| 3-D radiotherapy plan dose-volume histograms (77295) |
$10,815.75 |
$14,421 |
7.8× |
| Abdomen 2 views (74019) |
$1,096.12 |
$1,461.50 |
10.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$5,978.25 |
$7,971 |
14.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,657.75 |
$4,877 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$14,615.25 |
$19,487 |
4.6× |
| Angiography extremity unilateral rs&i (75710) |
$8,910 |
$11,880 |
2.8× |
| Angiography internal mammary rs&i (75756) |
$4,086 |
$5,448 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$24,988.50 |
$33,318 |
4.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$6,730.12 |
$8,973.50 |
2.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,424.50 |
$4,566 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$24,188.25 |
$32,251 |
4.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$24,988.50 |
$33,318 |
4.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$7,000.50 |
$9,334 |
2.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$12,080.25 |
$16,107 |
3.8× |
| Ankle 2 views (73600) |
$979.12 |
$1,305.50 |
11.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,431 |
$1,908 |
4.1× |
| Aortogram thoracic (75605) |
$24,988.50 |
$33,318 |
4.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,843 |
$5,124 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,066.75 |
$4,089 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,737.25 |
$4,983 |
1.2× |
| Arthrogram elbow (73085) |
$3,393 |
$4,524 |
9.7× |
| Arthrogram hip (73525) |
$2,868.38 |
$3,824.50 |
8.2× |
| Arthrogram shoulder (73040) |
$1,775.62 |
$2,367.50 |
5.1× |
| Arthrogram wrist (73115) |
$1,286.62 |
$1,715.50 |
3.7× |
| Arthrography knee lt (73580) |
$1,806.75 |
$2,409 |
5.2× |
| Basic radiation dosimetry calculation (77300) |
$521.25 |
$695 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,835 |
$3,780 |
7.1× |
| Bone &/joint imaging whole body (78306) |
$4,061.25 |
$5,415 |
10.1× |
| Bone age studies (77072) |
$931.88 |
$1,242.50 |
8.9× |
| Bone Imaging 3 Phase (78315) |
$2,477.25 |
$3,303 |
6.2× |
| Bone survey complete (77075) |
$1,960.50 |
$2,614 |
18.7× |
| Brachytx isodose complex (77318) |
$1,386 |
$1,848 |
3.7× |
| Brachytx isodose intermed (77317) |
$1,027.50 |
$1,370 |
2.7× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$793.50 |
$1,058 |
2.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$4,144.12 |
$5,525.50 |
10.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$8,364.75 |
$11,153 |
5.8× |
| Brain Imaging Vascular Flow Only (78610) |
$1,940.25 |
$2,587 |
3.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$5,091.75 |
$6,789 |
14.5× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,071.88 |
$2,762.50 |
3.8× |
| Cervical spine 2 or 3 views (72040) |
$1,068.75 |
$1,425 |
12.2× |
| Chest 1 view (71045) |
$797.25 |
$1,063 |
9.1× |
| Chest 3 views (71047) |
$787.50 |
$1,050 |
9.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$1,586.25 |
$2,115 |
9.0× |
| Clavicle complete (73000) |
$1,241.62 |
$1,655.50 |
14.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$421.88 |
$562.50 |
4.0× |
| Continuing medical physics consltj pr wk (77336) |
$1,062.75 |
$1,417 |
7.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$7,215 |
$9,620 |
20.6× |
| CT abdomen and pelvis without contrast (74176) |
$10,236 |
$13,648 |
42.7× |
| CT abdomen w contrast (74160) |
$4,544.25 |
$6,059 |
25.8× |
| CT abdomen w wo contrast (74170) |
$5,092.88 |
$6,790.50 |
28.9× |
| CT abdomen w/o contrast (74150) |
$3,203.25 |
$4,271 |
30.5× |
| CT angio hrt w/3d image (75574) |
$3,050.25 |
$4,067 |
8.7× |
| CT angiography upper extremity lt (73206) |
$8,358.75 |
$11,145 |
47.4× |
| CT c-spine w/o contrast (72125) |
$8,220.75 |
$10,961 |
78.3× |
| CT cervical spine w&w/o contrast (72127) |
$6,137.25 |
