| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,002 |
$3,500 |
1.4× |
| Abdomen 2 views (74019) |
$183.15 |
$407 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$710.83 |
$1,786 |
1.7× |
| Ankle 2 views (73600) |
$119.25 |
$265 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$319.05 |
$709 |
0.9× |
| Arthrogram hip (73525) |
$495.92 |
$967 |
1.3× |
| Arthrogram shoulder (73040) |
$470.79 |
$918 |
1.3× |
| Arthrogram wrist (73115) |
$350.78 |
$684 |
1.0× |
| Arthrography knee lt (73580) |
$286.16 |
$558 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$212.21 |
$371 |
1.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$446.56 |
$1,122 |
1.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$530.14 |
$1,332 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$959.98 |
$2,412 |
2.3× |
| Bone age studies (77072) |
$108 |
$240 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$1,103.65 |
$2,773 |
2.6× |
| Bone survey complete (77075) |
$221.85 |
$493 |
2.0× |
| Brain image w/flow 4 + views (78606) |
$464.07 |
$1,166 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,075.02 |
$5,578 |
1.4× |
| Brain Imaging Vascular Flow Only (78610) |
$295.32 |
$742 |
0.5× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$13.53 |
$34 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$211.50 |
$470 |
2.3× |
| Chest 1 view (71045) |
$108.46 |
$220 |
1.2× |
| Chest 3 views (71047) |
$234.67 |
$476 |
2.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$276.75 |
$615 |
1.5× |
| Clavicle complete (73000) |
$159.30 |
$354 |
1.7× |
| Continuing medical physics consltj pr wk (77336) |
$394.68 |
$690 |
2.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$860.22 |
$3,186 |
2.3× |
| CT abdomen and pelvis without contrast (74176) |
$573.48 |
$2,124 |
2.3× |
| CT abdomen w contrast (74160) |
$460.08 |
$1,704 |
2.5× |
| CT abdomen w wo contrast (74170) |
$552.15 |
$2,045 |
3.0× |
| CT abdomen w/o contrast (74150) |
$368.01 |
$1,363 |
3.3× |
| CT angio hrt w/3d image (75574) |
$1,400.54 |
$3,242 |
3.8× |
| CT angiography upper extremity lt (73206) |
$962.82 |
$3,566 |
5.2× |
| CT c-spine w/o contrast (72125) |
$799.74 |
$2,962 |
7.3× |
| CT cervical spine w&w/o contrast (72127) |
$1,199.61 |
$4,443 |
6.5× |
| CT cervical spine with contrast (72126) |
$999.81 |
$3,703 |
2.7× |
| CT chest w/wo contrast (71270) |
$615.33 |
$2,279 |
3.3× |
| CT chest with contrast (71260) |
$512.73 |
$1,899 |
2.8× |
| CT colonography w/dye (74262) |
$940.46 |
$2,177 |
5.1× |
| CT colonography w/o cntrst (74261) |
$752.11 |
$1,741 |
6.8× |
| CT head/brain with contrast (70460) |
$505.98 |
$1,874 |
2.7× |
| CT head/brain without and with contrast (70470) |
$607.23 |
$2,249 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$71.71 |
$166 |
0.8× |
| CT iac w contrast (70481) |
$825.39 |
$3,057 |
4.5× |
| CT limited/localized follow up study (76380) |
$428.98 |
$993 |
4.7× |
| CT lower ext w/o (73700) |
$442.53 |
$1,639 |
4.0× |
| CT lower extremity w wo contrast (73702) |
$663.93 |
$2,459 |
3.6× |
| CT lower extremity with contrast (73701) |
$553.23 |
$2,049 |
3.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,266.03 |
$4,689 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$844.02 |
$3,126 |
7.7× |
| CT lumbar spine with contrast (72132) |
$1,055.16 |
$3,908 |
2.9× |
| CT maxillofacial w contrast (70487) |
$828.90 |
$3,070 |
4.5× |
| CT maxillofacial w/o contrast (70486) |
$663.12 |
$2,456 |
6.0× |
| CT maxillofacial w/wo contrast (70488) |
$994.68 |
$3,684 |
5.4× |
| CT neck soft tissue w contrast (70491) |
$555.93 |
$2,059 |
3.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$990.36 |
$3,668 |
5.4× |
| CT orbits w/o contrast (70480) |
$660.15 |
$2,445 |
6.0× |
| CT pelvis w & w/o contrast (72194) |
$1,208.25 |
$4,475 |
6.5× |
| CT pelvis w/o contrast (72192) |
$805.41 |
$2,983 |
7.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$667.17 |
$2,471 |
3.6× |
| CT soft tissue neck w/o contrast (70490) |
$444.69 |
$1,647 |
4.0× |
| CT thoracic spine w/contrast (72129) |
$1,063.26 |
$3,938 |
5.7× |
| CT thoracic spine w/o contrast (72128) |
$850.50 |
$3,150 |
7.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,275.75 |
$4,725 |
6.9× |
| CT thorax w/o contrast (71250) |
$410.13 |
$1,519 |
3.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$916.92 |
$3,396 |
