| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,575.13 |
$3,478.50 |
2.1× |
| Abdomen 2 views (74019) |
$233.93 |
$316 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,278.13 |
$1,726.50 |
3.5× |
| Angiography extremity bilateral rs&i (75716) |
$5,781.37 |
$7,809.50 |
2.0× |
| Angiography extremity unilateral rs&i (75710) |
$5,781.37 |
$7,809.50 |
2.0× |
| Angiography internal mammary rs&i (75756) |
$983.30 |
$1,328.25 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,169.49 |
$1,579.75 |
0.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$588.17 |
$794.50 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,351.60 |
$1,825.75 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$564.29 |
$762.25 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,554.63 |
$2,100 |
0.5× |
| Ankle 2 views (73600) |
$277.61 |
$375 |
3.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$610.01 |
$824 |
1.9× |
| Aortogram thoracic (75605) |
$2,591.05 |
$3,500 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,047.11 |
$2,765.25 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,285.72 |
$1,736.75 |
0.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,192.81 |
$1,611.25 |
0.4× |
| Arthrogram elbow (73085) |
$466.20 |
$629.75 |
1.5× |
| Arthrogram hip (73525) |
$436.59 |
$589.75 |
1.4× |
| Arthrogram shoulder (73040) |
$480.45 |
$649 |
1.5× |
| Arthrogram wrist (73115) |
$436.78 |
$590 |
1.4× |
| Arthrography knee lt (73580) |
$915.01 |
$1,236 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$162.87 |
$220 |
1.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$501.74 |
$677.75 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$675.15 |
$912 |
1.9× |
| Bone &/joint imaging whole body (78306) |
$1,178.74 |
$1,592.25 |
3.3× |
| Bone age studies (77072) |
$244.30 |
$330 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,253.14 |
$1,692.75 |
3.5× |
| Bone survey complete (77075) |
$518.21 |
$700 |
5.5× |
| Brachytx isodose complex (77318) |
$665.53 |
$899 |
2.0× |
| Brachytx isodose intermed (77317) |
$527.09 |
$712 |
1.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$527.09 |
$712 |
1.6× |
| Brain image w/flow 4 + views (78606) |
$992.19 |
$1,340.25 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,264.72 |
$4,410 |
2.5× |
| Brain Imaging Vascular Flow Only (78610) |
$424.38 |
$573.25 |
0.9× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$570.40 |
$770.50 |
51.6× |
| Cervical spine 2 or 3 views (72040) |
$192.85 |
$260.50 |
2.4× |
| Chest 1 view (71045) |
$166.57 |
$225 |
2.1× |
| Chest 3 views (71047) |
$179.52 |
$242.50 |
2.3× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$422.90 |
$571.25 |
2.7× |
| Clavicle complete (73000) |
$166.94 |
$225.50 |
2.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$222.09 |
$300 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$290.20 |
$392 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,165.93 |
$2,925.75 |
6.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,396.21 |
$1,886 |
6.5× |
| CT abdomen w contrast (74160) |
$1,339.39 |
$1,809.25 |
8.4× |
| CT abdomen w wo contrast (74170) |
$1,707.13 |
$2,306 |
10.7× |
| CT abdomen w/o contrast (74150) |
$1,038.64 |
$1,403 |
11.0× |
| CT angio hrt w/3d image (75574) |
$1,135.25 |
$1,533.50 |
3.6× |
| CT angiography upper extremity lt (73206) |
$2,783.34 |
$3,759.75 |
17.5× |
| CT c-spine w/o contrast (72125) |
$1,790.05 |
$2,418 |
18.9× |
| CT cervical spine w&w/o contrast (72127) |
$2,197.21 |
$2,968 |
13.8× |
| CT cervical spine with contrast (72126) |
$1,924.78 |
$2,600 |
6.1× |
| CT chest w/wo contrast (71270) |
$1,318.10 |
$1,780.50 |
8.3× |
| CT chest with contrast (71260) |
$1,269.80 |
$1,715.25 |
8.0× |
| CT head/brain with contrast (70460) |
$1,216.50 |
$1,643.25 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,471.16 |
$1,987.25 |
9.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$1,091.76 |
$1,474.75 |
13.9× |
| CT iac w contrast (70481) |
$1,267.58 |
$1,712.25 |
8.0× |
| CT limited/localized follow up study (76380) |
$643.88 |
$869.75 |
8.2× |
| CT lower ext w/o (73700) |
$1,272.21 |
$1,718.50 |
13.4× |
| CT lower extremity w wo contrast (73702) |
$1,436.74 |
$1,940.75 |
9.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,776.72 |
$2,400 |
11.2× |
| CT lumbar spine w/o contrast (72131) |
$1,520.39 |
$2,053.75 |
16.1× |
| CT lumbar spine with contrast (72132) |
