| 3-D radiotherapy plan dose-volume histograms (77295) |
$771.90 |
$1,286.50 |
0.6× |
| Abdomen 2 views (74019) |
$121.20 |
$202 |
1.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$669.30 |
$1,115.50 |
1.7× |
| Acute venous thrombus image (78456) |
$558.60 |
$931 |
0.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$244.20 |
$407 |
0.1× |
| Angiography extremity bilateral rs&i (75716) |
$281.70 |
$469.50 |
0.1× |
| Angiography extremity unilateral rs&i (75710) |
$244.50 |
$407.50 |
0.1× |
| Angiography internal mammary rs&i (75756) |
$227.40 |
$379 |
0.1× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,055.10 |
$536 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$177.60 |
$296 |
0.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$175.80 |
$293 |
0.1× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$270 |
$450 |
0.0× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$189 |
$315 |
0.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,424.90 |
$4,041.50 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$195 |
$325 |
0.1× |
| Ankle 2 views (73600) |
$84.90 |
$141.50 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$350.70 |
$584.50 |
1.0× |
| Aortogram thoracic (75605) |
$7,788.60 |
$6,722.50 |
1.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$180 |
$300 |
0.1× |
| Aortography abdominal serialography rs&i (75625) |
$277.80 |
$368 |
0.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$345 |
$575 |
0.1× |
| Artery X-Rays Adrenal Gland (75731) |
$229.80 |
$383 |
0.1× |
| Arthrogram elbow (73085) |
$162.30 |
$270.50 |
0.5× |
| Arthrogram hip (73525) |
$174.60 |
$291 |
0.5× |
| Arthrogram shoulder (73040) |
$172.50 |
$287.50 |
0.5× |
| Arthrogram wrist (73115) |
$183.90 |
$306.50 |
0.5× |
| Arthrography knee lt (73580) |
$199.20 |
$332 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$70.20 |
$117 |
0.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$349.20 |
$582 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$410.40 |
$684 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$483.30 |
$805.50 |
1.2× |
| Bone age studies (77072) |
$78.30 |
$130.50 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$663.60 |
$1,106 |
1.7× |
| Bone Marrow Imaging Limited Area (78102) |
$298.20 |
$497 |
0.7× |
| Bone survey complete (77075) |
$147.30 |
$245.50 |
1.4× |
| Brachytx isodose complex (77318) |
$418.20 |
$697 |
1.1× |
| Brachytx isodose intermed (77317) |
$307.20 |
$512 |
0.8× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$235.20 |
$392 |
0.6× |
| Brain image w/flow 4 + views (78606) |
$616.20 |
$1,027 |
1.1× |
| Brain imaging < 4 static views (78600) |
$337.20 |
$562 |
0.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$391.80 |
$653 |
1.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$358.80 |
$598 |
0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$149.40 |
$249 |
0.1× |
| Brain Imaging Vascular Flow Only (78610) |
$329.40 |
$549 |
0.6× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$27 |
$45 |
2.4× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$347.40 |
$579 |
0.9× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$600.60 |
$1,001 |
1.7× |
| Cardiac shunt detection (78428) |
$298.80 |
$498 |
0.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$611.40 |
$1,019 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$99 |
$165 |
1.1× |
| Chest 1 view (71045) |
$98.10 |
$163.50 |
1.1× |
| Chest 3 views (71047) |
$69 |
$115 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$202.20 |
$337 |
1.1× |
| Cineradiography/videoradiography (76120) |
$136.20 |
$227 |
1.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$89.10 |
$148.50 |
0.1× |
| Clavicle complete (73000) |
$84 |
$140 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$448.50 |
$747.50 |
4.3× |
| Continuing medical physics consltj pr wk (77336) |
$251.70 |
$419.50 |
1.9× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$136.80 |
$228 |
0.8× |
| Corpora cavernosography (74445) |
$113.40 |
$189 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$607.50 |
$1,012.50 |
1.7× |
| CT abdomen and pelvis without contrast (74176) |
$317.40 |
$529 |
1.3× |
| CT abdomen w contrast (74160) |
$398.40 |
$664 |
2.3× |
| CT abdomen w wo contrast (74170) |
