| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$6,045.55 |
— |
| Abdomen 2 views (74019) |
— |
$687.03 |
— |
| Acute gastrointestinal blood loss imaging (78278) |
— |
$2,707.86 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$7,800.71 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$8,874.76 |
— |
| Angiography internal mammary rs&i (75756) |
— |
$5,280.28 |
— |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
— |
$5,194.31 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
— |
$5,618.04 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$4,026.39 |
— |
| Angiography Spinal Selective Rs&I (75705) |
— |
$3,804.85 |
— |
| Angiography visceral slctv/supraslctv rs&i (75726) |
— |
$4,370.70 |
— |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
— |
$4,793.70 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$2,233.42 |
— |
| Ankle 2 views (73600) |
— |
$334.79 |
— |
| Antegrade urography radiological supvj & interpj (74425) |
— |
$902.96 |
— |
| Aortogram thoracic (75605) |
— |
$3,982.51 |
— |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$12,830.22 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$4,594.57 |
— |
| Arthrogram elbow (73085) |
— |
$560.44 |
— |
| Arthrogram hip (73525) |
— |
$676.76 |
— |
| Arthrogram shoulder (73040) |
— |
$671.63 |
— |
| Arthrogram wrist (73115) |
— |
$633.63 |
— |
| Arthrography knee lt (73580) |
— |
$560.44 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$702.01 |
— |
| Bone &/Joint Imaging Limited Area (78300) |
— |
$1,761.22 |
— |
| Bone &/joint imaging whole body (78306) |
— |
$2,792.28 |
— |
| Bone age studies (77072) |
— |
$352.85 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$2,749.15 |
— |
| Bone survey complete (77075) |
— |
$1,380.22 |
— |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
— |
$1,145.15 |
— |
| Brain image w/flow 4 + views (78606) |
— |
$1,829.20 |
— |
| Brain imaging < 4 static views w vascular flow (78601) |
— |
$1,764.39 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$4,337.84 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$3,212 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$1,832.29 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$722.97 |
— |
| Chest 1 view (71045) |
— |
$464.18 |
— |
| Chest 3 views (71047) |
— |
$727.08 |
— |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
— |
$2,114.67 |
— |
| Cineradiography/videoradiography (76120) |
— |
$1,261.81 |
— |
| Clavicle complete (73000) |
— |
$334.79 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$542.42 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$1,112.66 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$6,854.89 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$5,598.93 |
— |
| CT abdomen w contrast (74160) |
— |
$3,665.18 |
— |
| CT abdomen w wo contrast (74170) |
— |
$4,069.80 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,206.14 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,420.87 |
— |
| CT angiography upper extremity lt (73206) |
— |
$3,553.25 |
— |
| CT c-spine w/o contrast (72125) |
— |
$3,398.18 |
— |
| CT cervical spine w&w/o contrast (72127) |
— |
$4,514.47 |
— |
| CT cervical spine with contrast (72126) |
— |
$4,033.86 |
— |
| CT chest w/wo contrast (71270) |
— |
$5,434.62 |
— |
| CT chest with contrast (71260) |
— |
$4,788.72 |
— |
| CT head/brain with contrast (70460) |
— |
$2,744.01 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,350.94 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$3,045.93 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$100 |
— |
| CT iac w contrast (70481) |
— |
$2,744.01 |
— |
| CT limited/localized follow up study (76380) |
— |
$1,566.26 |
— |
| CT lower ext w/o (73700) |
— |
$2,134 |
— |
| CT lower extremity w wo contrast (73702) |
— |
$3,265.99 |
— |
| CT lower extremity with contrast (73701) |
— |
$2,628.99 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$4,221.79 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$3,428.99 |
— |
| CT lumbar spine with contrast (72132) |
— |
$4,069.80 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,694.72 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$2,236.70 |
— |
| CT maxillofacial w/wo contrast (70488) |
— |
$2,931.94 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$2,501.65 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
— |
$3,072.63 |
— |
| CT orbits w/o contrast (70480) |
— |
$2,236.70 |
— |
| CT pelvis w & w/o contrast (72194) |
— |
$4,069.80 |
— |
| CT pelvis w/o contrast (72192) |
— |
$3,108.58 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$3,407.42 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,236.70 |
— |
| CT thoracic spine w/contrast (72129) |
— |
$3,782.26 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$3,277 |
— |
| CT thoracic spine w/wo contrast (72130) |
— |
$4,296.76 |
— |
| CT thorax w/o contrast (71250) |
— |
$3,735.02 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$3,690.86 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$2,134 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,628.99 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$4,819.48 |
— |
| Cta Abdomen (74175) |
— |
$4,230.01 |
— |
| CTA abdomen pelvis (74174) |
— |
$4,658.25 |
— |
| CTA chest (71275) |
— |
$4,776.34 |
— |
