| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,536.20 |
$9,227 |
4.0× |
| Abdomen 2 views (74019) |
$293.40 |
$489 |
2.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$992.40 |
$1,654 |
2.5× |
| Angiography extremity unilateral rs&i (75710) |
$2,590.80 |
$4,318 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,217.80 |
$5,363 |
1.0× |
| Ankle 2 views (73600) |
$225 |
$375 |
2.6× |
| Basic radiation dosimetry calculation (77300) |
$424.80 |
$708 |
3.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$946.80 |
$1,578 |
2.4× |
| Bone &/joint imaging whole body (78306) |
$1,597.80 |
$2,663 |
4.0× |
| Bone age studies (77072) |
$135.60 |
$226 |
1.3× |
| Bone Marrow Imaging Limited Area (78102) |
$775.20 |
$1,292 |
1.9× |
| Bone survey complete (77075) |
$622.20 |
$1,037 |
5.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,653.80 |
$4,423 |
7.6× |
| Cervical spine 2 or 3 views (72040) |
$384.60 |
$641 |
4.4× |
| Chest 1 view (71045) |
$208.80 |
$348 |
2.4× |
| Chest 3 views (71047) |
$344.40 |
$574 |
3.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$403.20 |
$672 |
2.3× |
| Clavicle complete (73000) |
$247.80 |
$413 |
2.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$214.80 |
$358 |
2.0× |
| Continuing medical physics consltj pr wk (77336) |
$412.20 |
$687 |
3.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,526.40 |
$7,544 |
12.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,451.20 |
$5,752 |
14.4× |
| CT abdomen w contrast (74160) |
$2,239.20 |
$3,732 |
12.7× |
| CT abdomen w wo contrast (74170) |
$2,845.80 |
$4,743 |
16.2× |
| CT abdomen w/o contrast (74150) |
$2,031.60 |
$3,386 |
19.4× |
| CT angio hrt w/3d image (75574) |
$1,966.80 |
$3,278 |
5.6× |
| CT angiography upper extremity lt (73206) |
$2,007 |
$3,345 |
11.4× |
| CT c-spine w/o contrast (72125) |
$1,471.80 |
$2,453 |
14.0× |
| CT cervical spine with contrast (72126) |
$1,858.20 |
$3,097 |
5.3× |
| CT chest w/wo contrast (71270) |
$2,347.20 |
$3,912 |
13.3× |
| CT chest with contrast (71260) |
$1,870.80 |
$3,118 |
10.6× |
| CT head/brain without and with contrast (70470) |
$2,289.60 |
$3,816 |
13.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$153 |
$255 |
1.8× |
| CT iac w contrast (70481) |
$2,124.60 |
$3,541 |
12.1× |
| CT lower ext w/o (73700) |
$1,633.80 |
$2,723 |
15.6× |
| CT lower extremity w wo contrast (73702) |
$2,015.40 |
$3,359 |
11.5× |
| CT lower extremity with contrast (73701) |
$1,710.60 |
$2,851 |
9.7× |
| CT lumbar spine w & w/o contrast (72133) |
$1,974.60 |
$3,291 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$1,471.80 |
$2,453 |
14.0× |
| CT maxillofacial w contrast (70487) |
$2,044.80 |
$3,408 |
11.6× |
| CT maxillofacial w/o contrast (70486) |
$1,527 |
$2,545 |
14.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,113.80 |
$3,523 |
12.0× |
| CT neck soft tissue w contrast (70491) |
$2,020.80 |
$3,368 |
11.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,391 |
$3,985 |
13.6× |
| CT orbits w/o contrast (70480) |
$1,848.60 |
$3,081 |
17.6× |
| CT pelvis w & w/o contrast (72194) |
$2,422.20 |
$4,037 |
13.8× |
| CT pelvis w/o contrast (72192) |
$1,353.60 |
$2,256 |
12.9× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,125.20 |
$3,542 |
12.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,437 |
$2,395 |
13.7× |
| CT thoracic spine w/o contrast (72128) |
$1,582.20 |
$2,637 |
15.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,680 |
$2,800 |
9.5× |
| CT thorax w/o contrast (71250) |
$1,317 |
$2,195 |
12.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,804.20 |
$3,007 |
10.3× |
| CT upper extremity w/o contrast rt (73200) |
$1,589.40 |
$2,649 |
15.2× |
| CT upper extremity with contrast (73201) |
$1,658.40 |
$2,764 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,908 |
$3,180 |
10.8× |
| Cta Abdomen (74175) |
$2,384.40 |
$3,974 |
13.6× |
| CTA abdomen pelvis (74174) |
$3,007.20 |
$5,012 |
8.6× |
| CTA chest (71275) |
$2,300.40 |
$3,834 |
13.1× |
| Cta Head (70496) |
$2,172.60 |
$3,621 |
12.3× |
| CTA lwr ext w&w/o contrast (73706) |
$2,472 |
$4,120 |
14.1× |
| Cta Neck (70498) |
$2,214.60 |
$3,691 |
12.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$523.20 |
$872 |
5.0× |
| Echoencephalography real time imaging (76506) |
$400.20 |
$667 |
3.8× |
| Esophagus (74220) |
$426.60 |
$711 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$457.80 |
$763 |
4.4× |
| Fluoroscopy up to 1 hr (76000) |
$560.40 |