5.0× |
| CT upper extremity w/o contrast rt (73200) |
$611.28 |
$2,264 |
5.5× |
| CT upper extremity with contrast (73201) |
$764.10 |
$2,830 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,290.38 |
$2,987 |
7.0× |
| Cta Abdomen (74175) |
$579.96 |
$2,148 |
3.1× |
| CTA abdomen pelvis (74174) |
$903.42 |
$3,346 |
2.5× |
| CTA chest (71275) |
$646.11 |
$2,393 |
3.5× |
| Cta Head (70496) |
$637.74 |
$2,362 |
3.4× |
| CTA lwr ext w&w/o contrast (73706) |
$697.14 |
$2,582 |
3.8× |
| Cta Neck (70498) |
$700.65 |
$2,595 |
3.8× |
| Cta Pelvis (72191) |
$1,268.73 |
$4,699 |
6.9× |
| Cystography minimum 3 views rs&i (74430) |
$242.55 |
$539 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$204.30 |
$454 |
1.9× |
| Dxa bone density study axial skeleton (77085) |
$228.15 |
$507 |
2.1× |
| Echoencephalography real time imaging (76506) |
$294.79 |
$519 |
2.7× |
| Esophagus (74220) |
$196.65 |
$437 |
1.1× |
| Fetal biophysical profile non-stress testing (76818) |
$481.66 |
$848 |
4.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$443.61 |
$781 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$337.50 |
$750 |
1.3× |
| Foot 2 views (73620) |
$139.50 |
$310 |
1.5× |
| Forearm 2 views (73090) |
$144.90 |
$322 |
1.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,035.99 |
$2,603 |
1.8× |
| Gated Heart Planar Single (78472) |
$756.20 |
$1,900 |
1.8× |
| Hand 2 views (73120) |
$103.05 |
$229 |
0.9× |
| Hand 3 views (73130) |
$160.20 |
$356 |
1.7× |
| Heart Infarct Image (78466) |
$403.97 |
$1,015 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,031.22 |
$2,591 |
1.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$753.02 |
$1,892 |
1.8× |
| Ht muscle image spect sing (78451) |
$1,641.75 |
$4,125 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$192.60 |
$428 |
2.1× |
| Hysterosalpingogram (74740) |
$238.05 |
$529 |
0.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$87.30 |
$194 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$416.71 |
$1,047 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$317.21 |
$797 |
0.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$660.68 |
$1,660 |
1.2× |
| Knee 3 views (73562) |
$172.80 |
$384 |
1.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$272.63 |
$685 |
0.6× |
| Lung perf&ventilat diferentl (78598) |
$618.49 |
$1,554 |
1.1× |
| Lung perfusion differential (78597) |
$378.10 |
$950 |
0.9× |
| Lung Ventilation Imaging (78579) |
$324.77 |
$816 |
0.8× |
| Lymphoscintigraphy (78195) |
$674.61 |
$1,695 |
1.2× |
| Mammary ductogram or galactogram multiple (77054) |
$243.90 |
$542 |
1.0× |
| Mammary ductogram or galactogram single (77053) |
$185.40 |
$412 |
0.7× |
| Meckels Diverticulum (78290) |
$675.41 |
$1,697 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$224.22 |
$392 |
0.6× |
| Mr safety determination physician/other qhp (76016) |
$59.85 |
$133 |
0.7× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$140.85 |
$313 |
2.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$17.10 |
$38 |
0.6× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$92.25 |
$205 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$219.15 |
$487 |
0.9× |
| MRA head w & w/o contrast (70546) |
$581.76 |
$3,179 |
1.6× |
| MRA head w/o contrast (70544) |
$387.78 |
$2,119 |
1.5× |
| MRA head with contrast (70545) |
$484.77 |
$2,649 |
1.3× |
| MRA neck w contrast (70548) |
$840.52 |
$4,593 |
2.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,008.51 |
$5,511 |
2.7× |
| MRA neck w/o contrast (70547) |
$672.34 |
$3,674 |
2.7× |
| MRI abdomen w contrast (74182) |
$1,834.78 |
$3,980 |
5.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,201.74 |
$4,776 |
6.0× |
| MRI abdomen w/o contrast (74181) |
$1,467.82 |
$3,184 |
5.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,377.47 |
$2,988 |
1.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,094.41 |
$2,374 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$828.88 |
$1,798 |
3.3× |
| MRI breast w/o contrast unilat (77046) |
$526.46 |
$1,142 |
2.1× |
| MRI c-spine with contrast (72142) |
$568.54 |
$2,170 |
1.5× |
| MRI cervical spine w/o contrast (72141) |
$454.83 |
$1,736 |
1.8× |
| MRI chest w/o & w/contrast material (71552) |
$1,995.67 |
$4,329 |
5.4× |
| MRI chest w/o contrast (71550) |
$1,330.45 |
$2,886 |
5.3× |
| MRI chest with contrast (71551) |
