| 3-D radiotherapy plan dose-volume histograms (77295) |
$856 |
$4,280 |
0.6× |
| Abdomen 2 views (74019) |
$70 |
$350 |
0.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$255 |
$1,275 |
0.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$625 |
$3,125 |
0.2× |
| Angiography extremity bilateral rs&i (75716) |
$1,051 |
$5,255 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$1,051 |
$5,255 |
0.3× |
| Angiography internal mammary rs&i (75756) |
$555.80 |
$2,779 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,735.40 |
$8,677 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$566.60 |
$2,833 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$412.20 |
$2,061 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$431.80 |
$2,159 |
0.1× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$311.20 |
$1,556 |
0.1× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$230.40 |
$1,152 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$194.80 |
$974 |
0.1× |
| Ankle 2 views (73600) |
$69.40 |
$347 |
0.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$148.60 |
$743 |
0.4× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$630.60 |
$3,153 |
0.1× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$886.40 |
$4,432 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$1,051 |
$5,255 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$555.80 |
$2,779 |
0.2× |
| Arthrogram elbow (73085) |
$84.80 |
$424 |
0.3× |
| Arthrogram hip (73525) |
$147 |
$735 |
0.4× |
| Arthrogram shoulder (73040) |
$154 |
$770 |
0.5× |
| Arthrogram wrist (73115) |
$86.20 |
$431 |
0.3× |
| Arthrography knee lt (73580) |
$123.40 |
$617 |
0.4× |
| Bone &/joint imaging whole body (78306) |
$488 |
$2,440 |
1.3× |
| Bone age studies (77072) |
$104.20 |
$521 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$412.20 |
$2,061 |
1.1× |
| Bone survey complete (77075) |
$155 |
$775 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$41.80 |
$209 |
0.5× |
| Chest 1 view (71045) |
$37.20 |
$186 |
0.4× |
| Chest 3 views (71047) |
$37.20 |
$186 |
0.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$184.40 |
$922 |
1.1× |
| Clavicle complete (73000) |
$107.20 |
$536 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$336 |
$336 |
3.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$984.40 |
$4,922 |
3.0× |
| CT abdomen and pelvis without contrast (74176) |
$961.80 |
$4,809 |
4.2× |
| CT abdomen w contrast (74160) |
$599.20 |
$2,996 |
3.6× |
| CT abdomen w wo contrast (74170) |
$709.80 |
$3,549 |
4.2× |
| CT abdomen w/o contrast (74150) |
$595.40 |
$2,977 |
6.0× |
| CT angio hrt w/3d image (75574) |
$320.60 |
$1,603 |
1.0× |
| CT angiography upper extremity lt (73206) |
$494 |
$2,470 |
2.9× |
| CT c-spine w/o contrast (72125) |
$709.80 |
$3,549 |
7.1× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$742 |
$3,710 |
4.4× |
| CT cervical spine w&w/o contrast (72127) |
$709.80 |
$3,549 |
4.2× |
| CT cervical spine with contrast (72126) |
$709.80 |
$3,549 |
2.1× |
| CT chest w/wo contrast (71270) |
$687 |
$3,435 |
4.1× |
| CT chest with contrast (71260) |
$641.20 |
$3,206 |
3.8× |
| CT colonography screening (74263) |
$498.20 |
$2,491 |
2.2× |
| CT colonography w/dye (74262) |
$195.40 |
$977 |
1.2× |
| CT colonography w/o cntrst (74261) |
$136.40 |
$682 |
1.4× |
| CT head/brain with contrast (70460) |
$470.80 |
$2,354 |
2.8× |
| CT head/brain without and with contrast (70470) |
$556.40 |
$2,782 |
3.3× |
| CT heart contrast eval cardiac structure&morph (75572) |
$618.20 |
$3,091 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$35 |
$35 |
0.4× |
| CT iac w contrast (70481) |
$528.60 |
$2,643 |
3.2× |
| CT limited/localized follow up study (76380) |
$211 |
$1,055 |
2.5× |
| CT lower ext w/o (73700) |
$325.20 |
$1,626 |
3.3× |
| CT lower extremity w wo contrast (73702) |
$427 |
$2,135 |
2.5× |
| CT lower extremity with contrast (73701) |
$363.80 |
$1,819 |
2.2× |
| CT lumbar spine w & w/o contrast (72133) |
$732.80 |
$3,664 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$709.80 |
$3,549 |
7.1× |
| CT lumbar spine with contrast (72132) |
$709.80 |
$3,549 |
2.1× |
| CT maxillofacial w contrast (70487) |
$528.60 |
$2,643 |
3.2× |
| CT maxillofacial w/o contrast (70486) |
$321 |
$1,605 |
3.2× |