$8,183 |
34.8× |
| CT cervical spine with contrast (72126) |
$5,250 |
$7,000 |
15.0× |
| CT chest w/wo contrast (71270) |
$5,036.25 |
$6,715 |
28.6× |
| CT chest with contrast (71260) |
$4,092.75 |
$5,457 |
23.2× |
| CT head/brain with contrast (70460) |
$5,992.12 |
$7,989.50 |
34.0× |
| CT head/brain without and with contrast (70470) |
$5,671.50 |
$7,562 |
32.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,769 |
$3,692 |
7.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$139.50 |
$186 |
1.6× |
| CT hrt w/3d image congen (75573) |
$2,769 |
$3,692 |
7.9× |
| CT iac w contrast (70481) |
$4,635.75 |
$6,181 |
26.3× |
| CT limited/localized follow up study (76380) |
$493.50 |
$658 |
5.6× |
| CT lower ext w/o (73700) |
$2,226.75 |
$2,969 |
21.2× |
| CT lower extremity w wo contrast (73702) |
$2,757.75 |
$3,677 |
15.7× |
| CT lower extremity with contrast (73701) |
$2,268.75 |
$3,025 |
12.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,291 |
$4,388 |
18.7× |
| CT lumbar spine w/o contrast (72131) |
$3,984.75 |
$5,313 |
37.9× |
| CT lumbar spine with contrast (72132) |
$3,213 |
$4,284 |
9.2× |
| CT maxillofacial w contrast (70487) |
$7,068.38 |
$9,424.50 |
40.1× |
| CT maxillofacial w/o contrast (70486) |
$3,526.12 |
$4,701.50 |
33.6× |
| CT maxillofacial w/wo contrast (70488) |
$4,300.50 |
$5,734 |
24.4× |
| CT neck soft tissue w contrast (70491) |
$3,196.50 |
$4,262 |
18.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,609.25 |
$3,479 |
14.8× |
| CT orbits w/o contrast (70480) |
$4,018.50 |
$5,358 |
38.3× |
| CT pelvis w & w/o contrast (72194) |
$3,740.62 |
$4,987.50 |
21.2× |
| CT pelvis w/o contrast (72192) |
$3,996.38 |
$5,328.50 |
38.1× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,303.75 |
$4,405 |
18.8× |
| CT soft tissue neck w/o contrast (70490) |
$3,073.50 |
$4,098 |
29.3× |
| CT thoracic spine w/contrast (72129) |
$4,306.50 |
$5,742 |
24.4× |
| CT thoracic spine w/o contrast (72128) |
$4,021.50 |
$5,362 |
38.3× |
| CT thoracic spine w/wo contrast (72130) |
$4,953.75 |
$6,605 |
28.1× |
| CT thorax w/o contrast (71250) |
$3,633 |
$4,844 |
34.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,769.25 |
$6,359 |
27.1× |
| CT upper extremity w/o contrast rt (73200) |
$3,800.25 |
$5,067 |
36.2× |
| CT upper extremity with contrast (73201) |
$4,310.25 |
$5,747 |
12.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$5,748.75 |
$7,665 |
32.6× |
| Cta Abdomen (74175) |
$3,216 |
$4,288 |
18.3× |
| CTA abdomen pelvis (74174) |
$14,627.25 |
$19,503 |
41.7× |
| CTA chest (71275) |
$6,500.25 |
$8,667 |
36.9× |
| Cta Head (70496) |
$11,247.38 |
$14,996.50 |
63.8× |
| CTA lwr ext w&w/o contrast (73706) |
$4,105.50 |
$5,474 |
23.3× |
| Cta Neck (70498) |
$6,904.50 |
$9,206 |
39.2× |
| Cta Pelvis (72191) |
$5,647.50 |
$7,530 |
32.1× |
| Cystography minimum 3 views rs&i (74430) |
$2,319.75 |
$3,093 |
6.6× |
| Dacryocystography (70170) |
$1,157.62 |
$1,543.50 |
4.8× |
| Diskogram cervical (72285) |
$7,796.25 |
$10,395 |
4.0× |
| Diskography lumbar (72295) |
$6,724.50 |
$8,966 |
3.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$918 |
$1,224 |
8.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$823.50 |
$1,098 |
7.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$1,189.50 |
$1,586 |
11.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$1,062 |
$1,416 |
10.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$699 |
$932 |
8.0× |
| Dxa bone density study axial skeleton (77085) |
$873 |
$1,164 |
8.3× |
| Echo exam of fetal heart (76825) |
$2,804.25 |
$3,739 |
5.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$1,750.50 |
$2,334 |
7.3× |
| Echoencephalography real time imaging (76506) |
$2,988.38 |
$3,984.50 |
28.5× |
| Esophagus (74220) |
$1,601.62 |
$2,135.50 |
9.1× |
| Fetal biophysical profile non-stress testing (76818) |