$1,663.29 |
$3,608 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,336.90 |
$2,900 |
3.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,024.34 |
$2,222 |
2.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$819.20 |
$1,777 |
3.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,011.84 |
$2,976 |
4.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,517.76 |
$4,464 |
4.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,264.80 |
$3,720 |
3.4× |
| MRI pelvis w contrast (72196) |
$1,191.22 |
$2,584 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,429.56 |
$3,101 |
3.9× |
| MRI pelvis w/o contrast (72195) |
$952.89 |
$2,067 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,313.39 |
$2,849 |
3.6× |
| MRI scan of leg joint before and after contrast (73723) |
$1,652.69 |
$3,585 |
4.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$682.25 |
$2,604 |
1.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$568.54 |
$2,170 |
1.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$682.25 |
$2,604 |
1.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$568.54 |
$2,170 |
1.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$682.25 |
$2,604 |
1.9× |
| MRI thoracic spine w/o contrast (72146) |
$454.83 |
$1,736 |
1.8× |
| MRI tmj (70336) |
$1,427.72 |
$3,097 |
5.7× |
| MRI upper ext joint w/o contrast (73221) |
$875.44 |
$1,899 |
3.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,604.28 |
$3,480 |
4.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,069.52 |
$2,320 |
4.2× |
| Myelogram Cervical (72240) |
$976.05 |
$2,169 |
1.2× |
| Myelogram Lumbar (72265) |
$989.55 |
$2,199 |
1.2× |
| Myelogram thoracic (72255) |
$778.05 |
$1,729 |
0.9× |
| Myelography 2 or more regions (72270) |
$1,254.60 |
$2,788 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,120.94 |
$5,329 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$3,290.38 |
$6,416 |
3.6× |
| Neck soft tissue (70360) |
$139.95 |
$311 |
1.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$209.75 |
$527 |
0.5× |
| Nm adrenal scan (78075) |
$920.97 |
$2,314 |
0.7× |
| Nm cisternogram (78630) |
$467.65 |
$1,175 |
0.8× |
| Nm gastric emptying study (78264) |
$854.90 |
$2,148 |
2.0× |
| Nm gastroesophageal reflux study (78262) |
$487.95 |
$1,226 |
1.2× |
| Nm peritoneal-venous shunt patency (78291) |
$336.71 |
$846 |
0.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,247.10 |
$7,425 |
2.9× |
| Nuclear medicine of heart pumping function (78473) |
$765.75 |
$1,924 |
1.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,014.50 |
$2,549 |
2.4× |
| Nuclear Rx Oral Admin (79005) |
$509.76 |
$994 |
2.1× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$308.42 |
$543 |
2.8× |
| Osseous survey infant (77076) |
$223.65 |
$497 |
2.0× |
| Parathyrd planar w/spect&CT (78072) |
$569.54 |
$1,431 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$522.97 |
$1,314 |
1.2× |
| Parathyroid imaging (78070) |
$458.10 |
$1,151 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$111.15 |
$247 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$3,188.04 |
$8,570 |
2.1× |
| PET imaging CT for attenuation limited area (78814) |
$1,867.44 |
$5,020 |
1.2× |
| PET imaging for CT attenuation whole body (78816) |
$3,207.01 |
$8,621 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,229.03 |
$2,666 |
3.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$458.10 |
$1,151 |
1.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$725.16 |
$1,822 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$321.75 |
$715 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$156.15 |
$347 |
1.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$224.10 |
$498 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$122.85 |
$273 |
1.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$147.60 |
$328 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$264.15 |
$587 |
2.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$475.33 |
$831 |
0.8× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$255.11 |
$446 |
2.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$316.89 |
$554 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$223.65 |
$497 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$101.25 |
$225 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$191.70 |