| Cta Head (70496) |
— |
$4,776.34 |
— |
| CTA lwr ext w&w/o contrast (73706) |
— |
$3,553.25 |
— |
| Cta Neck (70498) |
— |
$4,776.34 |
— |
| Cta Pelvis (72191) |
— |
$4,819.48 |
— |
| Cystography minimum 3 views rs&i (74430) |
— |
$888.31 |
— |
| Diskogram cervical (72285) |
— |
$1,853.64 |
— |
| Diskography lumbar (72295) |
— |
$3,028.99 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$278.30 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$763.02 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$372.74 |
— |
| Echo exam of eye (76529) |
— |
$1,099.73 |
— |
| Echo exam of fetal heart (76825) |
— |
$743.86 |
— |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
— |
$354.50 |
— |
| Echoencephalography real time imaging (76506) |
— |
$1,216.88 |
— |
| Esophagus (74220) |
— |
$1,001.28 |
— |
| Fetal biophysical profile non-stress testing (76818) |
— |
$1,277.49 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$691.95 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,132.73 |
— |
| Foot 2 views (73620) |
— |
$334.79 |
— |
| Forearm 2 views (73090) |
— |
$334.79 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,970.22 |
— |
| Hand 2 views (73120) |
— |
$496.03 |
— |
| Hand 3 views (73130) |
— |
$334.79 |
— |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
— |
$2,164.81 |
— |
| Hepatobiliary syst imaging including gallbladder (78226) |
— |
$2,164.81 |
— |
| Ht muscle image spect sing (78451) |
— |
$6,259.26 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$445.70 |
— |
| Hysterosalpingogram (74740) |
— |
$986.90 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$1,195.37 |
— |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
— |
$78.56 |
— |
| Kidney imaging morphology (78700) |
— |
$1,764.39 |
— |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
— |
$1,989.68 |
— |
| Kidney img morphology vascular flow 1 w/rx (78708) |
— |
$2,245.97 |
— |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
— |
$3,314.99 |
— |
| Knee 3 views (73562) |
— |
$572.01 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$1,829.20 |
— |
| Lung perf&ventilat diferentl (78598) |
— |
$5,886.26 |
— |
| Lung perfusion differential (78597) |
— |
$1,506.38 |
— |
| Lung Ventilation Imaging (78579) |
— |
$2,352.22 |
— |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
— |
$3,598.43 |
— |
| Lymphoscintigraphy (78195) |
— |
$2,967.89 |
— |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
— |
$857.66 |
— |
| Meckels Diverticulum (78290) |
— |
$2,314.24 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$1,041.90 |
— |
| MRA head w & w/o contrast (70546) |
— |
$5,065.50 |
— |
| MRA head w/o contrast (70544) |
— |
$2,976.60 |
— |
| MRA head with contrast (70545) |
— |
$3,397.15 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$5,065.50 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,976.60 |
— |
| MRI abdomen w contrast (74182) |
— |
$4,075.09 |
— |
| MRI abdomen w/o & w/contrast material (74183) |
— |
$5,769.50 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$3,204.30 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$4,282.30 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$3,670.70 |
— |
| MRI breast w/o contrast bilateral (77047) |
— |
$4,826.07 |
— |
| MRI c-spine with contrast (72142) |
— |
$3,212 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$3,212 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$3,204.30 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$5,065.50 |
— |
| MRI chest w/o contrast (71550) |
— |
$2,778.60 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$3,212 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$3,537.94 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$3,204.30 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,976.60 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$5,496.70 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$4,222.32 |
— |
| MRI pelvis w contrast (72196) |
— |
$3,078.80 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$5,534.10 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,920.50 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$5,841 |
— |
| MRI scan of heart before and after contrast with stress imaging (75563) |
— |
$2,998.69 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$5,281.10 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$5,712.30 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$3,670.70 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$5,712.30 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$3,212 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$5,712.30 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$3,204.30 |
— |
| MRI tmj (70336) |
— |
$2,481.23 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$3,204.30 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$5,683.70 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$2,835.90 |
— |
| Myelogram Lumbar (72265) |
— |
$4,513.73 |
— |
| Myelography 2 or more regions (72270) |
— |
$991.58 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$7,109.57 |
— |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
— |
$5,897 |
— |
| Neck soft tissue (70360) |
— |
$464.18 |
— |
| Nm adrenal scan (78075) |
— |
$2,957.22 |
— |
| Nm cisternogram (78630) |
— |