$1,385.25 |
$1,847 |
13.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$871.88 |
$1,162.50 |
8.3× |
| Fluoroscopy up to 1 hr (76000) |
$1,855.88 |
$2,474.50 |
7.7× |
| Foot 2 views (73620) |
$1,053 |
$1,404 |
12.0× |
| Forearm 2 views (73090) |
$1,171.12 |
$1,561.50 |
13.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$4,012.50 |
$5,350 |
7.4× |
| Gated Heart Planar Single (78472) |
$5,168.62 |
$6,891.50 |
12.9× |
| Hand 2 views (73120) |
$1,023.75 |
$1,365 |
9.7× |
| Hand 3 views (73130) |
$1,212 |
$1,616 |
13.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$4,897.50 |
$6,530 |
9.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$4,100.62 |
$5,467.50 |
10.2× |
| Ht muscle image spect sing (78451) |
$4,799.25 |
$6,399 |
3.7× |
| Humerus Min 2 Views Left (73060) |
$1,207.50 |
$1,610 |
13.8× |
| Hysterosalpingogram (74740) |
$2,397 |
$3,196 |
10.0× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,260.75 |
$1,681 |
2.3× |
| Intracavitary radiation source applic simple (77761) |
$1,324.50 |
$1,766 |
2.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$1,095 |
$1,460 |
10.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$2,955.38 |
$3,940.50 |
7.4× |
| Kidney imaging morphology (78700) |
$2,912.62 |
$3,883.50 |
7.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$3,739.88 |
$4,986.50 |
6.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$3,678 |
$4,904 |
6.7× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$5,190 |
$6,920 |
9.5× |
| Knee 3 views (73562) |
$1,103.25 |
$1,471 |
12.6× |
| Liver & spleen imaging static only (78215) |
$4,023.38 |
$5,364.50 |
10.0× |
| Liver imaging static only (78201) |
$3,670.50 |
$4,894 |
6.7× |
| Lung Ventilation Imaging (78579) |
$1,557.38 |
$2,076.50 |
3.9× |
| Lymphoscintigraphy (78195) |
$3,744.38 |
$4,992.50 |
6.9× |
| Mammary ductogram or galactogram multiple (77054) |
$3,403.50 |
$4,538 |
14.2× |
| Mammary ductogram or galactogram single (77053) |
$2,625.75 |
$3,501 |
11.0× |
| Meckels Diverticulum (78290) |
$4,672.12 |
$6,229.50 |
11.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,942.50 |
$2,590 |
5.2× |
| Mr safety determination physician/other qhp (76016) |
$338.25 |
$451 |
3.9× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$228 |
$304 |
3.8× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$93.75 |
$125 |
3.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$352.50 |
$470 |
3.7× |
| Mr safety med physics xm customization plng&mntr (76017) |
$927.75 |
$1,237 |
3.9× |
| MRA head w & w/o contrast (70546) |
$3,827.25 |
$5,103 |
10.9× |
| MRA head w/o contrast (70544) |
$3,048 |
$4,064 |
12.7× |
| MRA head with contrast (70545) |
$3,624 |
$4,832 |
10.3× |
| MRA neck w contrast (70548) |
$3,702.38 |
$4,936.50 |
10.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,434.75 |
$5,913 |
12.7× |
| MRA neck w/o contrast (70547) |
$3,282.38 |
$4,376.50 |
13.7× |
| MRI abdomen w contrast (74182) |
$5,876.25 |
$7,835 |
16.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$7,332.75 |
$9,777 |
20.9× |
| MRI abdomen w/o contrast (74181) |
$5,052.38 |
$6,736.50 |
21.1× |
| MRI any jnt lwr ext with con lt (73722) |
$4,489.50 |
$5,986 |
5.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$5,550 |
$7,400 |
7.0× |
| MRI c-spine with contrast (72142) |
$5,028 |
$6,704 |
14.3× |
| MRI cervical spine w/o contrast (72141) |
$5,325.75 |
$7,101 |
22.2× |
| MRI chest w/o & w/contrast material (71552) |
$5,995.50 |
$7,994 |
17.1× |
| MRI chest w/o contrast (71550) |
$3,898.50 |
$5,198 |
16.3× |
| MRI chest with contrast (71551) |
$5,094.75 |
$6,793 |
6.5× |
| MRI fetal sngl/1st gestation (74712) |
$5,069.25 |
$6,759 |
21.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$5,417.62 |
$7,223.50 |
15.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$11,831.25 |