| CT maxillofacial w/wo contrast (70488) |
$424.40 |
$2,122 |
2.5× |
| CT neck soft tissue w contrast (70491) |
$470.80 |
$2,354 |
2.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$549 |
$2,745 |
3.3× |
| CT orbits w/o contrast (70480) |
$470.80 |
$2,354 |
4.7× |
| CT pelvis w & w/o contrast (72194) |
$642 |
$3,210 |
3.8× |
| CT pelvis w/o contrast (72192) |
$556.40 |
$2,782 |
5.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$556.40 |
$2,782 |
3.3× |
| CT soft tissue neck w/o contrast (70490) |
$449.40 |
$2,247 |
4.5× |
| CT thoracic spine w/contrast (72129) |
$663.40 |
$3,317 |
4.0× |
| CT thoracic spine w/o contrast (72128) |
$663.40 |
$3,317 |
6.6× |
| CT thoracic spine w/wo contrast (72130) |
$684.80 |
$3,424 |
4.1× |
| CT thorax w/o contrast (71250) |
$595.40 |
$2,977 |
6.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$391.80 |
$1,959 |
2.3× |
| CT upper extremity w/o contrast rt (73200) |
$325.20 |
$1,626 |
3.3× |
| CT upper extremity with contrast (73201) |
$363.80 |
$1,819 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$589.60 |
$2,948 |
3.5× |
| Cta Abdomen (74175) |
$727.60 |
$3,638 |
4.3× |
| CTA abdomen pelvis (74174) |
$1,048.60 |
$5,243 |
3.1× |
| CTA chest (71275) |
$938.80 |
$4,694 |
5.6× |
| Cta Head (70496) |
$620.60 |
$3,103 |
3.7× |
| CTA lwr ext w&w/o contrast (73706) |
$620.60 |
$3,103 |
3.7× |
| Cta Neck (70498) |
$620.60 |
$3,103 |
3.7× |
| Cta Pelvis (72191) |
$581.40 |
$2,907 |
3.5× |
| Cystography minimum 3 views rs&i (74430) |
$148.80 |
$744 |
0.4× |
| Diskogram cervical (72285) |
$238.40 |
$1,192 |
0.1× |
| Diskography lumbar (72295) |
$980.80 |
$4,904 |
0.5× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$57.20 |
$286 |
0.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$57.20 |
$286 |
0.6× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$57.20 |
$286 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$184.40 |
$922 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$53.80 |
$269 |
0.6× |
| Echo exam of fetal heart (76825) |
$269.20 |
$1,346 |
0.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$125 |
$625 |
0.5× |
| Echoencephalography real time imaging (76506) |
$86.20 |
$431 |
0.9× |
| Esophagus (74220) |
$129.40 |
$647 |
0.8× |
| Fetal biophysical profile non-stress testing (76818) |
$57.20 |
$286 |
0.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$138.60 |
$693 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$144.60 |
$723 |
0.6× |
| Foot 2 views (73620) |
$88.40 |
$442 |
1.1× |
| Forearm 2 views (73090) |
$101.10 |
$505.50 |
1.2× |
| Gated Heart Planar Single (78472) |
$449.40 |
$2,247 |
1.2× |
| Hand 2 views (73120) |
$83.20 |
$416 |
0.8× |
| Hand 3 views (73130) |
$98 |
$490 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$416.80 |
$2,084 |
0.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$549.60 |
$2,748 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$427 |
$2,135 |
1.1× |
| Ht muscle image spect sing (78451) |
$807.80 |
$4,039 |
0.7× |
| Humerus Min 2 Views Left (73060) |
$100 |
$500 |
1.2× |
| Hysterosalpingogram (74740) |
$91.20 |
$456 |
0.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$86.50 |
$432.50 |
0.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$406.60 |
$2,033 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$340.20 |
$1,701 |
0.7× |
| Knee 3 views (73562) |
$107.40 |
$537 |
1.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$183.80 |
$919 |
0.3× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$832.60 |
$4,163 |
0.6× |
| MRA head w & w/o contrast (70546) |
$755.60 |
$3,778 |
2.3× |
| MRA head w/o contrast (70544) |
$588.60 |
$2,943 |
2.6× |
| MRA head with contrast (70545) |
$615 |
$3,075 |
1.8× |
| MRA neck w contrast (70548) |
$615 |
$3,075 |
1.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$780.80 |
$3,904 |
2.3× |
| MRA neck w/o contrast (70547) |
$588.60 |
$2,943 |
2.6× |
| MRI abdomen w contrast (74182) |
$639.60 |
$3,198 |
1.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,032.80 |
$5,164 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$489.60 |
$2,448 |
2.1× |
| MRI any jnt lwr ext with con lt (73722) |
$748.20 |
$3,741 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$682.60 |
$3,413 |
0.9× |
| MRI breast w/o contrast bilateral (77047) |