$1,554.63 |
$2,100 |
4.9× |
| CT maxillofacial w contrast (70487) |
$1,396.21 |
$1,886 |
8.8× |
| CT maxillofacial w/o contrast (70486) |
$1,406.57 |
$1,900 |
14.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,541.30 |
$2,082 |
9.7× |
| CT neck soft tissue w contrast (70491) |
$1,421.01 |
$1,919.50 |
8.9× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,437.29 |
$1,941.50 |
9.0× |
| CT orbits w/o contrast (70480) |
$1,188.92 |
$1,606 |
12.6× |
| CT pelvis w & w/o contrast (72194) |
$1,610.52 |
$2,175.50 |
10.1× |
| CT pelvis w/o contrast (72192) |
$1,038.64 |
$1,403 |
11.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,777.09 |
$2,400.50 |
11.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,310.15 |
$1,769.75 |
13.8× |
| CT thoracic spine w/contrast (72129) |
$1,406.57 |
$1,900 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$1,335.87 |
$1,804.50 |
14.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,628.66 |
$2,200 |
10.3× |
| CT thorax w/o contrast (71250) |
$1,406.57 |
$1,900 |
14.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,394.91 |
$1,884.25 |
8.8× |
| CT upper extremity w/o contrast rt (73200) |
$1,254.99 |
$1,695.25 |
13.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,823.46 |
$5,164.75 |
24.1× |
| Cta Abdomen (74175) |
$2,783.34 |
$3,759.75 |
17.5× |
| CTA abdomen pelvis (74174) |
$2,961.20 |
$4,000 |
9.4× |
| CTA chest (71275) |
$1,401.76 |
$1,893.50 |
8.8× |
| Cta Head (70496) |
$3,177.92 |
$4,292.75 |
20.0× |
| CTA lwr ext w&w/o contrast (73706) |
$2,783.34 |
$3,759.75 |
17.5× |
| Cta Neck (70498) |
$2,783.34 |
$3,759.75 |
17.5× |
| Cta Pelvis (72191) |
$533.76 |
$721 |
3.4× |
| Cystography minimum 3 views rs&i (74430) |
$421.60 |
$569.50 |
1.3× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$555.41 |
$750.25 |
5.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$359.60 |
$485.75 |
3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$185.08 |
$250 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$343.13 |
$463.50 |
3.6× |
| Echoencephalography real time imaging (76506) |
$339.43 |
$458.50 |
3.6× |
| Esophagus (74220) |
$380.14 |
$513.50 |
2.4× |
| Fetal biophysical profile non-stress testing (76818) |
$360.90 |
$487.50 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$254.11 |
$343.25 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$377.74 |
$510.25 |
1.7× |
| Foot 2 views (73620) |
$185.08 |
$250 |
2.3× |
| Forearm 2 views (73090) |
$250.41 |
$338.25 |
3.2× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$217.46 |
$293.75 |
1.0× |
| Gated Heart Planar Single (78472) |
$1,096.57 |
$1,481.25 |
3.0× |
| Hand 2 views (73120) |
$233.19 |
$315 |
2.5× |
| Hand 3 views (73130) |
$170.08 |
$229.75 |
2.2× |
| Heart Infarct Image (78466) |
$753.81 |
$1,018.25 |
2.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,428.41 |
$1,929.50 |
2.9× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,196.70 |
$1,616.50 |
3.3× |
| Ht muscle image spect sing (78451) |
$1,570.55 |
$2,121.50 |
1.3× |
| Humerus Min 2 Views Left (73060) |
$217.65 |
$294 |
2.8× |
| Hysterosalpingogram (74740) |
$542.83 |
$733.25 |
2.5× |
| Interstitial radiation source applic complex (77778) |
$1,341.98 |
$1,812.75 |
2.1× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,015.32 |
$1,371.50 |
1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$707.17 |
$955.25 |
1.4× |
| Intracavitary radiation source applic simple (77761) |
$489.52 |
$661.25 |
1.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$259.11 |
$350 |
2.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,524.28 |
$2,059 |
3.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,628.66 |
$2,200 |
3.3× |
| Knee 3 views (73562) |
$267.90 |
$361.88 |
3.4× |
| Liver & spleen imaging static only (78215) |
$853.20 |
$1,152.50 |
2.4× |
| Liver imaging static only (78201) |
$828.40 |
$1,119 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$1,332.54 |
$1,800 |
2.7× |
| Lung perfusion differential (78597) |
$814.33 |
$1,100 |
2.2× |
| Lymphoscintigraphy (78195) |
$1,344.01 |
$1,815.50 |
2.7× |
| Meckels Diverticulum (78290) |
$609.45 |
$823.25 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$347.94 |
$470 |
1.0× |
| MRA head w & w/o contrast (70546) |
$2,072.84 |
$2,800 |
6.6× |
| MRA head w/o contrast (70544) |
$1,861.48 |
$2,514.50 |
8.6× |
| MRA head with contrast (70545) |
$1,184.48 |
