
2.1× |
| Interstitial radiation source applic complex (77778) |
$857 |
$1,714 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$668 |
$1,336 |
1.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,129.50 |
$2,259 |
2.0× |
| K Flow/Funct Image W/O Drug (78707) |
$647.50 |
$1,295 |
1.2× |
| Knee 3 Views (73562) |
$411.50 |
$823 |
4.6× |
| Leveen/Shunt Patency Exam (78291) |
$334.50 |
$669 |
0.8× |
| Liver & Spleen Imaging Static Only (78215) |
$529.50 |
$1,059 |
1.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$900.50 |
$1,801 |
1.6× |
| Lung Ventilation Imaging (78579) |
$258 |
$516 |
0.6× |
| Lymph System Imaging (78195) |
$418.50 |
$837 |
0.7× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$1,492.50 |
$2,985 |
0.5× |
| Magnetic Image Jaw Joint (70336) |
$939.50 |
$1,879 |
3.8× |
| Meckels Divert Exam (78290) |
$715 |
$1,430 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$750.50 |
$1,501 |
1.9× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,110.50 |
$4,221 |
5.8× |
| MRA head w/o contrast (70544) |
$1,919 |
$3,838 |
7.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,499 |
$2,998 |
4.2× |
| MRA neck w/o contrast (70547) |
$1,212.50 |
$2,425 |
4.9× |
| MRI abdomen w contrast (74182) |
$979 |
$1,958 |
2.7× |
| MRI abdomen w/o contrast (74181) |
$1,494.50 |
$2,989 |
6.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,618 |
$3,236 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,147 |
$4,294 |
5.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,687.50 |
$3,375 |
2.1× |
| MRI cardiac w/o contrast (75557) |
$867 |
$1,734 |
3.5× |
| MRI cervical spine w/o cont (72141) |
$1,499 |
$2,998 |
6.1× |
| MRI chest w/o contrast (71550) |
$1,354 |
$2,708 |
5.5× |
| MRI chest wo w contrast (71552) |
$1,984 |
$3,968 |
5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,844.50 |
$3,689 |
5.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,530.50 |
$3,061 |
6.2× |
| MRI lumbar spine w contrast (72149) |
$1,416 |
$2,832 |
3.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,773 |
$3,546 |
4.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$989.50 |
$1,979 |
4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,333 |
$2,666 |
3.7× |
| MRI pelvis w contrast (72196) |
$1,190 |
$2,380 |
3.3× |
| MRI pelvis w/o & w contrast (72197) |
$1,736 |
$3,472 |
4.8× |
| MRI pelvis w/o contrast (72195) |
$1,205.50 |
$2,411 |
4.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,844.50 |
$3,689 |
7.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,014.50 |
$2,029 |
4.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,731.50 |
$3,463 |
4.8× |
| MRI, abdomen, combo (74183) |
$1,886 |
$3,772 |
5.2× |
| MRI, dorsal spine combo (72157) |
$2,525.50 |
$5,051 |
7.0× |
| MRI, joint upper extrem (73221) |
$1,697 |
$3,394 |
6.9× |
| MRI, joint upper extrem combo (73223) |
$1,975.50 |
$3,951 |
5.5× |
| MRI, lumbar spine combo (72158) |
$2,319 |
$4,638 |
6.4× |
| Myelogram Lumbar (72265) |
$619.50 |
$1,239 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,161 |
$4,322 |
1.6× |
| N-invas est c ffr sw aly CTA (75580) |
$1,361.50 |
$2,723 |
1.5× |
| Neck soft tissue (70360) |
$149 |
$298 |
1.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,878 |
$5,756 |
2.0× |
| Nuclear Rx Intra-Arterial (79445) |
$655.50 |
$1,311 |
2.7× |
| Nuclear Rx Oral Admin (79005) |
$655.50 |
$1,311 |
2.7× |
| Ob us nuchal meas 1 gest (76813) |
$217.50 |
$435 |
2.0× |
| Panoramic X-ray of jaws (70355) |
$73 |
$146 |
0.8× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$871.50 |
$1,743 |
1.6× |
| Parathyroid Planar Imaging (78070) |
$673.50 |
$1,347 |
1.6× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$575 |
$1,150 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$178 |
$356 |
1.6× |
| Peritoneogram Rs&I (74190) |
$748 |
$1,496 |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,003.50 |
$2,007 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$416.50 |
$833 |
1.0× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$298.50 |
$597 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$828 |
$1,656 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$278 |
$556 |
3.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$142 |
$284 |
1.6× |
| Radex elbow complete minimum 3 views (73080) |
$334.50 |
$669 |
3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$409 |
$818 |
3.8× |
| Radex fingr minimum 2 views (73140) |
$199.50 |
$399 |
2.2× |