$805 |
$4,025 |
3.5× |
| MRI c-spine with contrast (72142) |
$886.60 |
$4,433 |
2.7× |
| MRI cardiac w/o cont stress (75559) |
$252 |
$1,260 |
0.5× |
| MRI cardiac w/o contrast (75557) |
$259.20 |
$1,296 |
1.1× |
| MRI cervical spine w/o contrast (72141) |
$806 |
$4,030 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$805 |
$4,025 |
2.4× |
| MRI chest w/o contrast (71550) |
$559.20 |
$2,796 |
2.5× |
| MRI chest with contrast (71551) |
$562.40 |
$2,812 |
0.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$559.20 |
$2,796 |
1.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$559.20 |
$2,796 |
1.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$517.80 |
$2,589 |
2.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$588.60 |
$2,943 |
2.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$906.80 |
$4,534 |
2.7× |
| MRI orbit/face/neck w/contrast (70542) |
$615 |
$3,075 |
1.8× |
| MRI pelvis w contrast (72196) |
$748.20 |
$3,741 |
2.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$725.40 |
$3,627 |
2.2× |
| MRI pelvis w/o contrast (72195) |
$680 |
$3,400 |
3.0× |
| MRI scan of arm joint before and after contrast (73223) |
$805 |
$4,025 |
2.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$385.40 |
$1,927 |
0.5× |
| MRI scan of leg joint before and after contrast (73723) |
$805 |
$4,025 |
2.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$982.20 |
$4,911 |
2.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$886.60 |
$4,433 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,057.80 |
$5,289 |
3.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$886.60 |
$4,433 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$982.20 |
$4,911 |
2.9× |
| MRI thoracic spine w/o contrast (72146) |
$806 |
$4,030 |
3.5× |
| MRI tmj (70336) |
$201.80 |
$1,009 |
0.9× |
| MRI upper ext joint w/o contrast (73221) |
$648.60 |
$3,243 |
2.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$805 |
$4,025 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$559.20 |
$2,796 |
2.5× |
| Myelogram Cervical (72240) |
$145.60 |
$728 |
0.2× |
| Myelogram Lumbar (72265) |
$127.80 |
$639 |
0.2× |
| Myelogram thoracic (72255) |
$134.80 |
$674 |
0.2× |
| Myelography 2 or more regions (72270) |
$359.60 |
$1,798 |
0.5× |
| Myocardial Spect Multiple Studies (78452) |
$1,145 |
$5,725 |
0.9× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$998.20 |
$4,991 |
0.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$898.80 |
$4,494 |
0.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$1,442.60 |
$7,213 |
0.7× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$954 |
$4,770 |
1.2× |
| Neck soft tissue (70360) |
$115.80 |
$579 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$302.60 |
$1,513 |
0.8× |
| Nm gastric emptying study (78264) |
$317.60 |
$1,588 |
0.8× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$955.20 |
$4,776 |
0.8× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$597 |
$2,985 |
0.5× |
| Nuclear Rx Oral Admin (79005) |
$158.80 |
$794 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$106.30 |
$531.50 |
1.1× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$57.20 |
$286 |
0.6× |
| Orthopantogram (70355) |
$53.80 |
$269 |
0.6× |
| Osseous survey infant (77076) |
$116 |
$580 |
1.2× |
| Osseous survey limited (77074) |
$102.80 |
$514 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$272.20 |
$1,361 |
0.7× |
| Parathyroid imaging (78070) |
$257.20 |
$1,286 |
0.7× |
| Pelvis 1 or 2 views (72170) |
$76.90 |
$384.50 |
0.8× |
| Peritoneogram rs&i (74190) |
$150.40 |
$752 |
0.3× |
| PET image w/CT, skull-thigh (78815) |
$1,373.80 |
$6,869 |
1.0× |
| PET imaging CT for attenuation limited area (78814) |
$1,177 |
$5,885 |
0.9× |
| PET imaging for CT attenuation whole body (78816) |
$1,259.40 |
$6,297 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$906.80 |
$4,534 |
2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,201 |
$6,005 |
0.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,134 |
$5,670 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$297.60 |
$1,488 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$406.80 |
$2,034 |
0.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$157.60 |
$788 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$37.20 |
