| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,835.60 |
$9,726 |
4.3× |
| Abdomen 1 View (74018) |
$177 |
$295 |
2.1× |
| Abdomen 2 views (74019) |
$251.40 |
$419 |
2.5× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,220.40 |
$2,034 |
3.1× |
| Angio internal mammary (75756) |
$3,489 |
$5,815 |
1.1× |
| Angio pulmonary bilat (75743) |
$3,406.20 |
$5,677 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,551.40 |
$5,919 |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,551.40 |
$5,919 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,489 |
$5,815 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,286.20 |
$5,477 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,489 |
$5,815 |
1.1× |
| Ankle 2 views (73600) |
$176.40 |
$294 |
2.1× |
| Aortography thoracic serialography rs&i (75605) |
$3,489 |
$5,815 |
0.6× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,250.20 |
$5,417 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$3,489 |
$5,815 |
0.6× |
| Artery X-Rays Adrenal Gland (75731) |
$3,489 |
$5,815 |
1.1× |
| Artery X-Rays Pelvis (75736) |
$3,489 |
$5,815 |
0.6× |
| Artery X-Rays Spine (75705) |
$3,869.40 |
$6,449 |
0.7× |
| Arthrogram ankle (73615) |
$684 |
$1,140 |
2.0× |
| Arthrogram hip (73525) |
$714 |
$1,190 |
2.1× |
| Arthrogram Wrist (73115) |
$564 |
$940 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$276.60 |
$461 |
2.1× |
| Bone age studies (77072) |
$166.80 |
$278 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,947 |
$3,245 |
5.0× |
| Bone Imaging Whole Body (78306) |
$1,535.40 |
$2,559 |
3.9× |
| Bone survey infant (77076) |
$237 |
$395 |
2.3× |
| Brachytx isodose intermed (77317) |
$664.20 |
$1,107 |
1.8× |
| Brachytx Isodose Plan Simple (77316) |
$622.20 |
$1,037 |
1.7× |
| Brain Flow Imaging Only (78610) |
$859.20 |
$1,432 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,650.40 |
$6,084 |
2.6× |
| Cat Scan Follow-Up Study (76380) |
$603.60 |
$1,006 |
7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$891 |
$1,485 |
1.7× |
| Chest 1 view (71045) |
$193.80 |
$323 |
2.3× |
| Chest 2 views (71046) |
$218.40 |
$364 |
2.6× |
| Chest 3 views (71047) |
$273.60 |
$456 |
3.2× |
| Chest 4 or more views (71048) |
$284.40 |
$474 |
2.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,201.20 |
$2,002 |
1.6× |
| Clavicle complete (73000) |
$168.60 |
$281 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$219.60 |
$366 |
2.2× |
| Continuing medical physics consltj pr wk (77336) |
$581.40 |
$969 |
4.4× |
| Contrast Exam Abdominl Aorta (75625) |
$3,568.20 |
$5,947 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$432.60 |
$721 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$708 |
$1,180 |
2.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$799.80 |
$1,333 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,929.60 |
$3,216 |
5.7× |
| CT abdomen and pelvis without contrast (74176) |
$1,266.60 |
$2,111 |
5.4× |
| CT abdomen w contrast (74160) |
$1,034.40 |
$1,724 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,104.60 |
$1,841 |
6.5× |
| CT abdomen w/o contrast (74150) |
$783 |
$1,305 |
7.7× |
| CT Angio Abdomen and Pelvis (74174) |
$665.40 |
$1,109 |
2.0× |
| CT Angio Chest (71275) |
$665.40 |
$1,109 |
3.9× |
| CT Angio Head (70496) |
$665.40 |
$1,109 |
3.9× |
| CT angio hrt w/3d image (75574) |
$475.20 |
$792 |
1.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,566 |
$2,610 |
9.2× |
| CT Angio Neck (70498) |
$665.40 |
$1,109 |
3.9× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$783 |
$1,305 |
4.6× |
| CT cervical spine w/ contrast (72126) |
$900 |
$1,500 |
2.6× |
| CT cervical spine w/o contrast (72125) |
$665.40 |
$1,109 |
6.5× |
| CT cervical spine w/wo cont (72127) |
$1,034.40 |
$1,724 |
6.1× |
| CT chest w contrast (71260) |
$879 |
$1,465 |
5.1× |
| CT chest w/wo contrast (71270) |
$1,212.60 |
$2,021 |
7.1× |
| CT head/brain with contrast (70460) |
$900 |
$1,500 |
5.3× |
| CT head/brain without and with contrast (70470) |
$1,034.40 |
$1,724 |
6.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$429 |
$715 |
1.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$213 |