$454.80 |
$758 |
2.6× |
| CT abdomen w/o contrast (74150) |
$241.20 |
$402 |
2.3× |
| CT angio hrt w/3d image (75574) |
$738.90 |
$1,231.50 |
2.1× |
| CT angiography upper extremity lt (73206) |
$567.30 |
$945.50 |
3.2× |
| CT c-spine w/o contrast (72125) |
$316.80 |
$528 |
3.0× |
| CT cervical spine w&w/o contrast (72127) |
$475.80 |
$793 |
2.7× |
| CT cervical spine with contrast (72126) |
$395.40 |
$659 |
1.1× |
| CT chest w/wo contrast (71270) |
$468.30 |
$780.50 |
2.7× |
| CT chest with contrast (71260) |
$386.40 |
$644 |
2.2× |
| CT colonography screening (74263) |
$717.60 |
$1,196 |
3.0× |
| CT colonography w/dye (74262) |
$837.60 |
$1,396 |
4.8× |
| CT colonography w/o cntrst (74261) |
$730.80 |
$1,218 |
7.0× |
| CT head/brain with contrast (70460) |
$268.80 |
$448 |
1.5× |
| CT head/brain without and with contrast (70470) |
$321.30 |
$535.50 |
1.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$489.90 |
$816.50 |
1.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$173.70 |
$289.50 |
2.0× |
| CT hrt w/3d image congen (75573) |
$657.30 |
$1,095.50 |
1.9× |
| CT iac w contrast (70481) |
$481.80 |
$803 |
2.7× |
| CT limited/localized follow up study (76380) |
$243.30 |
$405.50 |
2.8× |
| CT lower ext w/o (73700) |
$309.90 |
$516.50 |
3.0× |
| CT lower extremity w wo contrast (73702) |
$486.30 |
$810.50 |
2.8× |
| CT lower extremity with contrast (73701) |
$393.60 |
$656 |
2.2× |
| CT lumbar spine w & w/o contrast (72133) |
$474.90 |
$791.50 |
2.7× |
| CT lumbar spine w/o contrast (72131) |
$259.80 |
$433 |
2.5× |
| CT lumbar spine with contrast (72132) |
$395.10 |
$658.50 |
1.1× |
| CT maxillofacial w contrast (70487) |
$279.90 |
$466.50 |
1.6× |
| CT maxillofacial w/o contrast (70486) |
$235.80 |
$393 |
2.2× |
| CT maxillofacial w/wo contrast (70488) |
$345.60 |
$576 |
2.0× |
| CT neck soft tissue w contrast (70491) |
$391.20 |
$652 |
2.2× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$528.30 |
$880.50 |
3.0× |
| CT orbits w/o contrast (70480) |
$402.30 |
$670.50 |
3.8× |
| CT pelvis w & w/o contrast (72194) |
$396.60 |
$661 |
2.3× |
| CT pelvis w/o contrast (72192) |
$239.40 |
$399 |
2.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$202.80 |
$338 |
2.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$462.90 |
$771.50 |
2.6× |
| CT soft tissue neck w/o contrast (70490) |
$313.20 |
$522 |
3.0× |
| CT thoracic spine w/contrast (72129) |
$397.80 |
$663 |
2.3× |
| CT thoracic spine w/o contrast (72128) |
$311.10 |
$518.50 |
3.0× |
| CT thoracic spine w/wo contrast (72130) |
$477.90 |
$796.50 |
2.7× |
| CT thorax w/o contrast (71250) |
$296.70 |
$494.50 |
2.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$492 |
$820 |
2.8× |
| CT upper extremity w/o contrast rt (73200) |
$308.70 |
$514.50 |
2.9× |
| CT upper extremity with contrast (73201) |
$386.40 |
$644 |
1.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$639.60 |
$1,066 |
3.6× |
| Cta Abdomen (74175) |
$524.70 |
$874.50 |
3.0× |
| CTA abdomen pelvis (74174) |
$669.30 |
$1,115.50 |
1.9× |
| CTA chest (71275) |
$510.60 |
$851 |
2.9× |
| Cta Head (70496) |
$527.10 |
$878.50 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$616.50 |
$1,027.50 |
3.5× |
| Cta Neck (70498) |
$541.20 |
$902 |
3.1× |
| Cta Pelvis (72191) |
$522.60 |
$871 |
3.0× |
| Cystography minimum 3 views rs&i (74430) |
$78 |
$130 |
0.2× |
| Dacryocystography (70170) |
$255.60 |
$426 |
1.1× |
| Diskogram cervical (72285) |
$122.40 |
$204 |
0.1× |
| Diskography lumbar (72295) |
$196.80 |
$254.50 |
0.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$58.80 |
$98 |
0.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$95.40 |
$159 |
0.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$116.40 |
$194 |
1.1× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$119.40 |
$199 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$93.90 |
$156.50 |
0.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$79.80 |
$133 |
0.9× |
| Dxa bone density study axial skeleton (77085) |
$82.20 |
$137 |
0.8× |
| Echo exam of eye (76529) |
$93.60 |
$156 |
1.1× |
| Echo exam of fetal heart (76825) |
$393 |
$655 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$246.60 |
$411 |
1.0× |
| Echoencephalography real time imaging (76506) |
$205.80 |
$343 |