$4,899.32 |
— |
| Nm gastric emptying study (78264) |
— |
$2,981.24 |
— |
| Nm gastroesophageal reflux study (78262) |
— |
$1,443.75 |
— |
| Nm peritoneal-venous shunt patency (78291) |
— |
$1,328.22 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$12,242.90 |
— |
| Nuclear medicine of heart muscle at rest with stress (78454) |
— |
$2,804 |
— |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
— |
$2,753.36 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,322.71 |
— |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
— |
$474.75 |
— |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
— |
$172.46 |
— |
| Orthopantogram (70355) |
— |
$563.63 |
— |
| Osseous survey infant (77076) |
— |
$1,105.99 |
— |
| Osseous survey limited (77074) |
— |
$1,146.08 |
— |
| Parathyrd planar w/spect&CT (78072) |
— |
$5,086.74 |
— |
| Parathyroid imaging (78070) |
— |
$1,978.93 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$701.41 |
— |
| Peritoneogram rs&i (74190) |
— |
$1,390.05 |
— |
| PET image w/CT, skull-thigh (78815) |
— |
$7,193.78 |
— |
| PET imaging CT for attenuation limited area (78814) |
— |
$6,579.48 |
— |
| PET imaging for CT attenuation whole body (78816) |
— |
$7,193.78 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$5,579.20 |
— |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
— |
$1,558.37 |
— |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
— |
$3,547 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,650.31 |
— |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
— |
$3,646.32 |
— |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
— |
$4,728 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$612.06 |
— |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
— |
$611.02 |
— |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
— |
$880.10 |
— |
| Radex hips bilateral with pelvis 2 views (73521) |
— |
$880.10 |
— |
| Radiation treatment delivery 1 mev >= complex (77412) |
— |
$1,793.05 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$798.97 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$478.56 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$898.58 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$492.94 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,983.45 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$1,097.81 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$1,146.08 |
— |
| Radiologic exam upr gi trc single contrast study (74240) |
— |
$1,581.70 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$521.69 |
— |
| Radiological examination surgical specimen (76098) |
— |
$417.97 |
— |
| Ribs bilateral 3 views (71110) |
— |
$780.48 |
— |
| Rp loclzj tum plnr whole body single day imaging (78802) |
— |
$3,086.95 |
— |
| Rp loclzj tum spect 1 area single day imaging (78803) |
— |
$4,577.54 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$4,407.67 |
— |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
— |
$3,389.96 |
— |
| Rp therapy intra-arterial particulate admn (79445) |
— |
$1,379.74 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$936.22 |
— |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
— |
$1,099.73 |
— |
| Scanogram (77073) |
— |
$507.31 |
— |
| Scapula complete (73010) |
— |
$521.69 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
— |
$711.68 |
— |
| Small bowel series (74250) |
— |
$1,439.78 |
— |
| Spec medical radj physics consltj (77370) |
— |
$556.61 |
— |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
— |
$432.40 |
— |
| Special dosimetry (77331) |
— |
$807.18 |
— |
| Special treatment procedure (77470) |
— |
$2,402.35 |
— |
| Spine thoracic 3 views (72072) |
— |
$801.02 |
— |
| Stereotactic body radiation delivery (77373) |
— |
$8,729.65 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$1,959.60 |
— |
| Ther rad simulaj-aided field setting complex (77290) |
— |
$1,313.30 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$959.10 |
— |
| Therapeutic Enema (74283) |
— |
$1,237.64 |
— |
| Thoracolumbar 2 views (72080) |
— |
$750.70 |
— |
| Thyroid carcinoma metastases img whole body (78018) |
— |
$3,634.38 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$983.14 |
— |
| Thyroid uptake measurement (78012) |
— |
$362.51 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,620.53 |
— |
| Tmj unilateral (70328) |
— |
$563.63 |
— |
| Treatment device intermediate (77333) |
— |
$894.47 |
— |
| Treatment devices simple (77332) |
— |
$349.63 |
— |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
— |
$4,209.47 |
— |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
— |
$1,636.13 |
— |
| Tx devices design & construction complex (77334) |
— |
$2,325.30 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,073.16 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$421.05 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$4,428.11 |
— |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
— |
$744.54 |
— |
| Upper Extremity Infant (73092) |
— |
$296.54 |
— |
| Urethrocystography retrograde rs&i (74450) |
— |
$590.50 |
— |
| Urethrocystography voiding (74455) |
— |
$611.04 |
— |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
— |
$1,355.01 |
— |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
— |
$1,405.38 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$1,051.67 |