$213 |
2.5× |
| CT hrt w/3d image congen (75573) |
$1,455 |
$2,425 |
4.3× |
| CT iac w contrast (70481) |
$900 |
$1,500 |
5.3× |
| CT l-spine w&w/o contrast (72133) |
$1,034.40 |
$1,724 |
6.1× |
| CT lower ext w/o (73700) |
$783 |
$1,305 |
7.7× |
| CT lower extremity w/contrast material (73701) |
$900 |
$1,500 |
5.3× |
| CT lumbar spine w contrast (72132) |
$900 |
$1,500 |
2.6× |
| CT lumbar spine w/o contrast (72131) |
$665.40 |
$1,109 |
6.5× |
| CT maxillofacial w contrast (70487) |
$900 |
$1,500 |
5.3× |
| CT maxillofacial wo contrast (70486) |
$665.40 |
$1,109 |
6.5× |
| CT neck tissue combo (70492) |
$1,034.40 |
$1,724 |
6.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,034.40 |
$1,724 |
6.1× |
| CT orbits w/o contrast (70480) |
$783 |
$1,305 |
7.7× |
| CT pelvis w&w/o contrast (72194) |
$1,034.40 |
$1,724 |
6.1× |
| CT pelvis w/o contrast (72192) |
$783 |
$1,305 |
7.7× |
| CT scan of leg combo (73702) |
$1,034.40 |
$1,724 |
6.1× |
| CT scans face/jaw combo (70488) |
$1,876.20 |
$3,127 |
11.0× |
| CT soft tissue neck w contrast (70491) |
$900 |
$1,500 |
5.3× |
| CT soft tissue neck w/o contrast (70490) |
$783 |
$1,305 |
7.7× |
| CT thoracic spine w contrast (72129) |
$900 |
$1,500 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$783 |
$1,305 |
7.7× |
| CT thoracic spine w/wo cont (72130) |
$1,034.40 |
$1,724 |
6.1× |
| CT thorax w/o contrast (71250) |
$665.40 |
$1,109 |
6.5× |
| CT unlisted procedure (76497) |
$241.80 |
$403 |
2.9× |
| CT upper ext wo (73200) |
$783 |
$1,305 |
7.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,841.40 |
$3,069 |
10.8× |
| CT upper extremity with contrast (73201) |
$900 |
$1,500 |
2.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$783 |
$1,305 |
4.6× |
| Cta Abdomen (74175) |
$783 |
$1,305 |
4.6× |
| CTA pelvis (72191) |
$783 |
$1,305 |
4.6× |
| Dilation ureters/urethra rs&i (74485) |
$1,545 |
$2,575 |
0.8× |
| Discography Cerv/Thor Spine (72285) |
$2,692.80 |
$4,488 |
1.4× |
| Diskography lumbar (72295) |
$2,622.60 |
$4,371 |
1.4× |
| Dxa Bone Density Axial (77080) |
$731.40 |
$1,219 |
7.2× |
| Dxa bone density study (77085) |
$723.60 |
$1,206 |
7.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$256.80 |
$428 |
3.0× |
| Echo Guide For Artery Repair (76936) |
$2,596.20 |
$4,327 |
12.3× |
| Esophagram (74220) |
$391.80 |
$653 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$375.60 |
$626 |
1.6× |
| Follow-Up Angiography (75898) |
$4,719 |
$7,865 |
1.5× |
| Foot 2 views (73620) |
$181.20 |
$302 |
2.1× |
| Forearm 2 views (73090) |
$180.60 |
$301 |
2.1× |
| Gastric emptying imaging study (78264) |
$1,330.80 |
$2,218 |
3.4× |
| Gated Heart Planar Single (78472) |
$1,424.40 |
$2,374 |
3.7× |
| Hand 2 views (73120) |
$172.80 |
$288 |
1.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$2,430 |
$4,050 |
0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,214 |
$3,690 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$1,066.80 |
$1,778 |
2.0× |
| Hepatobiliary System Imaging (78226) |
$1,066.80 |
$1,778 |
2.7× |
| Ht Musc Image Planar Mult (78454) |
$2,254.20 |
$3,757 |
1.8× |
| Ht Muscle Image Spect Sing (78451) |
$3,606.60 |
$6,011 |
2.9× |
| Hysterosalpingogram (74740) |
$391.80 |
$653 |
1.7× |
| Image fusion (77399) |
$206.40 |
$344 |
1.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$987.60 |
$1,646 |
1.8× |
| Joint Survey Single View (77077) |
$321 |
$535 |
3.2× |
| K Flow/Funct Image Multiple (78709) |
$1,265.40 |
$2,109 |
2.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,793.40 |
$2,989 |
3.4× |
| K Flow/Funct Image W/O Drug (78707) |
$1,059.60 |
$1,766 |
2.0× |
| Knee 3 Views (73562) |
$242.40 |
$404 |
2.9× |
| Liver & Spleen Imaging Static Only (78215) |
$1,113 |
$1,855 |
2.9× |
| Liver imaging static only (78201) |
$2,319.60 |
$3,866 |
4.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,552.80 |
$2,588 |
2.9× |
| Lung perfusion differential (78597) |
$974.40 |
$1,624 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,552.80 |
$2,588 |
2.9× |
| Lymph System Imaging (78195) |
$674.40 |
$1,124 |
1.3× |