$15,775 |
33.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$6,173.25 |
$8,231 |
25.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$3,273.75 |
$4,365 |
13.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$5,605.88 |
$7,474.50 |
16.0× |
| MRI orbit/face/neck w/contrast (70542) |
$3,880.12 |
$5,173.50 |
11.1× |
| MRI pelvis w contrast (72196) |
$5,118 |
$6,824 |
14.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$7,254 |
$9,672 |
20.7× |
| MRI pelvis w/o contrast (72195) |
$4,713.75 |
$6,285 |
19.7× |
| MRI scan of arm joint before and after contrast (73223) |
$6,786.38 |
$9,048.50 |
19.4× |
| MRI scan of leg joint before and after contrast (73723) |
$9,460.12 |
$12,613.50 |
27.0× |
| MRI spectroscopy (76390) |
$2,051.25 |
$2,735 |
23.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$10,224 |
$13,632 |
29.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$5,349 |
$7,132 |
15.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$7,255.50 |
$9,674 |
20.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$6,456 |
$8,608 |
18.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$7,528.50 |
$10,038 |
21.5× |
| MRI thoracic spine w/o contrast (72146) |
$4,977 |
$6,636 |
20.8× |
| MRI tmj (70336) |
$3,859.50 |
$5,146 |
16.1× |
| MRI upper ext joint w/o contrast (73221) |
$4,787.25 |
$6,383 |
20.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$6,750 |
$9,000 |
19.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,763.25 |
$6,351 |
19.9× |
| Myelogram Cervical (72240) |
$2,831.25 |
$3,775 |
3.6× |
| Myelogram Lumbar (72265) |
$3,514.50 |
$4,686 |
4.5× |
| Myelogram thoracic (72255) |
$4,050.38 |
$5,400.50 |
5.1× |
| Myelography 2 or more regions (72270) |
$3,199.50 |
$4,266 |
4.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$7,208.25 |
$9,611 |
5.5× |
| Myocardial Spect Multiple Studies (78452) |
$6,881.62 |
$9,175.50 |
5.3× |
| Neck soft tissue (70360) |
$1,232.25 |
$1,643 |
14.1× |
| Nm cisternogram (78630) |
$1,243.50 |
$1,658 |
2.3× |
| Nm gastric emptying study (78264) |
$2,958 |
$3,944 |
7.4× |
| Nm peritoneal-venous shunt patency (78291) |
$2,331 |
$3,108 |
5.8× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,240 |
$8,320 |
4.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$8,364.75 |
$11,153 |
5.8× |
| Nuclear medicine of heart pumping function (78473) |
$4,705.50 |
$6,274 |
11.7× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$9,366.75 |
$12,489 |
17.2× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$8,364.75 |
$11,153 |
5.8× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$4,012.50 |
$5,350 |
10.0× |
| Nuclear Rx Oral Admin (79005) |
$2,379.75 |
$3,173 |
10.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$465 |
$620 |
4.4× |
| Orthopantogram (70355) |
$856.50 |
$1,142 |
9.8× |
| Osseous survey limited (77074) |
$492.75 |
$657 |
4.7× |
| Parathyrd planar w/spect&CT (78072) |
$2,358.75 |
$3,145 |
4.3× |
| Parathyrd planar w/wo subtrj (78071) |
$2,377.88 |
$3,170.50 |
5.9× |
| Parathyroid imaging (78070) |
$4,399.12 |
$5,865.50 |
11.0× |
| Pelvis 1 or 2 views (72170) |
$998.62 |
$1,331.50 |
9.5× |
| PET image w/CT, skull-thigh (78815) |
$8,364.75 |
$11,153 |
5.8× |
| PET imaging for CT attenuation whole body (78816) |
$8,364.75 |
$11,153 |
5.8× |
| PET imaging limited area chest head/neck (78811) |
$7,208.25 |
$9,611 |
5.5× |
| PET whole body (78813) |
$8,364.75 |
$11,153 |
5.8× |
| Pr heart first pass single,planar (78481) |
$6,685.50 |
$8,914 |
12.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$9,944.25 |
$13,259 |
28.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,227.75 |
$5,637 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$12,078.75 |
$16,105 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,657.88 |
$2,210.50 |