2.0× |
| Esophageal motility (78258) |
$390.60 |
$651 |
1.0× |
| Esophagus (74220) |
$153 |
$255 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$141 |
$235 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$103.80 |
$173 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$89.70 |
$149.50 |
0.4× |
| Foot 2 views (73620) |
$99 |
$165 |
1.1× |
| Forearm 2 views (73090) |
$99 |
$165 |
1.1× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$81 |
$135 |
0.3× |
| Functional MRI brain by phys/psych (70555) |
$473.40 |
$789 |
2.0× |
| Functional MRI brain by tech (70554) |
$686.40 |
$1,144 |
2.9× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$867 |
$1,445 |
1.6× |
| Gastric mucosa imaging (78261) |
$435.60 |
$726 |
1.1× |
| Gastrointestinal Protein Loss (78282) |
$99 |
$165 |
0.2× |
| Gated Heart Planar Single (78472) |
$423.90 |
$706.50 |
1.1× |
| Hand 2 views (73120) |
$84 |
$140 |
0.8× |
| Hand 3 views (73130) |
$102 |
$170 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$445.80 |
$743 |
0.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$811.80 |
$1,353 |
1.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,282.80 |
$2,138 |
1.8× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$353.70 |
$589.50 |
0.9× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$225.90 |
$376.50 |
0.6× |
| Heart Infarct Image (78466) |
$333.60 |
$556 |
0.8× |
| Heart infarct image w ef (78468) |
$322.80 |
$538 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$293.40 |
$395 |
0.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$878.70 |
$1,464.50 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$644.40 |
$1,074 |
1.6× |
| High energy neutron radj tx dlvr 1/> isocenter (77423) |
$286.80 |
$478 |
0.5× |
| Ht muscle image spect sing (78451) |
$633.60 |
$1,056 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$99 |
$165 |
1.1× |
| Hyperthermia ntrstl prb 5/< (77610) |
$1,564.80 |
$2,608 |
2.8× |
| Hysterosalpingogram (74740) |
$130.20 |
$217 |
0.5× |
| Interstitial radiation source applic complex (77778) |
$917.40 |
$1,529 |
1.3× |
| Intracavitary Radiation Source Applic Complex (77763) |
$908.40 |
$1,514 |
1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$609 |
$1,015 |
1.1× |
| Intracavitary radiation source applic simple (77761) |
$403.20 |
$672 |
0.7× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$55.80 |
$93 |
0.5× |
| Kidney funcj study non-img radioisotopic study (78725) |
$183 |
$305 |
0.5× |
| Kidney imaging morphology (78700) |
$309 |
$515 |
0.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$434.10 |
$723.50 |
0.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$305.10 |
$508.50 |
0.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$684.90 |
$1,141.50 |
1.3× |
| Knee 3 views (73562) |
$99 |
$165 |
1.1× |
| Liver & spleen imaging static only (78215) |
$351 |
$585 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$206.40 |
$344 |
0.5× |
| Liver imaging static only (78201) |
$346.20 |
$577 |
0.6× |
| Liver imaging w/vascular flow (78202) |
$364.20 |
$607 |
0.7× |
| Lung perf&ventilat diferentl (78598) |
$547.80 |
$913 |
1.0× |
| Lung perfusion differential (78597) |
$345.60 |
$576 |
0.9× |
| Lung Ventilation Imaging (78579) |
$191.70 |
$319.50 |
0.5× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$123 |
$205 |
0.0× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$99 |
$165 |
0.2× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$122.40 |
$204 |
0.1× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$99 |
$165 |
0.0× |
| Lymphoscintigraphy (78195) |
$676.20 |
$1,127 |
1.2× |
| Mammary ductogram or galactogram multiple (77054) |
$108.60 |
$181 |
0.5× |
| Mammary ductogram or galactogram single (77053) |
$81 |
$135 |
0.3× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$99 |
$165 |
1.1× |
| Meckels Diverticulum (78290) |
$649.50 |
$1,082.50 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$769.20 |
$1,282 |
2.0× |
| MRA head w & w/o contrast (70546) |
$1,099.80 |
$1,833 |
3.1× |
| MRA head w/o contrast (70544) |
$708.60 |
$1,181 |
3.0× |
| MRA head with contrast (70545) |
$629.40 |
$1,049 |
1.8× |
| MRA neck w contrast (70548) |
$735.60 |
$1,226 |
2.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,090.50 |
$1,817.50 |
3.1× |