| Mammary ductogram or galactogram multiple (77054) |
$1,093.80 |
$1,823 |
4.7× |
| Mammary ductogram or galactogram single (77053) |
$810.60 |
$1,351 |
3.5× |
| Meckels Divert Exam (78290) |
$780 |
$1,300 |
2.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$612.60 |
$1,021 |
1.7× |
| Myelogram cervical (72240) |
$1,048.80 |
$1,748 |
1.4× |
| Myelogram Lumbar (72265) |
$910.20 |
$1,517 |
1.2× |
| Myelography thoracic (72255) |
$974.40 |
$1,624 |
1.3× |
| Myelograpy 2/more regions rs&i (72270) |
$1,371 |
$2,285 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$4,200.60 |
$7,001 |
3.3× |
| N-invas est c ffr sw aly CTA (75580) |
$2,644.20 |
$4,407 |
3.2× |
| Neck soft tissue (70360) |
$208.20 |
$347 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,712 |
$4,520 |
2.0× |
| Nuclear Rx Intra-Arterial (79445) |
$448.80 |
$748 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$2,250.60 |
$3,751 |
9.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$144 |
$240 |
1.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$193.80 |
$323 |
1.9× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$962.40 |
$1,604 |
1.8× |
| Parathyroid Planar Imaging (78070) |
$496.20 |
$827 |
1.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$962.40 |
$1,604 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$204.60 |
$341 |
2.0× |
| Peritoneogram Rs&I (74190) |
$948 |
$1,580 |
1.8× |
| Pet Image Skull-Thigh (78812) |
$2,180.40 |
$3,634 |
1.6× |
| Pet Image W/Ct Lmtd (78814) |
$2,067 |
$3,445 |
1.5× |
| PET image w/CT, full body (78816) |
$3,867 |
$6,445 |
2.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,867 |
$6,445 |
2.8× |
| PET whole body (78813) |
$2,180.40 |
$3,634 |
1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,563.20 |
$4,272 |
0.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$974.40 |
$1,624 |
2.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$419.40 |
$699 |
4.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$563.40 |
$939 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$218.40 |
$364 |
2.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$178.20 |
$297 |
2.1× |
| Radex elbow complete minimum 3 views (73080) |
$242.40 |
$404 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$281.40 |
$469 |
2.8× |
| Radex fingr minimum 2 views (73140) |
$168.60 |
$281 |
2.0× |
| Radex foot complete minimum 3 views (73630) |
$196.80 |
$328 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$190.20 |
$317 |
2.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$294.60 |
$491 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$231 |
$385 |
2.7× |
| Radex Ribs Unilateral 2 Views (71100) |
$217.20 |
$362 |
2.6× |
| Radex shoulder complete minimum 2 views (73030) |
$195.60 |
$326 |
2.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$198 |
$330 |
2.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$580.80 |
$968 |
3.4× |
| Radex Spine 1 View Specify Level (72020) |
$156 |
$260 |
1.8× |
| Radex Sternum Minimum 2 Views (71120) |
$214.80 |
$358 |
2.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$262.80 |
$438 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$169.80 |
$283 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$218.40 |
$364 |
2.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$475.20 |
$792 |
4.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,841.60 |
$24,736 |
2.1× |
| Radiation treatment delivery level 1 (77402) |
$378.60 |
$631 |
3.8× |
| Radiation treatment delivery level 2 (77407) |
$1,095 |
$1,825 |
2.9× |
| Radiation treatment delivery level 3 (77412) |
$1,095 |
$1,825 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$205.20 |
$342 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$265.80 |
$443 |
2.6× |
| Radiologic exam colon double contrast study (74280) |
$737.40 |
$1,229 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$580.80 |
$968 |
3.4× |
| Radiologic exam knee complete 4/more views (73564) |
$277.20 |
$462 |
2.7× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$207 |
$345 |
2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$490.80 |
$818 |
2.9× |