4.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$2,062.50 |
$2,750 |
3.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,251 |
$1,668 |
2.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$1,203 |
$1,604 |
13.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$2,188.50 |
$2,918 |
20.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$853.50 |
$1,138 |
8.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$675 |
$900 |
6.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$2,955.75 |
$3,941 |
28.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$1,672.50 |
$2,230 |
15.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$811.50 |
$1,082 |
9.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$1,105.12 |
$1,473.50 |
10.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$1,032.75 |
$1,377 |
11.8× |
| Radiologic exam colon single contrast study (74270) |
$2,184 |
$2,912 |
12.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,668.75 |
$2,225 |
9.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$2,471.25 |
$3,295 |
14.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$827.25 |
$1,103 |
9.5× |
| Radiological examination surgical specimen (76098) |
$843.75 |
$1,125 |
1.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$9,009 |
$12,012 |
2.8× |
| Ribs bilateral 3 views (71110) |
$1,356 |
$1,808 |
12.9× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,955.25 |
$2,607 |
4.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$4,491.75 |
$5,989 |
8.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$6,921.75 |
$9,229 |
12.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$6,201 |
$8,268 |
4.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$7,227.75 |
$9,637 |
5.0× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$6,377.25 |
$8,503 |
4.9× |
| Rp therapy intra-arterial particulate admn (79445) |
$1,540.50 |
$2,054 |
6.6× |
| Rp Therapy Intravenous Administration (79101) |
$2,190 |
$2,920 |
9.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$1,592.25 |
$2,123 |
6.6× |
| Scanogram (77073) |
$2,203.50 |
$2,938 |
21.0× |
| Scapula complete (73010) |
$1,066.12 |
$1,421.50 |
10.2× |
| Screening digital breast tomosynthesis (77063) |
$175.50 |
$234 |
7.5× |
| Sella turcica (70240) |
$495.75 |
$661 |
5.7× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$717 |
$956 |
6.8× |
| Simulation intermediate (77285) |
$2,199.75 |
$2,933 |
5.8× |
| Small bowel series (74250) |
$2,322.75 |
$3,097 |
13.2× |
| Spec medical radj physics consltj (77370) |
$1,267.50 |
$1,690 |
9.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,327.50 |
$1,770 |
3.5× |
| Special dosimetry (77331) |
$905.25 |
$1,207 |
6.7× |
| Special treatment procedure (77470) |
$3,845.25 |
$5,127 |
6.9× |
| Spine thoracic 3 views (72072) |
$2,250.38 |
$3,000.50 |
21.4× |
| Splenoportograpy rs&i (75810) |
$2,722.50 |
$3,630 |
0.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$918.75 |
$1,225 |
2.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$627 |
$836 |
1.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,517.75 |
$3,357 |
6.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,346.25 |
$1,795 |
10.0× |
| Therapeutic Enema (74283) |
$2,763 |
$3,684 |
15.7× |
| Thoracolumbar 2 views (72080) |
$1,287.75 |
$1,717 |
14.7× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,813.25 |
$3,751 |
5.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$3,764.62 |
$5,019.50 |
9.4× |
| Thyroid uptake measurement (78012) |
$1,572.38 |
$2,096.50 |
3.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$3,152.62 |
$4,203.50 |
7.9× |
| Tomogram (76100) |
$2,420.25 |
$3,227 |
23.0× |
| Treatment device intermediate (77333) |
$636 |
$848 |
4.7× |
| Treatment devices simple (77332) |
$450.75 |
$601 |
3.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$6,269.62 |