$1,600 |
3.7× |
| MRA neck w contrast (70548) |
$1,725.64 |
$2,331 |
5.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$796.75 |
$1,076.25 |
2.5× |
| MRA neck w/o contrast (70547) |
$1,554.63 |
$2,100 |
7.2× |
| MRI abdomen w contrast (74182) |
$2,209.98 |
$2,985.25 |
7.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,563.29 |
$3,462.50 |
8.1× |
| MRI abdomen w/o contrast (74181) |
$1,745.63 |
$2,358 |
8.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,951.25 |
$2,635.75 |
2.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,822.25 |
$2,461.50 |
2.6× |
| MRI c-spine with contrast (72142) |
$1,973.82 |
$2,666.25 |
6.2× |
| MRI cardiac w/o contrast (75557) |
$1,745.63 |
$2,358 |
8.1× |
| MRI cervical spine w/o contrast (72141) |
$2,076.91 |
$2,805.50 |
9.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,977.90 |
$2,671.75 |
6.3× |
| MRI chest w/o contrast (71550) |
$1,850.75 |
$2,500 |
8.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$814.33 |
$1,100 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,368.96 |
$3,200 |
11.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,798.37 |
$2,429.25 |
8.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,916.27 |
$2,588.50 |
6.1× |
| MRI pelvis w contrast (72196) |
$2,008.99 |
$2,713.75 |
6.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,289.38 |
$3,092.50 |
7.2× |
| MRI pelvis w/o contrast (72195) |
$1,745.63 |
$2,358 |
8.1× |
| MRI scan of arm joint before and after contrast (73223) |
$2,342.49 |
$3,164.25 |
7.4× |
| MRI spectroscopy (76390) |
$1,009.21 |
$1,363.25 |
12.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,186.66 |
$2,953.75 |
6.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,008.99 |
$2,713.75 |
6.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,186.66 |
$2,953.75 |
6.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,916.27 |
$2,588.50 |
6.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,971.05 |
$2,662.50 |
6.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,745.63 |
$2,358 |
8.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,917.19 |
$2,589.75 |
8.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,008.99 |
$2,713.75 |
6.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,789.31 |
$2,417 |
8.3× |
| Myocardial Spect Multiple Studies (78452) |
$3,240.85 |
$4,377.75 |
2.8× |
| Neck soft tissue (70360) |
$166.94 |
$225.50 |
2.1× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$794.34 |
$1,073 |
2.2× |
| Nm gastric emptying study (78264) |
$920.93 |
$1,244 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,035.23 |
$4,100 |
2.4× |
| Nuclear medicine of heart pumping function (78473) |
$1,342.16 |
$1,813 |
3.7× |
| Nuclear Rx Oral Admin (79005) |
$626.48 |
$846.25 |
3.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$372 |
$502.50 |
3.9× |
| Orthopantogram (70355) |
$217.46 |
$293.75 |
2.8× |
| Osseous survey infant (77076) |
$212.65 |
$287.25 |
2.2× |
| Osseous survey limited (77074) |
$514.14 |
$694.50 |
5.4× |
| Parathyroid imaging (78070) |
$999.41 |
$1,350 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$233.93 |
$316 |
2.5× |
| PET image w/CT, skull-thigh (78815) |
$3,784.78 |
$5,112.50 |
2.9× |
| PET imaging CT for attenuation limited area (78814) |
$2,961.20 |
$4,000 |
2.3× |
| PET imaging for CT attenuation whole body (78816) |
$3,784.78 |
$5,112.50 |
2.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$886.14 |
$1,197 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,760.80 |
$2,378.50 |
3.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$758.81 |
$1,025 |
1.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$244.30 |
$330 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$313.89 |
$424 |
3.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$219.31 |
$296.25 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$360.34 |
$486.75 |
3.8× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$342.76 |
$463 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$240.04 |
$324.25 |
2.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$291.31 |
$393.50 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$316.48 |
$427.50 |
3.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$161.57 |
$218.25 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$222.09 |
$300 |
2.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$176.75 |
$238.75 |
2.2× |