$934 |
2.3× |
| Foot 2 views (73620) |
$222 |
$370 |
2.5× |
| Forearm 2 views (73090) |
$309 |
$515 |
3.5× |
| Hand 3 views (73130) |
$274.80 |
$458 |
3.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,876.20 |
$3,127 |
3.4× |
| Ht muscle image spect sing (78451) |
$2,635.80 |
$4,393 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$202.20 |
$337 |
2.3× |
| Hysterosalpingogram (74740) |
$611.40 |
$1,019 |
2.6× |
| Knee 3 views (73562) |
$291 |
$485 |
3.3× |
| Lymphoscintigraphy (78195) |
$1,648.80 |
$2,748 |
3.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,449.80 |
$4,083 |
6.5× |
| MRA head w & w/o contrast (70546) |
$2,977.80 |
$4,963 |
8.5× |
| MRA head w/o contrast (70544) |
$2,568.60 |
$4,281 |
10.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,835.60 |
$4,726 |
8.1× |
| MRA neck w/o contrast (70547) |
$2,175.60 |
$3,626 |
9.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,829.80 |
$6,383 |
10.9× |
| MRI abdomen w/o contrast (74181) |
$3,321 |
$5,535 |
13.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,079.80 |
$5,133 |
3.9× |
| MRI cervical spine w/o contrast (72141) |
$2,692.80 |
$4,488 |
11.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,521.80 |
$4,203 |
7.2× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,439.60 |
$4,066 |
10.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,390 |
$5,650 |
9.7× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,696 |
$6,160 |
10.6× |
| MRI pelvis w/o contrast (72195) |
$2,325.60 |
$3,876 |
9.7× |
| MRI scan of arm joint before and after contrast (73223) |
$3,556.80 |
$5,928 |
10.2× |
| MRI scan of leg joint before and after contrast (73723) |
$4,083 |
$6,805 |
11.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,852.60 |
$6,421 |
11.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,057.60 |
$5,096 |
8.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,951 |
$6,585 |
11.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,473.20 |
$4,122 |
10.3× |
| MRI tmj (70336) |
$2,454.60 |
$4,091 |
10.3× |
| MRI upper ext joint w/o contrast (73221) |
$2,568.60 |
$4,281 |
10.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,432.60 |
$5,721 |
9.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,285.40 |
$3,809 |
9.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,501.60 |
$5,836 |
2.7× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,663 |
$6,105 |
2.6× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,663 |
$6,105 |
2.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,961.80 |
$6,603 |
1.8× |
| Neck soft tissue (70360) |
$258.60 |
$431 |
3.0× |
| Nm gastric emptying study (78264) |
$1,662.60 |
$2,771 |
4.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,433.40 |
$7,389 |
3.2× |
| Orthopantogram (70355) |
$165.60 |
$276 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,309.80 |
$2,183 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$196.20 |
$327 |
1.9× |
| PET image w/CT, skull-thigh (78815) |
$4,341.60 |
$7,236 |
3.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,913.80 |
$6,523 |
11.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$946.80 |
$1,578 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,345.80 |
$2,243 |
2.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$248.40 |
$414 |
2.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$423.60 |
$706 |
4.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$289.80 |
$483 |
2.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$946.20 |
$1,577 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$206.40 |
$344 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$247.20 |
$412 |
2.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$317.40 |
$529 |
3.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$332.40 |
$554 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$604.80 |
$1,008 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$702 |
$1,170 |
4.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$645 |
$1,075 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$177.60 |
$296 |
2.0× |
| Rp Therapy Intravenous Administration (79101) |
$709.80 |
$1,183 |
3.0× |
| Sacroiliac Joints < 3 Views (72200) |
$160.80 |
$268 |
1.5× |
| Scapula complete (73010) |
$246.60 |
$411 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$27.60 |
$46 |
1.2× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$346.80 |
$578 |
3.3× |
| Small bowel series (74250) |
$514.20 |
$857 |
2.9× |