| Radex foot complete minimum 3 views (73630) |
$281.50 |
$563 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$247.50 |
$495 |
2.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$147.50 |
$295 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$224 |
$448 |
2.5× |
| Radex Ribs Unilateral 2 Views (71100) |
$101.50 |
$203 |
1.1× |
| Radex shoulder complete minimum 2 views (73030) |
$376 |
$752 |
4.2× |
| Radex Spine 1 View Specify Level (72020) |
$285.50 |
$571 |
3.2× |
| Radex Sternum Minimum 2 Views (71120) |
$183 |
$366 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$383 |
$766 |
4.3× |
| Radex Toe Minimum 2 Views (73660) |
$210 |
$420 |
2.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$223 |
$446 |
2.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$260 |
$520 |
2.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$8,144 |
$16,288 |
1.1× |
| Radiation treatment delivery level 1 (77402) |
$145 |
$290 |
1.4× |
| Radiation treatment delivery level 2 (77407) |
$145 |
$290 |
0.4× |
| Radiation treatment delivery level 3 (77412) |
$480.50 |
$961 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$346 |
$692 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$201.50 |
$403 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$468 |
$936 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$253 |
$506 |
1.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$307.50 |
$615 |
1.7× |
| Radiologic exam knee complete 4/more views (73564) |
$549 |
$1,098 |
5.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$183 |
$366 |
1.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$162 |
$324 |
0.9× |
| Radiologic exam swallow function contrast study (74230) |
$304.50 |
$609 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$307.50 |
$615 |
1.7× |
| Radiologic examination femur 1 view (73551) |
$103.50 |
$207 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$252 |
$504 |
2.8× |
| Radiologic examination knee 1/2 views (73560) |
$243.50 |
$487 |
2.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$288.50 |
$577 |
3.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$423.50 |
$847 |
1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$340 |
$680 |
0.9× |
| Renal Cyst Study (74470) |
$745 |
$1,490 |
1.3× |
| Ribs bilateral 3 views (71110) |
$191 |
$382 |
1.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$504.50 |
$1,009 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$504.50 |
$1,009 |
1.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,744.50 |
$3,489 |
3.1× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,253.50 |
$2,507 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,744.50 |
$3,489 |
1.3× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,979 |
$3,958 |
1.3× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,744.50 |
$3,489 |
1.3× |
| Rp Therapy Intravenous Administration (79101) |
$336 |
$672 |
1.4× |
| Scapula (73010) |
$264 |
$528 |
2.4× |
| Shoulder 1 view (73020) |
$196.50 |
$393 |
2.2× |
| Shoulder Arthrography (73040) |
$387 |
$774 |
1.1× |
| Skull less than 4 views (70250) |
$285 |
$570 |
2.6× |
| Special dosimetry (77331) |
$322 |
$644 |
2.3× |
| Special Physics Consult (77370) |
$317.50 |
$635 |
2.3× |
| Special teletherapy port plan (77321) |
$750.50 |
$1,501 |
1.9× |
| Special treatment procedure (77470) |
$1,122.50 |
$2,245 |
2.0× |
| Stereotactic Body Radiation Delivery (77373) |
$5,817 |
$11,634 |
3.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$346.50 |
$693 |
0.9× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$156 |
$312 |
0.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$883 |
$1,766 |
2.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$530 |
$1,060 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$591.50 |
$1,183 |
4.3× |
| Thoracic spine 2 views (72070) |
$183 |
$366 |
1.7× |
| Thoracic spine 3 views (72072) |
$430.50 |
$861 |
4.0× |
| Thoracolumbar 2 views (72080) |
$414.50 |
$829 |
4.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$210 |
$420 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$560 |
$1,120 |
1.4× |
| Tx Devices Design & Construction Complex (77334) |
$496.50 |
$993 |
1.3× |
| Tx devices design & construction simple (77332) |
$569.50 |
$1,139 |
4.1× |
| Ultrasound Breast Limited (76642) |
$120.50 |
$241 |
1.3× |
| Ultrasound Exam Aaa Screen (76706) |
$155 |
$310 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$341 |