| Radiologic exam swallow function contrast study (74230) |
$518.40 |
$864 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$520.80 |
$868 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$195.60 |
$326 |
2.3× |
| Radiologic examination knee 1/2 views (73560) |
$190.20 |
$317 |
2.2× |
| Radiologic Examination Osseous Survey Limited (77074) |
$364.80 |
$608 |
3.6× |
| Radiologic examination tibia & fibula 2 views (73590) |
$186 |
$310 |
2.2× |
| Renal Cyst Study (74470) |
$436.20 |
$727 |
0.8× |
| Ribs bilateral 3 views (71110) |
$262.80 |
$438 |
2.6× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$841.20 |
$1,402 |
2.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,036.20 |
$1,727 |
2.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,942 |
$6,570 |
7.4× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,402.20 |
$2,337 |
2.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,365.20 |
$3,942 |
4.5× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,339.20 |
$2,232 |
1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,646 |
$4,410 |
1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,332.80 |
$3,888 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$1,232.40 |
$2,054 |
5.4× |
| Scapula (73010) |
$181.20 |
$302 |
1.8× |
Screening Digital Breast Tomosynthesis Bi (77063)
range across 8 matching MRF lines |
$47.40–$57.60 |
$79–$96 |
varies |
| Sella turcica (70240) |
$155.40 |
$259 |
1.8× |
| Shoulder 1 view (73020) |
$160.80 |
$268 |
1.9× |
| Shoulder Arthrography (73040) |
$695.40 |
$1,159 |
2.0× |
| Sialogram (70390) |
$493.80 |
$823 |
2.1× |
| Skull less than 4 views (70250) |
$226.20 |
$377 |
2.2× |
| Special dosimetry (77331) |
$225 |
$375 |
1.7× |
| Special Physics Consult (77370) |
$705.60 |
$1,176 |
5.4× |
| Special teletherapy port plan (77321) |
$1,692.60 |
$2,821 |
4.6× |
| Special treatment procedure (77470) |
$2,140.80 |
$3,568 |
4.0× |
| Srs Multisource (77371) |
$51,555.60 |
$85,926 |
7.2× |
| Stereotactic Body Radiation Delivery (77373) |
$3,655.20 |
$6,092 |
2.1× |
| Sternoclavicular joints (71130) |
$224.40 |
$374 |
2.6× |
| Superior sagittal sinus venogram (75870) |
$3,489 |
$5,815 |
1.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,143.60 |
$1,906 |
3.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$400.20 |
$667 |
1.1× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$843.60 |
$1,406 |
3.6× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,042.80 |
$1,738 |
2.9× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$969 |
$1,615 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$843 |
$1,405 |
6.4× |
| Thoracic spine 2 views (72070) |
$213 |
$355 |
2.1× |
| Thoracic spine 3 views (72072) |
$238.20 |
$397 |
2.3× |
| Thoracolumbar 2 views (72080) |
$218.40 |
$364 |
2.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,374 |
$2,290 |
3.5× |
| Tx Devices Design & Construction Complex (77334) |
$786.60 |
$1,311 |
2.2× |
| Tx devices design & construction intermediate (77333) |
$612.60 |
$1,021 |
4.7× |
| Ultrasound Breast Limited (76642) |
$519 |
$865 |
6.1× |
| Ultrasound Exam Aaa Screen (76706) |
$160.20 |
$267 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$605.40 |
$1,009 |
5.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$598.80 |
$998 |
7.1× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,741.20 |
$2,902 |
17.5× |
| Unlisted us procedure (76999) |
$285 |
$475 |
3.4× |
| Upper gi w/o kub (74240) |
$573.60 |
$956 |
3.4× |
| Urethrocystogram voiding (74455) |
$436.20 |
$727 |
1.9× |
| Urethrocystography retrograde (74450) |
$408.60 |
$681 |
1.8× |
| Us breast unilateral complete (76641) |
$232.20 |
$387 |
2.3× |
| Us chest (76604) |
$580.80 |
$968 |
5.7× |
| Us complete joint (76881) |
$627.60 |
$1,046 |
6.2× |
| Us exam, pelvic, limited (76857) |
$244.80 |
$408 |
2.4× |
| Us head (76506) |
$637.80 |
$1,063 |
6.3× |
| Us kidney transplant (76776) |
$981 |
$1,635 |
9.6× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$624 |
$1,040 |
6.1× |
| Us ob limited 1 or more fetuses (76815) |
$735.60 |
$1,226 |
7.2× |
| Us ob transvaginal (76817) |
$696 |
$1,160 |
6.8× |