| Radiologic exam colon single contrast study (74270) |
$377.74 |
$510.25 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$555.23 |
$750 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$555.23 |
$750 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$182.67 |
$246.75 |
2.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$242.08 |
$327 |
3.1× |
| Radiological examination surgical specimen (76098) |
$814.33 |
$1,100 |
1.6× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,097.31 |
$1,482.25 |
2.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,517.02 |
$3,400 |
5.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,813.14 |
$3,800 |
2.4× |
| Sacroiliac Joints < 3 Views (72200) |
$192.48 |
$260 |
2.0× |
| Scanogram (77073) |
$242.08 |
$327 |
2.6× |
| Scapula complete (73010) |
$183.22 |
$247.50 |
1.9× |
| Screening digital breast tomosynthesis (77063) |
$92.54 |
$125 |
4.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$213.02 |
$287.75 |
2.3× |
| Sialogram (70390) |
$319.25 |
$431.25 |
1.5× |
| Simulation intermediate (77285) |
$416.97 |
$563.25 |
1.2× |
| Small bowel series (74250) |
$380.14 |
$513.50 |
2.4× |
| Spec medical radj physics consltj (77370) |
$359.97 |
$486.25 |
3.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$366.45 |
$495 |
1.1× |
| Special dosimetry (77331) |
$183.59 |
$248 |
1.5× |
| Special treatment procedure (77470) |
$852.27 |
$1,151.25 |
1.7× |
| Spine thoracic 3 views (72072) |
$241.89 |
$326.75 |
2.6× |
| Spleen imaging only (78185) |
$596.13 |
$805.25 |
1.6× |
| Tbs Technical Calculation Only (77091) |
$172.49 |
$233 |
2.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$872.81 |
$1,179 |
2.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$345.72 |
$467 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,038.64 |
$1,403 |
3.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$370.15 |
$500 |
3.0× |
| Thoracolumbar 2 views (72080) |
$162.31 |
$219.25 |
2.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,295.53 |
$1,750 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$565.96 |
$764.50 |
1.6× |
| Thyroid uptake measurement (78012) |
$498.59 |
$673.50 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$775.65 |
$1,047.75 |
2.1× |
| Tmj unilateral (70328) |
$234.31 |
$316.50 |
3.0× |
| Tomogram (76100) |
$498.96 |
$674 |
5.3× |
| Treatment device intermediate (77333) |
$278.54 |
$376.25 |
2.3× |
| Treatment devices simple (77332) |
$278.54 |
$376.25 |
2.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,517.02 |
$3,400 |
5.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,478.56 |
$1,997.25 |
4.1× |
| Tx devices design & construction complex (77334) |
$412.16 |
$556.75 |
1.2× |
| Ultrasound elastography first target lesion (76982) |
$370.15 |
$500 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$470.83 |
$636 |
5.0× |
| Umbilical-artery Doppler (OB) (76820) |
$507.48 |
$685.50 |
5.4× |
| Unlisted magnetic resonance procedure (76498) |
$740.30 |
$1,000 |
9.4× |
| Upper Extremity Infant (73092) |
$185.08 |
$250 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$397.54 |
$537 |
1.8× |
| Urethrocystography voiding (74455) |
$361.45 |
$488.25 |
1.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$406.79 |
$549.50 |
2.6× |
| Us abdl aorta screen aaa (76706) |
$259.11 |
$350 |
2.7× |
| Us breast unilateral complete (76641) |
$377 |
$509.25 |
4.0× |
| Us breast unilateral limited (76642) |
$204.32 |
$276 |
2.6× |
| Us chest (76604) |
$370.15 |
$500 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$439.37 |
$593.50 |
4.6× |
| Us elastography parenchyma (76981) |
$370.15 |
$500 |
3.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$236.90 |
$320 |
2.5× |
| Us guided compression repair (76936) |
$703.29 |
$950 |
3.6× |
| Us infant hips dynamic (76885) |
$468.80 |
$633.25 |
5.9× |
| Us ob detailed single fetus (76811) |
$468.80 |
$633.25 |
2.2× |
| Us ob transvaginal (76817) |
$250.04 |
$337.75 |
2.6× |
| Us pelvic non ob complete (76856) |
$505.62 |
$683 |
5.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$250.04 |
$337.75 |
2.6× |
| Us pregnancy ltd (76815) |
$610.75 |
$825 |
6.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$510.44 |
$689.50 |
5.4× |
| Us retroperitoneal complete (76770) |
$481.20 |
$650 |
5.1× |
| Us retroperitoneal limited (76775) |
$454.54 |
$614 |
4.8× |
| Us scrotum and contents (76870) |