$8,359.50 |
11.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$3,053.25 |
$4,071 |
7.6× |
| Tx devices design & construction complex (77334) |
$1,064.25 |
$1,419 |
2.8× |
| Ultrasound elastography first target lesion (76982) |
$408 |
$544 |
3.9× |
| Ultrasound, abdomen limited (76705) |
$2,235.38 |
$2,980.50 |
21.3× |
| Umbilical-artery Doppler (OB) (76820) |
$1,008.75 |
$1,345 |
9.6× |
| Upper Extremity Infant (73092) |
$592.50 |
$790 |
5.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$2,774.25 |
$3,699 |
6.9× |
| Urethrocystography retrograde rs&i (74450) |
$1,008.75 |
$1,345 |
4.2× |
| Urethrocystography voiding (74455) |
$2,589.75 |
$3,453 |
10.8× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$3,017.25 |
$4,023 |
17.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$3,176.25 |
$4,235 |
18.0× |
| Us abdl aorta screen aaa (76706) |
$765.75 |
$1,021 |
7.3× |
| Us breast unilateral complete (76641) |
$810.38 |
$1,080.50 |
7.7× |
| Us breast unilateral limited (76642) |
$566.25 |
$755 |
6.5× |
| Us chest (76604) |
$1,180.50 |
$1,574 |
11.2× |
| Us compl joint r-t w/image documentation (76881) |
$1,275.75 |
$1,701 |
12.1× |
| Us elastography parenchyma (76981) |
$408 |
$544 |
3.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$888.38 |
$1,184.50 |
8.5× |
| Us infant hips dynamic (76885) |
$715.50 |
$954 |
8.2× |
| Us infant hips limited static (76886) |
$654.38 |
$872.50 |
7.5× |
| Us kidney transplant (76776) |
$1,189.50 |
$1,586 |
11.3× |
| Us ob detailed single fetus (76811) |
$1,236 |
$1,648 |
5.2× |
| Us ob transvaginal (76817) |
$2,081.62 |
$2,775.50 |
19.8× |
| Us pelvic non ob complete (76856) |
$1,981.50 |
$2,642 |
18.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,368.75 |
$1,825 |
13.0× |
| Us pregnancy ltd (76815) |
$1,444.50 |
$1,926 |
13.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$2,592.38 |
$3,456.50 |
24.7× |
| Us retroperitoneal complete (76770) |
$2,074.50 |
$2,766 |
19.8× |
| Us retroperitoneal limited (76775) |
$2,178.75 |
$2,905 |
20.7× |
| Us scrotum and contents (76870) |
$1,173.38 |
$1,564.50 |
11.2× |
| Us soft tissue head/neck (76536) |
$1,527 |
$2,036 |
14.5× |
| Us spinal canal and contents (76800) |
$1,155 |
$1,540 |
11.0× |
| Us transrectal (76872) |
$1,485.75 |
$1,981 |
14.1× |
| Us transrectal prostate volume (76873) |
$2,424 |
$3,232 |
23.1× |
| Us xtr non-vasc lmtd (76882) |
$677.25 |
$903 |
6.4× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$3,762 |
$5,016 |
6.8× |
| Vascular flow imaging (78445) |
$1,236 |
$1,648 |
3.1× |
| Venogram extremity bilateral (75822) |
$2,834.25 |
$3,779 |
1.8× |
| Venography caval inferior serialography rs&i (75825) |
$5,205 |
$6,940 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$3,915 |
$5,220 |
2.5× |
| Venography extremity unilateral rs&i (75820) |
$1,848.75 |
$2,465 |
1.2× |
| Venography Renal Bilateral (75833) |
$5,743.88 |
$7,658.50 |
1.8× |
| Venography renal unilateral selective rs&i (75831) |
$5,697.75 |
$7,597 |
1.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,403.62 |
$5,871.50 |
1.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$24,722.25 |
$32,963 |
4.4× |
| Vertebral fracture assessment via dxa (77086) |
$727.88 |
$970.50 |
8.3× |
| Wrist 2 views (73100) |
$1,090.12 |
$1,453.50 |
12.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$2,128.50 |
$2,838 |
20.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$1,270.88 |
$1,694.50 |
14.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$1,242.75 |
$1,657 |
14.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$2,601.75 |
$3,469 |
14.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$1,051.12 |
$1,401.50 |
12.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$1,299.75 |
$1,733 |
14.9× |
| X-ray exam entire spi 4/5 vw (72083) |