| MRA neck w/o contrast (70547) |
$711.90 |
$1,186.50 |
3.0× |
| MRI abdomen w contrast (74182) |
$700.20 |
$1,167 |
2.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$881.40 |
$1,469 |
2.5× |
| MRI abdomen w/o contrast (74181) |
$577.80 |
$963 |
2.4× |
| MRI any jnt lwr ext with con lt (73722) |
$679.20 |
$1,132 |
0.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$673.50 |
$1,122.50 |
0.9× |
| MRI bone marrow blood supply (77084) |
$617.40 |
$1,029 |
2.6× |
| MRI breast w/o contrast bilateral (77047) |
$554.10 |
$923.50 |
2.3× |
| MRI c-spine with contrast (72142) |
$471.60 |
$786 |
1.3× |
| MRI cardiac w/o cont stress (75559) |
$595.80 |
$993 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$417 |
$695 |
1.7× |
| MRI cervical spine w/o contrast (72141) |
$401.10 |
$668.50 |
1.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,043.10 |
$1,738.50 |
3.0× |
| MRI chest w/o contrast (71550) |
$754.20 |
$1,257 |
3.1× |
| MRI chest with contrast (71551) |
$745.80 |
$1,243 |
0.9× |
| MRI fetal sngl/1st gestation (74712) |
$483 |
$805 |
2.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$720.60 |
$1,201 |
2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$615.60 |
$1,026 |
1.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$645.90 |
$1,076.50 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$528 |
$880 |
2.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$722.70 |
$1,204.50 |
2.1× |
| MRI orbit/face/neck w/contrast (70542) |
$592.50 |
$987.50 |
1.7× |
| MRI pelvis w contrast (72196) |
$613.80 |
$1,023 |
1.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$879 |
$1,465 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$661.50 |
$1,102.50 |
2.8× |
| MRI scan of arm joint before and after contrast (73223) |
$831.90 |
$1,386.50 |
2.4× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$726 |
$1,210 |
0.9× |
| MRI scan of leg joint before and after contrast (73723) |
$832.50 |
$1,387.50 |
2.4× |
| MRI spectroscopy (76390) |
$420 |
$700 |
4.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$647.10 |
$1,078.50 |
1.8× |
| MRI spinal canal lumbar w/contrast material (72149) |
$463.80 |
$773 |
1.3× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$644.40 |
$1,074 |
1.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$468 |
$780 |
1.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$648.90 |
$1,081.50 |
1.9× |
| MRI thoracic spine w/o contrast (72146) |
$404.40 |
$674 |
1.7× |
| MRI tmj (70336) |
$569.10 |
$948.50 |
2.4× |
| MRI upper ext joint w/o contrast (73221) |
$430.20 |
$717 |
1.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$890.40 |
$1,484 |
2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$660.60 |
$1,101 |
2.8× |
| Myelogram Cervical (72240) |
$106.20 |
$177 |
0.1× |
| Myelogram Lumbar (72265) |
$102.60 |
$171 |
0.1× |
| Myelogram thoracic (72255) |
$105 |
$175 |
0.1× |
| Myelography 2 or more regions (72270) |
$137.40 |
$229 |
0.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$147.60 |
$246 |
0.1× |
| Myocardial infarct spect (78469) |
$379.20 |
$632 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$894 |
$1,490 |
0.7× |
| Neck soft tissue (70360) |
$84 |
$140 |
1.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$528.60 |
$881 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$99 |
$165 |
0.2× |
| Nm adrenal scan (78075) |
$840 |
$1,400 |
0.6× |
| Nm bone marrow multiple (78103) |
$381.60 |
$636 |
1.0× |
| Nm bone marrow wb (78104) |
$429 |
$715 |
1.1× |
| Nm cisternogram (78630) |
$629.40 |
$1,049 |
1.2× |
| Nm csf leak detection (78650) |
$619.80 |
$1,033 |
0.5× |
| Nm gastric emptying study (78264) |
$653.70 |
$1,089.50 |
1.6× |
| Nm gastroesophageal reflux study (78262) |
$433.20 |
$722 |
1.1× |
| Nm peritoneal-venous shunt patency (78291) |
$442.80 |
$738 |
1.1× |
| Nm red cell sequestration (78140) |
$223.20 |
$372 |
0.6× |
| Nm whole blood volume (78122) |
$156 |
$260 |
0.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,509.40 |
$5,849 |
2.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$186.60 |
$311 |
0.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$766.80 |
$1,278 |
0.6× |
| Nuclear medicine of heart pumping function (78473) |
$454.20 |
$757 |
1.1× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$358.20 |
