| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,482.48 |
$9,137.47 |
3.9× |
| Abdomen 1 View (74018) |
$247.64 |
$412.73 |
2.8× |
| Abdomen 2 views (74019) |
$316.30 |
$527.16 |
3.0× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,360.55 |
$2,267.59 |
3.4× |
| Angio internal mammary (75756) |
$1,629.33 |
$2,715.55 |
0.5× |
| Angio pulmonary bilat (75743) |
$3,535.57 |
$5,892.62 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,924.46 |
$4,874.10 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$3,570.38 |
$5,950.63 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,144.82 |
$5,241.37 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,150 |
$5,250 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,704.33 |
$2,840.55 |
0.5× |
| Ankle 2 views (73600) |
$217.55 |
$362.58 |
2.5× |
| Aortography thoracic serialography rs&i (75605) |
$3,167.26 |
$5,278.77 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,570 |
$5,950 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$4,658.99 |
$7,764.98 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$2,001.74 |
$3,336.24 |
0.6× |
| Artery X-Rays Pelvis (75736) |
$3,993.41 |
$6,655.69 |
0.7× |
| Artery X-Rays Spine (75705) |
$4,094.60 |
$6,824.33 |
0.7× |
| Arthrogram ankle (73615) |
$495.58 |
$825.96 |
1.4× |
| Arthrogram hip (73525) |
$520.38 |
$867.30 |
1.5× |
| Arthrogram Wrist (73115) |
$495.58 |
$825.96 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$473.01 |
$788.35 |
3.5× |
| Bone age studies (77072) |
$175.04 |
$291.73 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,875.14 |
$3,125.24 |
4.7× |
| Bone Imaging Limited Area (78300) |
$1,333.26 |
$2,222.10 |
3.3× |
| Bone Imaging Multiple Areas (78305) |
$446.03 |
$743.39 |
1.1× |
| Bone Imaging Whole Body (78306) |
$1,823.30 |
$3,038.83 |
4.5× |
| Bone marrow imaging limited area (78102) |
$702.26 |
$1,170.44 |
1.7× |
| Bone marrow imaging; multiple areas (78103) |
$367.06 |
$611.77 |
0.9× |
| Bone marrow imaging; whole body (78104) |
$452.36 |
$753.93 |
1.1× |
| Bone survey infant (77076) |
$233.11 |
$388.52 |
2.2× |
| Brachytx isodose complex (77318) |
$705.45 |
$1,175.75 |
1.9× |
| Brachytx isodose intermed (77317) |
$640.03 |
$1,066.72 |
1.7× |
| Brachytx Isodose Plan Simple (77316) |
$633.91 |
$1,056.51 |
1.7× |
| Brain Flow Imaging Only (78610) |
$472.92 |
$788.20 |
0.9× |
| Brain Image W/Flow < 4 Views (78601) |
$1,063.48 |
$1,772.47 |
2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,553.68 |
$2,589.46 |
2.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,028.73 |
$5,047.88 |
2.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$566.74 |
$944.57 |
1.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,959 |
$4,931.66 |
8.4× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$3,628.80 |
$6,048 |
4.6× |
| Cardiac Shunt Detection (78428) |
$1,354.80 |
$2,258 |
3.4× |
| Cat Scan Follow-Up Study (76380) |
$742.44 |
$1,237.40 |
8.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$895.95 |
$1,493.25 |
1.6× |
| Cerebrospinal Fluid Scan (78630) |
$1,609.18 |
$2,681.97 |
3.0× |
| Chest 1 view (71045) |
$220.04 |
$366.74 |
2.5× |
| Chest 2 views (71046) |
$393.82 |
$656.37 |
4.5× |
| Chest 3 views (71047) |
$274.10 |
$456.83 |
3.1× |
| Chest 4 or more views (71048) |
$393.55 |
$655.92 |
3.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$265.61 |
$442.68 |
2.5× |
| Cholecystography Oral Contrast (74290) |
$186.25 |
$310.41 |
1.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$424.92 |
$708.20 |
4.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,336.32 |
$2,227.20 |
1.7× |
| Clavicle complete (73000) |
$236.29 |
$393.82 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$184.05 |
$306.75 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$694.39 |
$1,157.31 |
5.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,389.09 |
$5,648.49 |
1.1× |
| Contrast X-Ray Bladder (74430) |
$326.08 |
$543.46 |
0.9× |
| Contrast X-Ray Of Elbow (73085) |
$495.60 |
$826 |
1.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$495.60 |
$826 |
1.4× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$200.39 |
$333.99 |
1.1× |
| Corpora cavernosography (74445) |
$565.20 |
$942 |
5.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,172.12 |