$3,027 |
$4,036 |
28.8× |
| X-ray exam hip uni 1 view (73501) |
$892.50 |
$1,190 |
10.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$876.75 |
$1,169 |
10.0× |
| X-ray exam hip uni 4/> views (73503) |
$613.88 |
$818.50 |
5.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$917.62 |
$1,223.50 |
8.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$1,203 |
$1,604 |
11.5× |
| X-ray exam of femur 1 (73551) |
$406.50 |
$542 |
4.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$3,127.50 |
$4,170 |
17.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$2,004.75 |
$2,673 |
19.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$1,368.38 |
$1,824.50 |
15.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$1,260.75 |
$1,681 |
14.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$8,838.75 |
$11,785 |
4.2× |
| X-ray head for orthodontia (70350) |
$846.75 |
$1,129 |
9.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$1,125 |
$1,500 |
12.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$1,965 |
$2,620 |
18.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$906.75 |
$1,209 |
10.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$424.50 |
$566 |
4.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$896.25 |
$1,195 |
8.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$1,368.38 |
$1,824.50 |
13.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$3,209.25 |
$4,279 |
30.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$1,287.75 |
$1,717 |
14.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$1,012.50 |
$1,350 |
11.6× |
| X-ray of voice box or throat (70370) |
$790.50 |
$1,054 |
9.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$1,635.75 |
$2,181 |
15.6× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$3,636.75 |
$4,849 |
6.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$2,154.75 |
$2,873 |
6.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$1,752.75 |
$2,337 |
20.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$1,833.75 |
$2,445 |
17.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$1,780.50 |
$2,374 |
17.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$834.75 |
$1,113 |
7.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$1,045.50 |
$1,394 |
12.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$1,227.75 |
$1,637 |
14.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$1,996.12 |
$2,661.50 |
22.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$882 |
$1,176 |
10.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$1,816.88 |
$2,422.50 |
17.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$1,222.12 |
$1,629.50 |
11.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$1,032.75 |
$1,377 |
11.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$794.62 |
$1,059.50 |
9.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$819 |
$1,092 |
9.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$1,535.62 |
$2,047.50 |
14.6× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$688.50 |
$918 |
6.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$1,105.50 |
$1,474 |
12.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$1,212 |
$1,616 |
13.9× |
| Xr arthrogram ankle (73615) |
$1,476.38 |
$1,968.50 |
4.2× |
| Xr c-spine 6 or more views (72052) |
$1,160.25 |
$1,547 |
11.0× |
| Xr chest 4+ views (71048) |
$1,326.75 |
$1,769 |
12.6× |
| Xr finger(s) 2+ views (73140) |
$1,082.25 |
$1,443 |
12.4× |
| Xr optic foramina (70190) |
$1,473.75 |
$1,965 |
16.9× |
| Xr shoulder 1 view (73020) |
$1,143 |
$1,524 |
13.1× |
| Xr spine cervical 4 or 5 views (72050) |
$2,162.25 |
$2,883 |
20.6× |
| Xr tibia/fibula 2 views (73590) |
$1,182.75 |
$1,577 |
13.5× |
| Xr tmj bilateral (70330) |
$1,071 |
$1,428 |
12.3× |
| Xray knee 1 or 2 views rt (73560) |
$979.50 |
$1,306 |
11.2× |