| Special treatment procedure (77470) |
$1,329 |
$2,215 |
2.4× |
| Spine thoracic 3 views (72072) |
$334.80 |
$558 |
3.2× |
| Stereotactic body radiation delivery (77373) |
$6,544.20 |
$10,907 |
3.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,829.40 |
$3,049 |
4.9× |
| Ther rad simulaj-aided field setting simple (77280) |
$890.40 |
$1,484 |
6.6× |
| Thoracolumbar 2 views (72080) |
$248.40 |
$414 |
2.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,944.60 |
$3,241 |
3.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,302 |
$2,170 |
3.2× |
| Tmj unilateral (70328) |
$220.80 |
$368 |
2.5× |
| Tx devices design & construction complex (77334) |
$958.80 |
$1,598 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$747.60 |
$1,246 |
7.1× |
| Umbilical-artery Doppler (OB) (76820) |
$165 |
$275 |
1.6× |
| Upper Extremity Infant (73092) |
$112.20 |
$187 |
1.1× |
| Us abdl aorta screen aaa (76706) |
$390 |
$650 |
3.7× |
| Us breast unilateral complete (76641) |
$486 |
$810 |
4.6× |
| Us breast unilateral limited (76642) |
$454.20 |
$757 |
5.2× |
| Us chest (76604) |
$338.40 |
$564 |
3.2× |
| Us infant hips dynamic (76885) |
$261.60 |
$436 |
3.0× |
| Us ob transvaginal (76817) |
$516 |
$860 |
4.9× |
| Us pelvic non ob complete (76856) |
$760.80 |
$1,268 |
7.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$467.40 |
$779 |
4.5× |
| Us pregnancy ltd (76815) |
$487.80 |
$813 |
4.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$688.80 |
$1,148 |
6.6× |
| Us retroperitoneal complete (76770) |
$522 |
$870 |
5.0× |
| Us retroperitoneal limited (76775) |
$498.60 |
$831 |
4.8× |
| Us scrotum and contents (76870) |
$766.80 |
$1,278 |
7.3× |
| Us soft tissue head/neck (76536) |
$793.20 |
$1,322 |
7.6× |
| Us spinal canal and contents (76800) |
$345.60 |
$576 |
3.3× |
| Us xtr non-vasc lmtd (76882) |
$558.60 |
$931 |
5.3× |
| Venography extremity unilateral rs&i (75820) |
$1,120.20 |
$1,867 |
0.7× |
| Wrist 2 views (73100) |
$361.20 |
$602 |
4.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$342 |
$570 |
3.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$357.60 |
$596 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$709.80 |
$1,183 |
4.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$257.40 |
$429 |
2.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$362.40 |
$604 |
4.2× |
| X-ray exam hip uni 1 view (73501) |
$224.40 |
$374 |
2.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$237 |
$395 |
2.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$480 |
$800 |
4.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$333.60 |
$556 |
3.2× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$246.60 |
$411 |
2.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$309.60 |
$516 |
3.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$271.20 |
$452 |
3.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$120.60 |
$201 |
1.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$297.60 |
$496 |
2.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$322.20 |
$537 |
3.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$206.40 |
$344 |
2.4× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$315 |
$525 |
3.6× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$325.80 |
$543 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$417.60 |
$696 |
4.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$270.60 |
$451 |
2.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$283.80 |
$473 |
3.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$270 |
$450 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$430.20 |
$717 |
4.9× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$226.20 |
$377 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$396 |
$660 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$329.40 |
$549 |
3.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$292.80 |
$488 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$297.60 |
$496 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$195.60 |
$326 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$309 |
$515 |
3.5× |
| Xr chest 4+ views (71048) |
$355.80 |
$593 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$208.80 |
$348 |
2.4× |
| Xr shoulder 1 view (73020) |
$187.80 |
$313 |
2.2× |
| Xr spine cervical 4 or 5 views (72050) |
$565.80 |
$943 |
5.4× |
| Xr tibia/fibula 2 views (73590) |
$278.40 |
$464 |
3.2× |
| Xray knee 1 or 2 views rt (73560) |
$280.20 |
$467 |
3.2× |