$6,953.54 |
11.9× |
| CT abdomen and pelvis without contrast (74176) |
$3,538.08 |
$5,896.80 |
14.8× |
| CT abdomen w contrast (74160) |
$3,061.80 |
$5,103 |
17.4× |
| CT abdomen w wo contrast (74170) |
$3,061.80 |
$5,103 |
17.4× |
| CT abdomen w/o contrast (74150) |
$2,177.28 |
$3,628.80 |
20.7× |
| CT Angio Abdomen and Pelvis (74174) |
$5,576.98 |
$9,294.97 |
15.9× |
| CT Angio Chest (71275) |
$3,774.58 |
$6,290.97 |
21.4× |
| CT Angio Head (70496) |
$3,544.24 |
$5,907.07 |
20.1× |
| CT angio hrt w/3d image (75574) |
$1,896.81 |
$3,161.35 |
5.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,061.80 |
$5,103 |
17.4× |
| CT Angio Neck (70498) |
$3,506.47 |
$5,844.12 |
19.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,389.24 |
$5,648.73 |
19.2× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,477.48 |
$2,462.46 |
8.4× |
| CT cervical spine w/ contrast (72126) |
$2,304.59 |
$3,840.99 |
6.6× |
| CT cervical spine w/o contrast (72125) |
$2,042.26 |
$3,403.77 |
19.4× |
| CT cervical spine w/wo cont (72127) |
$3,061.80 |
$5,103 |
17.4× |
| CT chest w contrast (71260) |
$2,003.90 |
$3,339.84 |
11.4× |
| CT chest w/wo contrast (71270) |
$3,061.80 |
$5,103 |
17.4× |
| CT colonography screening (74263) |
$1,233.01 |
$2,055.02 |
5.1× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$699 |
$1,165 |
6.7× |
| CT head/brain with contrast (70460) |
$1,681.39 |
$2,802.32 |
9.5× |
| CT head/brain without and with contrast (70470) |
$2,041.88 |
$3,403.14 |
11.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,876.48 |
$3,127.46 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$79 |
$131.67 |
0.9× |
| CT hrt w/3d image congen (75573) |
$934.40 |
$1,557.33 |
2.7× |
| CT iac w contrast (70481) |
$1,543.83 |
$2,573.05 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$1,677.35 |
$2,795.59 |
9.5× |
| CT lower ext w/o (73700) |
$1,715.36 |
$2,858.93 |
16.3× |
| CT lower extremity w/contrast material (73701) |
$2,399.92 |
$3,999.86 |
13.6× |
| CT lumbar spine w contrast (72132) |
$2,381.40 |
$3,969 |
6.8× |
| CT lumbar spine w/o contrast (72131) |
$2,054.79 |
$3,424.65 |
19.6× |
| CT maxillofacial w contrast (70487) |
$2,004.41 |
$3,340.68 |
11.4× |
| CT maxillofacial wo contrast (70486) |
$1,704.54 |
$2,840.90 |
16.2× |
| CT neck tissue combo (70492) |
$2,311.02 |
$3,851.70 |
13.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,563.46 |
$2,605.77 |
8.9× |
| CT orbits w/o contrast (70480) |
$1,678.86 |
$2,798.10 |
16.0× |
| CT pelvis w&w/o contrast (72194) |
$2,047.67 |
$3,412.78 |
11.6× |
| CT pelvis w/o contrast (72192) |
$1,621.86 |
$2,703.10 |
15.4× |
| CT scan of leg combo (73702) |
$2,069.09 |
$3,448.48 |
11.7× |
| CT scans face/jaw combo (70488) |
$1,908.20 |
$3,180.33 |
10.8× |
| CT soft tissue neck w contrast (70491) |
$1,984.18 |
$3,306.97 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,539.67 |
$2,566.11 |
14.7× |
| CT thoracic spine w contrast (72129) |
$2,274.17 |
$3,790.29 |
12.9× |
| CT thoracic spine w/o contrast (72128) |
$1,890.44 |
$3,150.74 |
18.0× |
| CT thoracic spine w/wo cont (72130) |
$3,303.95 |
$5,506.58 |
18.8× |
| CT thorax w/o contrast (71250) |
$1,680.11 |
$2,800.19 |
16.0× |
CT unlisted procedure (76497)
range across 6 matching MRF lines |
$316.92–$3,852.68 |
$528.20–$6,421.14 |
varies |
| CT upper ext wo (73200) |
$1,847.32 |
$3,078.86 |
17.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,845.36 |
$3,075.60 |
10.5× |
| CT upper extremity with contrast (73201) |
$2,394.81 |
$3,991.35 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,768.15 |
$4,613.58 |
15.7× |
| Cta Abdomen (74175) |
$3,522.40 |
$5,870.67 |
20.0× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$7,050.71 |
$11,751.19 |
20.1× |
| CTA pelvis (72191) |
$3,257.44 |
$5,429.06 |
18.5× |
| Dilation ureters/urethra rs&i (74485) |
$1,525.20 |
$2,542 |
0.7× |
| Discography Cerv/Thor Spine (72285) |
$2,050.91 |
$3,418.19 |
1.0× |
| Diskography lumbar (72295) |
$2,358.23 |
$3,930.39 |
1.2× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$318.34 |
$530.57 |
3.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$431.41 |
$719.01 |
4.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$332.64 |
$554.40 |
3.2× |
| Dxa Bone Density Axial (77080) |
$381.19 |
$635.32 |