— |
| Us breast unilateral complete (76641) |
— |
$441.55 |
— |
| Us breast unilateral limited (76642) |
— |
$441.55 |
— |
| Us chest (76604) |
— |
$730.16 |
— |
| Us compl joint r-t w/image documentation (76881) |
— |
$268 |
— |
| Us elastography parenchyma (76981) |
— |
$403 |
— |
| Us fetal nuchal translucency 1st gestation (76813) |
— |
$167.87 |
— |
| Us guided compression repair (76936) |
— |
$951.86 |
— |
| Us infant hips dynamic (76885) |
— |
$1,099.73 |
— |
| Us infant hips limited static (76886) |
— |
$207.95 |
— |
| Us kidney transplant (76776) |
— |
$302.68 |
— |
| Us ob detailed single fetus (76811) |
— |
$944.77 |
— |
| Us ob transvaginal (76817) |
— |
$897.93 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,709.29 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$1,253.48 |
— |
| Us pregnancy ltd (76815) |
— |
$499.18 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$939.59 |
— |
| Us retroperitoneal complete (76770) |
— |
$937.32 |
— |
| Us retroperitoneal limited (76775) |
— |
$875.39 |
— |
| Us scrotum and contents (76870) |
— |
$627.47 |
— |
| Us soft tissue head/neck (76536) |
— |
$778.68 |
— |
| Us spinal canal and contents (76800) |
— |
$268 |
— |
| Us transrectal (76872) |
— |
$1,271.36 |
— |
| Us transrectal prostate volume (76873) |
— |
$1,228.23 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$268 |
— |
| Us, eye b-scan (76512) |
— |
$769.81 |
— |
| Vascular flow imaging (78445) |
— |
$819.02 |
— |
| Venogram extremity bilateral (75822) |
— |
$1,657.50 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$2,067.25 |
— |
| Venography caval superior serialography rs&i (75827) |
— |
$1,657.50 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,674.96 |
— |
| Venography Renal Bilateral (75833) |
— |
$1,549.26 |
— |
| Venography renal unilateral selective rs&i (75831) |
— |
$1,657.50 |
— |
| Venous sampling thru cath w/wo angiography rs& (75893) |
— |
$4,528.40 |
— |
| Wrist 2 views (73100) |
— |
$334.79 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$687.03 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$521.69 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$334.79 |
— |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
— |
$1,992.28 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$385.11 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$385.11 |
— |
| X-ray exam entire spi 4/5 vw (72083) |
— |
$1,075.22 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$490.20 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$776.37 |
— |
| X-ray exam hip uni 4/> views (73503) |
— |
$954.17 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$752.75 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,394.60 |
— |
| X-ray exam of femur 1 (73551) |
— |
$260.85 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$631.57 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$631.57 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$334.79 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$334.79 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$570.98 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$906.80 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$398.46 |
— |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
— |
$296.54 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$872.91 |
— |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
— |
$1,297.04 |
— |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
— |
$872.91 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$516.56 |
— |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
— |
$296.54 |
— |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
— |
$998.62 |
— |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
— |
$3,108.93 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$634.66 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$744.54 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$1,207.69 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$714.76 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$714.76 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$488.83 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$883.18 |
— |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
— |
$382.03 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$846.48 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$631.57 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$473.42 |
— |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
— |
$505.26 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$516.56 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$750.70 |
— |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
— |
$872.91 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$334.79 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$334.79 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$991.01 |
— |
| Xr chest 4+ views (71048) |
— |
$991.01 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$334.79 |
— |
| Xr shoulder 1 view (73020) |
— |
$445.70 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$872.91 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$445.70 |
— |
| Xr tmj bilateral (70330) |
— |
$563.63 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$572.01 |
— |