$394.39 |
$532.75 |
4.2× |
| Us soft tissue head/neck (76536) |
$501.37 |
$677.25 |
5.3× |
| Us spinal canal and contents (76800) |
$469.72 |
$634.50 |
5.0× |
| Us transrectal (76872) |
$333.14 |
$450 |
3.5× |
| Venogram extremity bilateral (75822) |
$678.30 |
$916.25 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,303.48 |
$1,760.75 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$1,373.63 |
$1,855.50 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$864.86 |
$1,168.25 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,601.27 |
$2,163 |
0.6× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$935.92 |
$1,264.25 |
0.2× |
| Wrist 2 views (73100) |
$249.85 |
$337.50 |
3.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$206.91 |
$279.50 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$206.91 |
$279.50 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$299.82 |
$405 |
3.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$426.23 |
$575.75 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$280.39 |
$378.75 |
3.6× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$247.36 |
$334.13 |
3.1× |
| X-ray exam hip uni 1 view (73501) |
$268.73 |
$363 |
3.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$244.30 |
$330 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$266.88 |
$360.50 |
2.8× |
| X-ray eye for foreign body (70030) |
$186 |
$251.25 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$268.73 |
$363 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$166.94 |
$225.50 |
2.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$279.83 |
$378 |
3.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$231.25 |
$312.38 |
2.9× |
| X-ray IV pyelogram+drip infusn (74410) |
$419.01 |
$566 |
2.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$277.61 |
$375 |
3.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$259.11 |
$350 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$196.18 |
$265 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$285.94 |
$386.25 |
3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$282.24 |
$381.25 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$332.02 |
$448.50 |
3.5× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$282.24 |
$381.25 |
3.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$226.72 |
$306.25 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$247.82 |
$334.75 |
3.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$269.84 |
$364.50 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$222.09 |
$300 |
2.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$823.95 |
$1,113 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$183.04 |
$247.25 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$233.93 |
$316 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$247.63 |
$334.50 |
2.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$277.61 |
$375 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$183.04 |
$247.25 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$211.54 |
$285.75 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$250.04 |
$337.75 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$179.71 |
$242.75 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$288.90 |
$390.25 |
3.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$220.98 |
$298.50 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$198.22 |
$267.75 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$184.70 |
$249.50 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$162.31 |
$219.25 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$233.93 |
$316 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$274.28 |
$370.50 |
2.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$186.56 |
$252 |
2.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$287.33 |
$388.13 |
3.6× |
| Xr arthrogram ankle (73615) |
$423.82 |
$572.50 |
1.3× |
| Xr c-spine 6 or more views (72052) |
$352.01 |
$475.50 |
3.7× |
| Xr chest 4+ views (71048) |
$171.19 |
$231.25 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$192.48 |
$260 |
2.4× |
| Xr shoulder 1 view (73020) |
$166.57 |
$225 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$335.36 |
$453 |
3.5× |
| Xr tibia/fibula 2 views (73590) |
$277.34 |
$374.63 |
3.5× |
| Xr tmj bilateral (70330) |
$351.46 |
$474.75 |
4.5× |
| Xray knee 1 or 2 views rt (73560) |
$161.57 |
$218.25 |
2.1× |