3.6× |
| Dxa bone density study (77085) |
$365.14 |
$608.57 |
3.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$220.43 |
$367.38 |
2.5× |
| Echo exam of fetal heart (76825) |
$855.38 |
$1,425.64 |
1.6× |
| Echo exam uterus (76831) |
$409.50 |
$682.50 |
1.7× |
| Echo Guide For Artery Repair (76936) |
$687.35 |
$1,145.58 |
3.2× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$378 |
$630 |
1.6× |
| Echograp Trans R Pros Study (76873) |
$459.40 |
$765.66 |
4.4× |
| Esophagram (74220) |
$501.34 |
$835.57 |
2.8× |
| Fetal Biophys Profile W/Nst (76818) |
$541.74 |
$902.90 |
5.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$404.98 |
$674.97 |
3.9× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,136.26 |
$1,893.77 |
4.7× |
| Fluoroscopy up to 1 hr (76000) |
$463.80 |
$773 |
1.9× |
| Follow-Up Angiography (75898) |
$1,939.14 |
$3,231.90 |
0.6× |
| Foot 2 views (73620) |
$287.92 |
$479.87 |
3.3× |
| Forearm 2 views (73090) |
$317.62 |
$529.37 |
3.6× |
| Gastric emptying imaging study (78264) |
$1,861.14 |
$3,101.90 |
4.6× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$2,536.50 |
$4,227.50 |
6.3× |
| Gastroesophageal Reflux Exam (78262) |
$493.75 |
$822.91 |
1.2× |
| Gated Heart Planar Single (78472) |
$1,588.83 |
$2,648.05 |
4.0× |
| Hand 2 views (73120) |
$318 |
$530 |
3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,599.36 |
$2,665.60 |
2.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,763.29 |
$2,938.82 |
2.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,138.90 |
$3,564.84 |
3.1× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,368.95 |
$5,614.92 |
1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,563.49 |
$4,272.48 |
0.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,900.64 |
$3,167.73 |
3.5× |
| Hepatobiliary System Imaging (78226) |
$1,760.38 |
$2,933.97 |
4.4× |
| Ht Musc Image Planar Mult (78454) |
$1,595.26 |
$2,658.77 |
1.2× |
| Ht Muscle Image Spect Sing (78451) |
$3,064.87 |
$5,108.11 |
2.4× |
| Hyperthermia external generated superficial (77600) |
$893.86 |
$1,489.76 |
2.3× |
| Hysterosalpingogram (74740) |
$702.41 |
$1,170.68 |
2.9× |
| Image fusion (77399) |
$376.03 |
$626.72 |
2.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$403.88 |
$673.14 |
4.6× |
| Infant hip ultrasound, limited static exam (76886) |
$220.50 |
$367.50 |
2.5× |
| Infusion Ivp (74410) |
$690.85 |
$1,151.41 |
3.9× |
| Interstitial radiation source applic complex (77778) |
$1,162.45 |
$1,937.41 |
1.7× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,107.14 |
$1,845.24 |
1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$3,384.04 |
$5,640.06 |
6.1× |
| Intracavitary radiation source applic simple (77761) |
$796.97 |
$1,328.29 |
1.4× |
| Joint Survey Single View (77077) |
$124.24 |
$207.07 |
1.2× |
| K Flow/Funct Image Multiple (78709) |
$1,193.73 |
$1,989.55 |
2.2× |
| K Flow/Funct Image W/Drug (78708) |
$1,698.91 |
$2,831.51 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,468.04 |
$2,446.73 |
2.7× |
| Kidney Imaging Morphol (78700) |
$539.97 |
$899.95 |
1.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$651.59 |
$1,085.99 |
1.6× |
| Knee 3 Views (73562) |
$319.24 |
$532.06 |
3.7× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$445.14 |
$741.90 |
1.1× |
| Leveen/Shunt Patency Exam (78291) |
$441.21 |
$735.35 |
1.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,471.52 |
$2,452.54 |
3.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$504.82 |
$841.37 |
1.3× |
| Liver imaging static only (78201) |
$1,279.10 |
$2,131.83 |
2.3× |
| Liver imaging w/vascular flow (78202) |
$1,255.15 |
$2,091.92 |
2.3× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,610.93 |
$2,684.88 |
3.0× |
| Lung perfusion differential (78597) |
$1,199.16 |
$1,998.60 |
3.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,381.40 |
$3,969 |
4.4× |
| Lung Ventilation Imaging (78579) |
$828.73 |
$1,381.21 |
2.1× |
| Lymph System Imaging (78195) |
$1,939.47 |
$3,232.45 |
3.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$700.80 |
$1,168 |
1.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$1,238.59 |
$2,064.32 |
0.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,694.05 |
$4,490.09 |
0.8× |
| Magnetic Image Jaw Joint (70336) |
$1,658.77 |