$426 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$227.77 |
$462 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$410.85 |
$913 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$397.80 |
$884 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$299.70 |
$666 |
1.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$124.20 |
$276 |
1.4× |
| Radiological examination surgical specimen (76098) |
$116.10 |
$258 |
0.2× |
| Ribs bilateral 3 views (71110) |
$205.65 |
$457 |
1.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$345.86 |
$869 |
0.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$547.25 |
$1,375 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$653.12 |
$1,641 |
1.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$653.12 |
$1,641 |
0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$716.80 |
$1,801 |
0.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$424.67 |
$1,067 |
0.3× |
| Rp Therapy Intravenous Administration (79101) |
$348.73 |
$680 |
1.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$354.43 |
$624 |
1.4× |
| Scanogram (77073) |
$256.05 |
$569 |
2.3× |
| Scapula complete (73010) |
$120.60 |
$268 |
1.1× |
| Screening digital breast tomosynthesis (77063) |
$37.24 |
$49 |
1.6× |
| Sella turcica (70240) |
$81 |
$180 |
0.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$228.60 |
$508 |
2.1× |
| Sialogram (70390) |
$278.10 |
$618 |
1.1× |
| Simulation intermediate (77285) |
$821.96 |
$1,437 |
2.1× |
| Small bowel series (74250) |
$271.35 |
$603 |
1.5× |
| Spec medical radj physics consltj (77370) |
$518.23 |
$906 |
3.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$318.03 |
$556 |
0.8× |
| Special dosimetry (77331) |
$191.62 |
$335 |
1.4× |
| Special treatment procedure (77470) |
$566.28 |
$990 |
1.0× |
| Spine thoracic 3 views (72072) |
$229.95 |
$511 |
2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$491.35 |
$859 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$326.61 |
$571 |
0.8× |
| Ther rad simulaj-aided field setting complex (77290) |
$915.20 |
$1,600 |
2.3× |
| Ther rad simulaj-aided field setting simple (77280) |
$482.20 |
$843 |
3.4× |
| Thoracolumbar 2 views (72080) |
$117.90 |
$262 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$885.55 |
$2,225 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$386.86 |
$972 |
0.9× |
| Thyroid uptake measurement (78012) |
$241.19 |
$606 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$526.55 |
$1,323 |
1.2× |
| Tomogram (76100) |
$221.85 |
$493 |
2.0× |
| Treatment device intermediate (77333) |
$464.46 |
$812 |
3.3× |
| Treatment devices simple (77332) |
$207.06 |
$362 |
1.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$959.18 |
$2,410 |
1.7× |
| Tx devices design & construction complex (77334) |
$545.69 |
$954 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$506.09 |
$891 |
4.6× |
| Umbilical-artery Doppler (OB) (76820) |
$169.83 |
$299 |
1.5× |
| Upper Extremity Infant (73092) |
$158.40 |
$352 |
1.4× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$113.03 |
$284 |
1.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$335.51 |
$843 |
0.8× |
| Urethrocystography retrograde rs&i (74450) |
$319.95 |
$711 |
1.3× |
| Urethrocystography voiding (74455) |
$362.25 |
$805 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$693.90 |
$1,542 |
3.8× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$626.85 |
$1,393 |
3.4× |
| Us abdl aorta screen aaa (76706) |
$218.11 |
$384 |
2.0× |
| Us breast unilateral complete (76641) |
$402.14 |
$708 |
3.6× |
| Us breast unilateral limited (76642) |
$330.01 |
$581 |
3.6× |
| Us chest (76604) |
$337.39 |
$594 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$516.31 |
$909 |
4.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$239.13 |
$421 |
2.2× |
| Us infant hips dynamic (76885) |
$224.36 |
$395 |
2.4× |
| Us infant hips limited static (76886) |
$163.58 |
$288 |
1.8× |
| Us kidney transplant (76776) |
$268.66 |
$473 |
2.4× |
| Us ob detailed single fetus (76811) |
$354.43 |
$624 |
1.4× |
| Us ob transvaginal (76817) |
$391.35 |
$689 |
3.5× |
| Us pelvic non ob complete (76856) |
$593.56 |
$1,045 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$435.09 |
$766 |
3.9× |
| Us pregnancy ltd (76815) |
$303.31 |
$534 |
2.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$507.22 |
$893 |
4.6× |