| Us pelvic non ob complete (76856) |
$271.20 |
$452 |
2.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$696 |
$1,160 |
6.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$533.40 |
$889 |
5.2× |
| Us retroperitoneal complete (76770) |
$709.20 |
$1,182 |
7.0× |
| Us retroperitoneal limited (76775) |
$709.80 |
$1,183 |
7.0× |
| Us scrotum and contents (76870) |
$668.40 |
$1,114 |
6.6× |
| Us thyroid (76536) |
$660 |
$1,100 |
6.5× |
| Us transrectal (76872) |
$508.20 |
$847 |
5.0× |
| Vein X-Ray Chest (75827) |
$3,075 |
$5,125 |
2.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,329.80 |
$3,883 |
0.8× |
| Venogram Sinus/Jugular (75860) |
$3,489 |
$5,815 |
1.1× |
| Venography Adrenal Unilateral (75840) |
$3,489 |
$5,815 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,489 |
$5,815 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$1,503.60 |
$2,506 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$2,404.80 |
$4,008 |
1.6× |
| Venography Renal Bilateral (75833) |
$3,617.40 |
$6,029 |
1.2× |
| Venography Renal Unilateral (75831) |
$3,489 |
$5,815 |
1.1× |
| Venous sampling by catheter (75893) |
$3,276.60 |
$5,461 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$723.60 |
$1,206 |
8.5× |
| Wrist 2 views (73100) |
$168 |
$280 |
2.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$196.20 |
$327 |
2.3× |
| X-ray antegrade pyelogram tube (74425) |
$530.40 |
$884 |
1.6× |
| X-Ray Aorta Leg Arteries (75630) |
$4,923.60 |
$8,206 |
1.6× |
| X-Ray Bend Only L-S Spine (72120) |
$241.20 |
$402 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$181.20 |
$302 |
2.1× |
| X-Ray Exam Breast Specimen (76098) |
$360.60 |
$601 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$148.20 |
$247 |
1.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$169.20 |
$282 |
1.7× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$198 |
$330 |
1.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$195.60 |
$326 |
2.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$221.40 |
$369 |
2.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$331.80 |
$553 |
3.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$262.20 |
$437 |
2.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$331.80 |
$553 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$496.80 |
$828 |
4.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$380.40 |
$634 |
3.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$256.80 |
$428 |
3.0× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$470.40 |
$784 |
4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$295.20 |
$492 |
2.9× |
| X-ray eye for foreign body (70030) |
$226.20 |
$377 |
2.7× |
| X-ray humerus (73060) |
$184.80 |
$308 |
2.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,093.20 |
$1,822 |
6.4× |
| X-ray IV pyelogram+tomography (74415) |
$1,580.40 |
$2,634 |
9.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$176.40 |
$294 |
2.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$242.40 |
$404 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$269.40 |
$449 |
2.6× |
| X-ray nose-rectum child f.b. (76010) |
$196.80 |
$328 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$423 |
$705 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$193.20 |
$322 |
1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$160.80 |
$268 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$237 |
$395 |
2.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$475.20 |
$792 |
5.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$309.60 |
$516 |
3.0× |
| X-Ray Stress View (77071) |
$297 |
$495 |
3.5× |
| X-ray thoracic spine 4 vw (72074) |
$250.80 |
$418 |
2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$667.20 |
$1,112 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$243.60 |
$406 |
2.4× |
| X-Rays Bone Survey Complete (77075) |
$544.80 |
$908 |
5.3× |
| Xr c-spine 4 or 5 views (72050) |
$368.40 |
$614 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$198 |
$330 |
2.3× |
| Xr orbits complete 4 views (70200) |
$317.40 |
$529 |
3.1× |
| Xr Tomogram Single Plane (76100) |
$510 |
$850 |
5.0× |