$2,764.61 |
6.9× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$2,505.67 |
$4,176.11 |
14.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$2,005.45 |
$3,342.42 |
3.7× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$2,813.09 |
$4,688.49 |
16.0× |
| Magnetic Resonance Elastography (76391) |
$1,736.89 |
$2,894.81 |
7.2× |
| Mammary ductogram or galactogram single (77053) |
$295.75 |
$492.92 |
1.2× |
| Meckels Divert Exam (78290) |
$1,417.03 |
$2,361.72 |
3.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$798.01 |
$1,330.02 |
2.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,980.92 |
$3,301.54 |
5.3× |
| Mr safety determination physician/other qhp (76016) |
$186 |
$310 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$50.40 |
$84 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$204.73 |
$341.22 |
2.1× |
| Mr safety implt pos&/immoblj (76019) |
$137.25 |
$228.75 |
2.3× |
| Mr safety med physics xm customization plng&mntr (76017) |
$513.60 |
$856 |
2.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$3,061.80 |
$5,103 |
8.7× |
| MRA head w/o contrast (70544) |
$2,674.86 |
$4,458.10 |
11.2× |
| MRA head with contrast (70545) |
$1,753.94 |
$2,923.24 |
5.0× |
| MRA neck w contrast (70548) |
$2,951.65 |
$4,919.42 |
8.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,341.59 |
$5,569.31 |
9.5× |
| MRA neck w/o contrast (70547) |
$2,510.57 |
$4,184.28 |
10.5× |
| MRI abdomen w contrast (74182) |
$1,823.47 |
$3,039.12 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$2,197.95 |
$3,663.25 |
9.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,394.58 |
$3,990.96 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,690.46 |
$6,150.76 |
10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,857.68 |
$4,762.80 |
3.6× |
| MRI bone marrow blood supply (77084) |
$1,349.86 |
$2,249.77 |
5.6× |
| MRI brain functional w/o physician admnistration (70554) |
$987.52 |
$1,645.86 |
4.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,083.19 |
$3,471.99 |
8.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,780.67 |
$2,967.78 |
7.4× |
| MRI cardiac w/o cont stress (75559) |
$1,506.82 |
$2,511.37 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$2,445.07 |
$4,075.12 |
10.2× |
| MRI cervical spine w contrast (72142) |
$2,231.16 |
$3,718.60 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$2,266.09 |
$3,776.81 |
9.5× |
| MRI chest w/o contrast (71550) |
$1,593.75 |
$2,656.25 |
6.6× |
| MRI chest with contrast (71551) |
$1,581.08 |
$2,635.13 |
2.0× |
| MRI chest wo w contrast (71552) |
$2,270.14 |
$3,783.56 |
6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,541.64 |
$2,569.40 |
4.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,830.86 |
$6,384.76 |
10.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,115.46 |
$3,525.77 |
8.8× |
| MRI lumbar spine w contrast (72149) |
$2,181.58 |
$3,635.96 |
6.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,946.32 |
$6,577.20 |
11.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,551.50 |
$4,252.50 |
10.6× |
| MRI orbit face neck w contrast (70542) |
$1,720.74 |
$2,867.90 |
4.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,691.51 |
$6,152.52 |
10.5× |
| MRI pelvis w contrast (72196) |
$1,745.15 |
$2,908.58 |
5.0× |
| MRI pelvis w/o & w contrast (72197) |
$3,742.20 |
$6,237 |
10.7× |
| MRI pelvis w/o contrast (72195) |
$2,721.60 |
$4,536 |
11.4× |
| MRI spectroscopy (76390) |
$1,322.36 |
$2,203.93 |
15.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,034.41 |
$3,390.69 |
8.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,447.90 |
$2,413.16 |
4.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,074.10 |
$3,456.83 |
8.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,402 |
$5,670 |
9.7× |
| MRI, abdomen, combo (74183) |
$3,810.24 |
$6,350.40 |
10.9× |
| MRI, dorsal spine combo (72157) |
$3,957.73 |
$6,596.21 |
11.3× |
| MRI, dorsal spine contrast (72147) |
$1,853.47 |
$3,089.11 |
5.3× |
| MRI, joint upper extrem (73221) |
$1,788.37 |
$2,980.61 |
7.5× |
| MRI, joint upper extrem combo (73223) |
$2,354 |
$3,923.33 |
6.7× |
| MRI, lumbar spine combo (72158) |
$3,196.33 |
$5,327.21 |
9.1× |
| Myelogram cervical (72240) |
$875.40 |
$1,459 |
1.1× |
| Myelogram Lumbar (72265) |