$186 |
0.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$60.20 |
$301 |
0.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$60.20 |
$301 |
0.6× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$101.60 |
$508 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$116.80 |
$584 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$37.20 |
$186 |
0.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$67.40 |
$337 |
0.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$37.20 |
$186 |
0.4× |
| Radiologic exam colon single contrast study (74270) |
$208.20 |
$1,041 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$127.40 |
$637 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$120 |
$600 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$36 |
$180 |
0.4× |
| Radiological examination surgical specimen (76098) |
$185.60 |
$928 |
0.4× |
| Review by radiologist of adrenal gland vein image (75840) |
$715 |
$3,575 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$537.20 |
$2,686 |
0.2× |
| Ribs bilateral 3 views (71110) |
$108.80 |
$544 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$589.80 |
$2,949 |
1.1× |
| Scanogram (77073) |
$86.20 |
$431 |
0.9× |
| Scapula complete (73010) |
$127.40 |
$637 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$10.60 |
$53 |
0.5× |
| Sialogram (70390) |
$101 |
$505 |
0.4× |
| Small bowel series (74250) |
$150.40 |
$752 |
0.9× |
| Spine thoracic 3 views (72072) |
$96.30 |
$481.50 |
1.0× |
| Splenoportograpy rs&i (75810) |
$715 |
$3,575 |
0.2× |
| Superior sagittal sinus venogram (75870) |
$416.80 |
$2,084 |
0.1× |
| Thoracolumbar 2 views (72080) |
$118 |
$590 |
1.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$366 |
$1,830 |
0.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$272.20 |
$1,361 |
0.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$487.80 |
$2,439 |
1.3× |
| Ultrasound scan of cornea to determine thickness (76514) |
$10.80 |
$54 |
0.4× |
| Ultrasound scan to determine eye length and lens power (76519) |
$46.40 |
$232 |
0.5× |
| Ultrasound, abdomen limited (76705) |
$219.20 |
$1,096 |
2.2× |
| Umbilical-artery Doppler (OB) (76820) |
$46.60 |
$233 |
0.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$98.60 |
$293 |
1.2× |
| Unlisted fluoroscopic procedure (76496) |
$74.40 |
$372 |
0.9× |
| Unlisted magnetic resonance procedure (76498) |
$257.60 |
$1,288 |
3.1× |
| Unlisted Ultrasound Procedure (76999) |
$52.20 |
$261 |
0.6× |
| Upper Extremity Infant (73092) |
$87 |
$435 |
0.9× |
| Urethrocystography retrograde rs&i (74450) |
$90.90 |
$454.50 |
0.4× |
| Urethrocystography voiding (74455) |
$94.20 |
$471 |
0.4× |
| Us abdl aorta screen aaa (76706) |
$57.20 |
$286 |
0.6× |
| Us breast unilateral complete (76641) |
$96 |
$480 |
1.0× |
| Us breast unilateral limited (76642) |
$98.20 |
$491 |
1.2× |
| Us chest (76604) |
$149.80 |
$749 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$109.60 |
$548 |
1.1× |
| Us elastography parenchyma (76981) |
$86.20 |
$431 |
0.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$57.20 |
$286 |
0.6× |
| Us guided compression repair (76936) |
$332.60 |
$1,663 |
1.6× |
| Us infant hips limited static (76886) |
$63.60 |
$318 |
0.8× |
| Us kidney transplant (76776) |
$170 |
$850 |
1.7× |
| Us ob detailed single fetus (76811) |
$132.90 |
$664.50 |
0.6× |
| Us ob transvaginal (76817) |
$179 |
$895 |
1.8× |
| Us pelvic non ob complete (76856) |
$179.70 |
$898.50 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$121 |
$605 |
1.2× |
| Us pregnancy ltd (76815) |
$155.40 |
$777 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$103.80 |
$519 |
1.0× |
| Us retroperitoneal complete (76770) |
$302.20 |
$1,511 |
3.0× |
| Us retroperitoneal limited (76775) |
$191.60 |
$958 |
1.9× |
| Us scrotum and contents (76870) |
$327.40 |
$1,637 |
3.3× |
| Us soft tissue head/neck (76536) |
$352.60 |
$1,763 |
3.5× |
| Us spinal canal and contents (76800) |
$59.40 |
$297 |
0.6× |
| Us transrectal (76872) |
$47 |
$235 |
0.5× |
| Us xtr non-vasc lmtd (76882) |
$134.20 |
$671 |
1.3× |
| Us, eye b-scan (76512) |
$61.20 |
$306 |
0.6× |
| Venogram extremity bilateral (75822) |
$560.40 |
$2,802 |
0.4× |
| Venography caval inferior serialography rs&i (75825) |
$1,041.20 |