$597 |
0.7× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$195.60 |
$326 |
0.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$148.80 |
$248 |
0.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$527.40 |
$879 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$388.20 |
$647 |
1.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$391.20 |
$652 |
1.0× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$725.40 |
$1,209 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$332.40 |
$554 |
0.8× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$294 |
$490 |
0.5× |
| Nuclear Rx Oral Admin (79005) |
$180.60 |
$301 |
0.8× |
| Nuclr Rx Interstit Colloid (79300) |
$165.60 |
$276 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$191.10 |
$318.50 |
1.8× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$180.60 |
$301 |
1.4× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$96 |
$160 |
0.9× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$108 |
$180 |
1.0× |
| Orthopantogram (70355) |
$53.40 |
$89 |
0.6× |
| Osseous survey infant (77076) |
$158.40 |
$264 |
1.5× |
| Osseous survey limited (77074) |
$83.40 |
$139 |
0.8× |
| Parathyrd planar w/spect&CT (78072) |
$697.80 |
$1,163 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$619.80 |
$1,033 |
1.5× |
| Parathyroid imaging (78070) |
$579.60 |
$966 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$85.20 |
$142 |
0.8× |
| Perineogram (74775) |
$99 |
$165 |
0.4× |
| Peritoneogram rs&i (74190) |
$99 |
$165 |
0.2× |
| PET image w/CT, skull-thigh (78815) |
$1,333.50 |
$2,222.50 |
0.9× |
| PET imaging CT for attenuation limited area (78814) |
$225.60 |
$376 |
0.2× |
| PET imaging for CT attenuation whole body (78816) |
$1,334.70 |
$2,224.50 |
0.9× |
| PET imaging limited area chest head/neck (78811) |
$160.80 |
$268 |
0.1× |
| PET whole body (78813) |
$204 |
$340 |
0.1× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$172.20 |
$287 |
0.1× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$185.40 |
$309 |
0.1× |
| Platelet survival study (78191) |
$282.60 |
$471 |
0.7× |
| Pr csf ventriculography (78635) |
$640.80 |
$1,068 |
1.2× |
| Pr gi endoscopic ultrasound (76975) |
$99 |
$165 |
0.4× |
| Pr heart first pass single,planar (78481) |
$265.20 |
$442 |
0.5× |
| Pr MRI brain w/ dye (70558) |
$514.50 |
$857.50 |
2.9× |
| Pr MRI brain w/o & w/ dye (70559) |
$1,787.10 |
$2,978.50 |
10.1× |
| Pr MRI brain w/o dye (70557) |
$440.40 |
$734 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$876.30 |
$1,460.50 |
2.5× |
| Pr non-imaging heart function (78414) |
$99 |
$165 |
0.2× |
| Pr red cell survival study (78130) |
$282.60 |
$471 |
0.7× |
| Pr sono bone density measure,peripheral (76977) |
$61.20 |
$102 |
0.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$177.60 |
$296 |
0.1× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$180 |
$300 |
0.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$419.40 |
$699 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$637.20 |
$1,062 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$84.90 |
$141.50 |
0.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$64.20 |
$107 |
0.7× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$92.40 |
$154 |
0.9× |
| Radex hips bilateral with pelvis 2 views (73521) |
$69 |
$115 |
0.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$91.80 |
$153 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$121.20 |
$202 |
1.2× |
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure |
$2,130.60 |
$3,551 |
0.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$511.80 |
$853 |
0.9× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$210 |
$350 |
2.0× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$476.40 |
$794 |
1.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$82.20 |
$137 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$99 |
$165 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$69.60 |
$116 |
0.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$98.10 |
$163.50 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$261.60 |
$436 |
1.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$300.60 |
$501 |
1.7× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$77.40 |
$129 |