$1,350.68 |
$2,251.14 |
1.7× |
| Myelography thoracic (72255) |
$1,014.13 |
$1,690.21 |
1.3× |
| Myelograpy 2/more regions rs&i (72270) |
$1,615.24 |
$2,692.06 |
2.1× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$840.74 |
$1,401.23 |
2.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,145.78 |
$3,576.30 |
1.6× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,255.15 |
$2,091.92 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,393.64 |
$7,322.73 |
3.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$1,731.60 |
$2,886 |
1.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,731.60 |
$2,886 |
1.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$2,700.60 |
$4,501 |
1.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$3,300.60 |
$5,501 |
1.5× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$2,700.60 |
$4,501 |
1.8× |
| N-invas est c ffr sw aly CTA (75580) |
$5,133.32 |
$8,555.53 |
6.0× |
| Neck soft tissue (70360) |
$191.89 |
$319.82 |
2.2× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$600.89 |
$1,001.49 |
1.6× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$454.74 |
$757.90 |
1.1× |
| Nm csf leak detection (78650) |
$1,433.25 |
$2,388.75 |
1.1× |
| Nm myocard infarct spect (78469) |
$1,490.58 |
$2,484.30 |
2.7× |
| Nonvascular Shunt X-Ray (75809) |
$697.07 |
$1,161.78 |
6.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,996.41 |
$9,994.01 |
4.3× |
| Nuclear Rx Intra-Arterial (79445) |
$1,172.68 |
$1,954.46 |
5.0× |
| Nuclear Rx Oral Admin (79005) |
$1,514.24 |
$2,523.73 |
6.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$366.50 |
$610.83 |
3.5× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$264.70 |
$441.16 |
2.5× |
| Optic foramina (70190) |
$138.73 |
$231.21 |
1.6× |
| Panoramic X-ray of jaws (70355) |
$219.22 |
$365.36 |
2.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$2,254.06 |
$3,756.76 |
4.1× |
| Parathyroid Planar Imaging (78070) |
$1,522.84 |
$2,538.06 |
3.8× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,873.69 |
$3,122.81 |
4.7× |
| Pelvis 1 or 2 views (72170) |
$270.84 |
$451.40 |
2.6× |
| Peritoneogram Rs&I (74190) |
$563.20 |
$938.67 |
1.0× |
| Pet Image W/Ct Lmtd (78814) |
$4,422.60 |
$7,371 |
3.1× |
| PET image w/CT, full body (78816) |
$5,231.06 |
$8,718.43 |
3.6× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,099.76 |
$6,832.94 |
2.9× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,253.07 |
$3,755.12 |
1.7× |
| Pet Myocardial Sngl Study (78491) |
$1,584.32 |
$2,640.54 |
1.1× |
| PET whole body (78813) |
$5,148.14 |
$8,580.24 |
3.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,376.74 |
$3,961.24 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,348.42 |
$2,247.36 |
3.4× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,188.31 |
$1,980.52 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$418.63 |
$697.72 |
4.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$492.03 |
$820.05 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$296.24 |
$493.74 |
3.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$121.09 |
$201.81 |
1.4× |
| Radex elbow complete minimum 3 views (73080) |
$325.88 |
$543.14 |
3.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$281.80 |
$469.66 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$218.03 |
$363.38 |
2.5× |
| Radex foot complete minimum 3 views (73630) |
$365.31 |
$608.85 |
4.2× |
| Radex Hand Minimum 3 Views (73130) |
$317.78 |
$529.64 |
3.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$113.43 |
$189.05 |
1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$238.14 |
$396.90 |
2.3× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$257.89 |
$429.82 |
3.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$296.32 |
$493.87 |
3.4× |
| Radex shoulder complete minimum 2 views (73030) |
$306.88 |
$511.46 |
3.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$151.82 |
$253.04 |
1.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$290.91 |
$484.85 |
1.7× |
| Radex Spine 1 View Specify Level (72020) |
$283.12 |
$471.86 |
3.2× |
| Radex Sternum Minimum 2 Views (71120) |
$218.24 |
$363.73 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$477.80 |
$796.34 |
5.5× |
| Radex Toe Minimum 2 Views (73660) |
$191.86 |
$319.76 |