$5,206 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$560.40 |
$2,802 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$373.60 |
$1,868 |
0.2× |
| Venography Renal Bilateral (75833) |
$496 |
$2,480 |
0.2× |
| Venography renal unilateral selective rs&i (75831) |
$389.20 |
$1,946 |
0.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$467.20 |
$2,336 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$259.80 |
$1,299 |
0.0× |
| Vertebral fracture assessment via dxa (77086) |
$34.40 |
$172 |
0.4× |
| Wrist 2 views (73100) |
$64.80 |
$324 |
0.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$142.60 |
$713 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$103.80 |
$519 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$98 |
$490 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$199.20 |
$996 |
1.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$56.80 |
$284 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$102.80 |
$514 |
1.2× |
| X-ray exam entire spi 4/5 vw (72083) |
$109.20 |
$546 |
1.1× |
| X-ray exam hip uni 1 view (73501) |
$35.80 |
$179 |
0.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$37.20 |
$186 |
0.4× |
| X-ray exam hip uni 4/> views (73503) |
$60.20 |
$301 |
0.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$60.20 |
$301 |
0.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$103.80 |
$519 |
1.0× |
| X-ray exam of femur 1 (73551) |
$30 |
$150 |
0.4× |
| X-ray eye for foreign body (70030) |
$114 |
$570 |
1.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$86.40 |
$432 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$98 |
$490 |
1.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$295.20 |
$1,476 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$101.60 |
$508 |
1.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$50.80 |
$254 |
0.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$127.40 |
$637 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$98 |
$490 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$97.20 |
$486 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$100.90 |
$504.50 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$101.10 |
$505.50 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$54.80 |
$274 |
0.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$81.10 |
$405.50 |
1.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$97.20 |
$486 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$132.60 |
$663 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$130.80 |
$654 |
1.3× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$427 |
$2,135 |
0.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$161.20 |
$806 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$74 |
$370 |
0.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$127.40 |
$637 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$123.50 |
$617.50 |
1.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$86.60 |
$433 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$80.20 |
$401 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$126.20 |
$631 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$112 |
$560 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$55.60 |
$278 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$131.80 |
$659 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$127.40 |
$637 |
1.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$99.80 |
$499 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$116.80 |
$584 |
1.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$86.40 |
$432 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$87.60 |
$438 |
0.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$98 |
$490 |
1.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$93.60 |
$468 |
1.1× |
| Xr arthrogram ankle (73615) |
$84.80 |
$424 |
0.3× |
| Xr c-spine 6 or more views (72052) |
$78.80 |
$394 |
0.8× |
| Xr chest 4+ views (71048) |
$68 |
$340 |
0.7× |
| Xr finger(s) 2+ views (73140) |
$90.40 |
$452 |
1.1× |
| Xr shoulder 1 view (73020) |
$111 |
$555 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$60.20 |
$301 |
0.6× |
| Xr tibia/fibula 2 views (73590) |
$85.10 |
$425.50 |
1.0× |
| Xr tmj bilateral (70330) |
$176.40 |
$882 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$98 |
$490 |
1.2× |