| Us retroperitoneal complete (76770) |
$583.34 |
$1,027 |
5.3× |
| Us retroperitoneal limited (76775) |
$191.42 |
$337 |
1.7× |
| Us scrotum and contents (76870) |
$546.42 |
$962 |
5.0× |
| Us soft tissue head/neck (76536) |
$528.81 |
$931 |
4.8× |
| Us spinal canal and contents (76800) |
$231.18 |
$407 |
2.1× |
| Us transrectal (76872) |
$341.37 |
$601 |
3.1× |
| Us xtr non-vasc lmtd (76882) |
$332.85 |
$586 |
3.0× |
| Venography extremity unilateral rs&i (75820) |
$303.75 |
$675 |
0.2× |
| Vertebral fracture assessment via dxa (77086) |
$158.85 |
$353 |
1.7× |
| Wrist 2 views (73100) |
$139.50 |
$310 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$221.85 |
$493 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$169.65 |
$377 |
1.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$211.95 |
$471 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$455.85 |
$1,013 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$175.50 |
$390 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$216.45 |
$481 |
2.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$254.70 |
$566 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$99.45 |
$221 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$186.75 |
$415 |
2.0× |
| X-ray exam hip uni 4/> views (73503) |
$233.55 |
$519 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$200.25 |
$445 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$316.80 |
$704 |
2.9× |
| X-ray exam of femur 1 (73551) |
$83.70 |
$186 |
0.9× |
| X-ray eye for foreign body (70030) |
$75.60 |
$168 |
0.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$206.10 |
$458 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$176.40 |
$392 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$199.80 |
$444 |
2.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$105.30 |
$234 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$263.25 |
$585 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$236.70 |
$526 |
2.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$83.70 |
$186 |
0.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$168.75 |
$375 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$383.40 |
$852 |
3.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$154.80 |
$344 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$61.20 |
$136 |
0.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$234 |
$520 |
2.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$166.50 |
$370 |
1.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$386.55 |
$859 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$176.85 |
$393 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$200.70 |
$446 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$252.45 |
$561 |
2.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$236.70 |
$526 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$143.10 |
$318 |
1.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$199.80 |
$444 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$195.75 |
$435 |
2.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$124.65 |
$277 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$212.40 |
$472 |
1.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$184.95 |
$411 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$148.50 |
$330 |
1.6× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$165.60 |
$368 |
1.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$104.40 |
$232 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$221.85 |
$493 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$264.60 |
$588 |
2.4× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$115.65 |
$257 |
1.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$198.90 |
$442 |
2.2× |
| Xr c-spine 6 or more views (72052) |
$343.35 |
$763 |
3.1× |
| Xr chest 4+ views (71048) |
$265.23 |
$538 |
2.4× |
| Xr Cholecystography Oral Contrast (74290) |
$198.90 |
$442 |
1.1× |
| Xr finger(s) 2+ views (73140) |
$117.90 |
$262 |
1.3× |
| Xr optic foramina (70190) |
$126 |
$280 |
1.4× |
| Xr shoulder 1 view (73020) |
$144.90 |
$322 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$291.15 |
$647 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$119.70 |
$266 |
1.3× |
| Xr tmj bilateral (70330) |
$175.50 |
$390 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$141.75 |
$315 |
1.5× |