$682 |
3.2× |
| Umbilical-artery Doppler (OB) (76820) |
$177.50 |
$355 |
1.6× |
| Unlisted Dx Radiographic Procedure (76499) |
$114 |
$228 |
1.3× |
| Unlisted fluoroscopic procedure (76496) |
$122 |
$244 |
1.4× |
| Upper gi w/o kub (74240) |
$307.50 |
$615 |
1.7× |
| Urethrocystogram voiding (74455) |
$644 |
$1,288 |
2.6× |
| Urethrocystography retrograde (74450) |
$117 |
$234 |
0.5× |
| Us breast unilateral complete (76641) |
$120.50 |
$241 |
1.1× |
| Us chest (76604) |
$311 |
$622 |
2.9× |
| Us complete joint (76881) |
$323.50 |
$647 |
3.0× |
| Us exam, pelvic, limited (76857) |
$272.50 |
$545 |
2.5× |
| Us head (76506) |
$440.50 |
$881 |
4.1× |
| Us kidney transplant (76776) |
$187 |
$374 |
1.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$179.50 |
$359 |
1.7× |
| Us ob detailed single fetus (76811) |
$772 |
$1,544 |
3.1× |
| Us ob limited 1 or more fetuses (76815) |
$584.50 |
$1,169 |
5.4× |
| Us ob transvaginal (76817) |
$572 |
$1,144 |
5.3× |
| Us pelvic non ob complete (76856) |
$297 |
$594 |
2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$274 |
$548 |
2.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$513.50 |
$1,027 |
4.7× |
| Us retroperitoneal complete (76770) |
$274 |
$548 |
2.5× |
| Us retroperitoneal limited (76775) |
$126 |
$252 |
1.2× |
| Us scrotum and contents (76870) |
$274 |
$548 |
2.5× |
| Us spinal canal and contents (76800) |
$285.50 |
$571 |
2.6× |
| Us thyroid (76536) |
$406.50 |
$813 |
3.8× |
| Us transrectal (76872) |
$238 |
$476 |
2.2× |
| Vein X-Ray Chest (75827) |
$1,049 |
$2,098 |
0.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,130.50 |
$2,261 |
0.3× |
| Venogram Sinus/Jugular (75860) |
$711.50 |
$1,423 |
0.2× |
| Venography Adrenal Unilateral (75840) |
$3,605.50 |
$7,211 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$2,216 |
$4,432 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$620.50 |
$1,241 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$1,877 |
$3,754 |
1.2× |
| Venography Renal Bilateral (75833) |
$2,005 |
$4,010 |
0.6× |
| Venography Renal Unilateral (75831) |
$2,216 |
$4,432 |
0.7× |
Venous sampling by catheter (75893)
likely a partial charge, not the full procedure |
$1,155 |
$2,310 |
0.2× |
| Wrist 2 views (73100) |
$206.50 |
$413 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$142 |
$284 |
1.6× |
| X-ray antegrade pyelogram tube (74425) |
$392 |
$784 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$2,194.50 |
$4,389 |
0.7× |
| X-Ray Bend Only L-S Spine (72120) |
$189.50 |
$379 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$206.50 |
$413 |
2.3× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$196 |
$392 |
2.2× |
| X-Ray Exam Hip Uni 1 View (73501) |
$160 |
$320 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$179 |
$358 |
2.0× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$270 |
$540 |
2.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$183 |
$366 |
1.7× |
| X-Ray Exam L-S Spine Bending (72114) |
$493 |
$986 |
4.6× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$157 |
$314 |
1.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$466 |
$932 |
4.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$252 |
$504 |
2.3× |
| X-ray eye for foreign body (70030) |
$136 |
$272 |
1.5× |
| X-ray humerus (73060) |
$210 |
$420 |
2.3× |
| X-ray IV pyelogram (ivp) (74400) |
$840 |
$1,680 |
4.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$136 |
$272 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$136 |
$272 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$288.50 |
$577 |
2.7× |
| X-ray nose-rectum child f.b. (76010) |
$143.50 |
$287 |
1.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$260.50 |
$521 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$196 |
$392 |
1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$178 |
$356 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$154.50 |
$309 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$308 |
$616 |
3.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$559.50 |
$1,119 |
5.2× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$672 |
$1,344 |
1.9× |
| X-Rays Bone Length Studies (77073) |
$335.50 |
$671 |
3.1× |
| X-Rays Bone Survey Complete (77075) |
$345.50 |
$691 |
3.2× |
| Xr c-spine 4 or 5 views (72050) |
$466.50 |
$933 |
4.3× |
| Xr facial bones less than 3 views (70140) |
$136 |
$272 |
1.5× |
| Xr orbits complete 4 views (70200) |
$194.50 |
$389 |
1.8× |