2.2× |
| Radex upper extremity infant minimum 2 views (73092) |
$113.43 |
$189.05 |
1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$309.46 |
$515.76 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$575.76 |
$959.60 |
5.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$13,067.46 |
$21,779.10 |
1.8× |
| Radiation treatment delivery level 1 (77402) |
$1,200 |
$2,000 |
11.7× |
| Radiation treatment delivery level 2 (77407) |
$1,860 |
$3,100 |
4.8× |
| Radiation treatment delivery level 3 (77412) |
$2,400 |
$4,000 |
4.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$181.22 |
$302.04 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$244.51 |
$407.52 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$785.86 |
$1,309.77 |
4.5× |
| Radiologic exam colon single contrast study (74270) |
$633.56 |
$1,055.94 |
3.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$579.55 |
$965.91 |
3.3× |
| Radiologic exam knee complete 4/more views (73564) |
$357.20 |
$595.34 |
3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$355.88 |
$593.13 |
3.4× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$561.67 |
$936.12 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$505.08 |
$841.80 |
2.9× |
| Radiologic exam teeth complete full mouth (70320) |
$204.53 |
$340.89 |
0.9× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$152.17 |
$253.62 |
0.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$657.77 |
$1,096.29 |
3.7× |
| Radiologic examination femur 1 view (73551) |
$158.96 |
$264.93 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$290.44 |
$484.07 |
3.3× |
| Radiologic examination knee 1/2 views (73560) |
$273.20 |
$455.33 |
3.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$298.33 |
$497.21 |
2.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$124.24 |
$207.07 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$306.47 |
$510.79 |
3.5× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$69.80 |
$116.34 |
0.8× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$749.55 |
$1,249.25 |
3.2× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$397.29 |
$662.15 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$397.29 |
$662.15 |
1.0× |
| Ribs bilateral 3 views (71110) |
$381.04 |
$635.06 |
3.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,494.49 |
$2,490.81 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,603.09 |
$2,671.81 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,357.46 |
$5,595.76 |
6.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,175.81 |
$3,626.35 |
4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,723.06 |
$4,538.43 |
5.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,731.46 |
$4,552.43 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,814.88 |
$6,358.14 |
2.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,006.39 |
$5,010.65 |
2.3× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$878.33 |
$1,463.89 |
3.7× |
| Rp Therapy Intravenous Administration (79101) |
$755.45 |
$1,259.09 |
3.2× |
| Rp Therapy Unlisted Procedure (79999) |
$2,430.66 |
$4,051.10 |
10.4× |
| Salivary Gland Imaging Serial Images (78231) |
$367.06 |
$611.77 |
0.9× |
| Scapula (73010) |
$223.85 |
$373.08 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$95.23 |
$158.71 |
4.1× |
| Sella turcica (70240) |
$92.48 |
$154.13 |
1.1× |
| Shoulder 1 view (73020) |
$268.60 |
$447.67 |
3.1× |
| Shoulder Arthrography (73040) |
$261.79 |
$436.32 |
0.7× |
| Sialogram (70390) |
$295.76 |
$492.93 |
1.2× |
| Skull less than 4 views (70250) |
$277.54 |
$462.56 |
2.6× |
| Special dosimetry (77331) |
$539.97 |
$899.95 |
4.0× |
| Special Physics Consult (77370) |
$945.67 |
$1,576.11 |
7.0× |
| Special teletherapy port plan (77321) |
$530.47 |
$884.11 |
1.4× |
| Special treatment procedure (77470) |
$1,787.51 |
$2,979.19 |
3.2× |
| Speech evaluation, complex (70371) |
$527.06 |
$878.44 |
2.2× |
| Spleen Imaging (78185) |
$367.06 |
$611.77 |
0.9× |
| Srs Multisource (77371) |
$31,800 |
$53,000 |
4.3× |
| Stereotactic Body Radiation Delivery (77373) |
$8,344.87 |
$13,908.12 |
4.6× |
| Sternoclavicular joints (71130) |
$218.48 |
$364.13 |
2.5× |
| Superior sagittal sinus venogram (75870) |
$2,122.85 |
$3,538.08 |
0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$130.96 |
$218.27 |
1.3× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$99.13 |
$165.22 |
1.1× |
| Tbs technical calculation only (77091) |
$99.13 |
$165.22 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,679.31 |
$2,798.85 |
4.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$620.10 |
$1,033.50 |
1.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$255.35 |
$425.58 |
1.1× |
| Testicular Imaging W/Flow (78761) |
$449.57 |
$749.28 |
1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,636.36 |
$2,727.26 |
4.4× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$669.97 |
$1,116.61 |
1.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$834.76 |
$1,391.26 |
6.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$232.32 |
$387.20 |
1.3× |
| Thoracic spine 2 views (72070) |
$312.80 |
$521.34 |
3.0× |
| Thoracic spine 3 views (72072) |
$395.95 |
$659.91 |
3.8× |
| Thoracolumbar 2 views (72080) |
$298.58 |
$497.64 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$673.01 |
$1,121.69 |
1.7× |
| Thyroid Met Imaging Body (78018) |
$1,724.28 |
$2,873.80 |
3.2× |
| Thyroid Uptake Measurement (78012) |
$680.77 |
$1,134.61 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,459.04 |
$2,431.74 |
3.6× |
| Tx Devices Design & Construction Complex (77334) |
$1,207.28 |
$2,012.13 |
3.2× |
| Tx devices design & construction intermediate (77333) |
$730.71 |
$1,217.85 |
5.4× |
| Tx devices design & construction simple (77332) |
$262.55 |
$437.59 |
1.9× |
| Ultrasound Breast Limited (76642) |
$346.19 |
$576.99 |
4.0× |
| Ultrasound elastography first target lesion (76982) |
$355.91 |
$593.18 |
3.4× |
| Ultrasound Elastography Parenchyma (76981) |
$232.30 |
$387.17 |
2.2× |
| Ultrasound Exam Aaa Screen (76706) |
$430.21 |
$717.01 |
4.1× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$622.88 |
$1,038.14 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$629.42 |
$1,049.03 |
6.0× |
| Umbilical-artery Doppler (OB) (76820) |
$340.14 |
$566.90 |
3.2× |
Unlisted Dx Radiographic Procedure (76499)
range across 6 matching MRF lines |
$266.76–$2,679.11 |
$444.60–$4,465.19 |
varies |
Unlisted fluoroscopic procedure (76496)
range across 11 matching MRF lines |
$360–$3,433.99 |
$600–$5,723.32 |
varies |
| Unlisted magnetic resonance procedure (76498) |
$1,728 |
$2,880 |
19.8× |
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999)
range across 2 matching MRF lines |
$403.49–$463.68 |
$672.48–$772.80 |
varies |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,244.40 |
$2,074 |
12.1× |
Unlisted us procedure (76999)
range across 4 matching MRF lines |
$135–$2,231.09 |
$225–$3,718.48 |
varies |
| Upper gi w/o kub (74240) |
$555.04 |
$925.06 |
3.2× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$32.60 |
$54.34 |
2.9× |
| Urea breath test c-14 isotopic analysis (78268) |
$197.34 |
$328.90 |
2.1× |
| Ureteral Reflux Study (78740) |
$432.89 |
$721.49 |
1.1× |
| Urethrocystogram voiding (74455) |
$702.97 |
$1,171.61 |
2.9× |
| Urethrocystography retrograde (74450) |
$615.08 |
$1,025.14 |
2.6× |
| Us breast unilateral complete (76641) |
$442.26 |
$737.10 |
4.2× |
| Us chest (76604) |
$567.07 |
$945.11 |
5.4× |
| Us complete joint (76881) |
$623.67 |
$1,039.45 |
5.9× |
| Us exam, pelvic, limited (76857) |
$560.25 |
$933.75 |
5.3× |
| Us head (76506) |
$496.36 |
$827.27 |
4.7× |
| Us kidney transplant (76776) |
$684.31 |
$1,140.51 |
6.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$316.25 |
$527.09 |
3.0× |
| Us ob detailed single fetus (76811) |
$690.48 |
$1,150.80 |
2.9× |
| Us ob limited 1 or more fetuses (76815) |
$459 |
$765 |
4.4× |
| Us ob transvaginal (76817) |
$509 |
$848.33 |
4.8× |
| Us pelvic non ob complete (76856) |
$761.44 |
$1,269.06 |
7.3× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$660.98 |
$1,101.64 |
6.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$393.32 |
$655.54 |
3.7× |
| Us retroperitoneal complete (76770) |
$691.73 |
$1,152.88 |
6.6× |
| Us retroperitoneal limited (76775) |
$518.80 |
$864.66 |
4.9× |
| Us scrotum and contents (76870) |
$612.55 |
$1,020.91 |
5.8× |
| Us spinal canal and contents (76800) |
$450.60 |
$751 |
4.3× |
| Us thyroid (76536) |
$630.55 |
$1,050.92 |
6.0× |
| Us transrectal (76872) |
$545.16 |
$908.60 |
5.2× |
| Vascular Flow Imaging (78445) |
$367.06 |
$611.77 |
0.9× |
| Vein X-Ray Chest (75827) |
$1,934.62 |
$3,224.36 |
1.2× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$1,869.20 |
$3,115.34 |
0.6× |
| Vein X-Ray Skull Epidural (75872) |
$1,006.40 |
$1,677.34 |
1.6× |
| Vein X-Ray Spleen/Liver (75810) |
$2,320.33 |
$3,867.22 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$2,052.67 |
$3,421.11 |
0.6× |
| Venography Adrenal Unilateral (75840) |
$2,833.34 |
$4,722.24 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,950.06 |
$4,916.76 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,438.01 |
$2,396.69 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,200.91 |
$2,001.51 |
0.8× |
| Venography Orbital Rs&I (75880) |
$1,128.41 |
$1,880.69 |
1.8× |
| Venography Renal Bilateral (75833) |
$2,786.27 |
$4,643.79 |
0.9× |
| Venography Renal Unilateral (75831) |
$2,571.95 |
$4,286.58 |
0.8× |
| Venous sampling by catheter (75893) |
$4,762.80 |
$7,938 |
0.9× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$609.73 |
$1,016.22 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$267.91 |
$446.52 |
3.1× |
| Wrist 2 views (73100) |
$292.17 |
$486.95 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$199.75 |
$332.92 |
2.3× |
| X-ray antegrade pyelogram tube (74425) |
$593.37 |
$988.95 |
1.7× |
| X-Ray Aorta Leg Arteries (75630) |
$3,407.32 |
$5,678.87 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$341.30 |
$568.84 |
3.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$291.94 |
$486.57 |
3.3× |
| X-Ray Exam Breast Specimen (76098) |
$458.88 |
$764.80 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$187.70 |
$312.83 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$464.96 |
$774.93 |
4.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$539.81 |
$899.68 |
5.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$196.47 |
$327.45 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$296.05 |
$493.42 |
3.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$300 |
$500 |
2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$349.16 |
$581.93 |
3.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$436.16 |
$726.93 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$545.64 |
$909.40 |
5.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$535.91 |
$893.19 |
5.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$325.79 |
$542.99 |
3.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$477.64 |
$796.06 |
4.5× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$394.69 |
$657.82 |
3.8× |
| X-ray eye for foreign body (70030) |
$276 |
$460 |
3.2× |
| X-ray humerus (73060) |
$309.31 |
$515.52 |
3.5× |
| X-ray IV pyelogram (ivp) (74400) |
$687.80 |
$1,146.33 |
3.9× |
| X-ray IV pyelogram+tomography (74415) |
$673.80 |
$1,123 |
3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$121.12 |
$201.87 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$299.78 |
$499.64 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$337.54 |
$562.56 |
3.2× |
| X-ray nose-rectum child f.b. (76010) |
$113.43 |
$189.05 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$550.49 |
$917.49 |
5.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$170.92 |
$284.87 |
1.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$162.73 |
$271.22 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$278.57 |
$464.28 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$328.04 |
$546.74 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$350.76 |
$584.60 |
3.3× |
| X-Ray Stress View (77071) |
$101.73 |
$169.55 |
1.2× |
| X-ray thoracic spine 4 vw (72074) |
$432.22 |
$720.37 |
4.1× |
| X-Ray Tmj Unilat (70328) |
$115.69 |
$192.82 |
1.3× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$719.37 |
$1,198.95 |
2.1× |
| X-Rays Bone Length Studies (77073) |
$312.91 |
$521.51 |
3.0× |
| X-Rays Bone Survey Complete (77075) |
$810.79 |
$1,351.31 |
7.7× |
| Xr c-spine 4 or 5 views (72050) |
$453.04 |
$755.07 |
4.3× |
| Xr facial bones less than 3 views (70140) |
$121.12 |
$201.87 |
1.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$193.41 |
$322.35 |
1.8× |
| Xr orbits complete 4 views (70200) |
$155.33 |
$258.88 |
1.5× |
| Xr Tomogram Single Plane (76100) |
$300 |
$500 |
2.9× |