0.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$184.20 |
$307 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$156 |
$260 |
0.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$49.20 |
$82 |
0.6× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$72.60 |
$121 |
0.8× |
| Radiological examination surgical specimen (76098) |
$75.30 |
$125.50 |
0.1× |
| Radiopharm Dacryocystography (78660) |
$318 |
$530 |
0.8× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$204 |
$340 |
0.9× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$179.40 |
$299 |
0.8× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$168.60 |
$281 |
0.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$181.20 |
$302 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$301.20 |
$404.50 |
0.1× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$289.80 |
$391 |
0.1× |
| Ribs bilateral 3 views (71110) |
$80.70 |
$134.50 |
0.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$270.60 |
$451 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$584.40 |
$974 |
1.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$352.20 |
$587 |
0.6× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$223.80 |
$373 |
1.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$240.60 |
$401 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$196.80 |
$328 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$83.40 |
$139 |
0.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$167.40 |
$279 |
0.7× |
| Salivary gland function study (78232) |
$166.80 |
$278 |
0.4× |
| Salivary gland imaging (78230) |
$313.80 |
$523 |
0.8× |
| Salivary gland imaging serial images (78231) |
$212.40 |
$354 |
0.5× |
| Scanogram (77073) |
$79.20 |
$132 |
0.8× |
| Scapula complete (73010) |
$84 |
$140 |
0.8× |
| Screening digital breast tomosynthesis (77063) |
$61.20 |
$102 |
2.6× |
| Sella turcica (70240) |
$83.10 |
$138.50 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$149.40 |
$249 |
1.4× |
| Sialogram (70390) |
$167.70 |
$279.50 |
0.7× |
| Simulation intermediate (77285) |
$765.60 |
$1,276 |
2.0× |
| Small bowel series (74250) |
$159.60 |
$266 |
0.9× |
| Spec medical radj physics consltj (77370) |
$330 |
$550 |
2.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$144.60 |
$241 |
0.4× |
| Special dosimetry (77331) |
$111.90 |
$186.50 |
0.8× |
| Special treatment procedure (77470) |
$262.50 |
$437.50 |
0.5× |
| Speech evaluation complex (70371) |
$96 |
$160 |
0.4× |
| Spine thoracic 3 views (72072) |
$83.40 |
$139 |
0.8× |
| Spleen imaging only (78185) |
$393 |
$655 |
1.0× |
| Splenoportograpy rs&i (75810) |
$120 |
$200 |
0.0× |
| Stereotactic body radiation delivery (77373) |
$2,704.20 |
$4,507 |
1.5× |
| Superior sagittal sinus venogram (75870) |
$184.20 |
$307 |
0.1× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$123.60 |
$206 |
1.2× |
| Tbs Technical Calculation Only (77091) |
$160.80 |
$268 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$303 |
$505 |
0.8× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$157.20 |
$262 |
0.4× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$99 |
$165 |
0.4× |
| Testicular Imaging With Vascular Flow (78761) |
$367.80 |
$613 |
0.9× |
| Ther rad simulaj-aided field setting complex (77290) |
$952.50 |
$1,587.50 |
2.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$511.50 |
$852.50 |
3.8× |
| Therapeutic Enema (74283) |
$253.50 |
$422.50 |
1.4× |
| Thoracolumbar 2 views (72080) |
$65.40 |
$109 |
0.7× |
| Thyroid carcinoma metastases img addl study (78016) |
$516.60 |
$861 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$562.80 |
$938 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$375 |
$625 |
0.9× |
| Thyroid uptake measurement (78012) |
$165 |
$259.50 |
0.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$472.80 |
$788 |
1.2× |
| Tmj unilateral (70328) |
$84 |
$140 |
1.0× |
| Tomogram (76100) |
$120 |
$200 |
1.1× |
| Treatment device intermediate (77333) |
$156.60 |
$261 |
1.2× |
| Treatment devices simple (77332) |
$108.30 |
$180.50 |
0.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,060.80 |
$1,768 |
1.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$198.60 |
$331 |
0.5× |
| Tx devices design & construction complex (77334) |
$203.70 |
$339.50 |
0.5× |
| Ultrasound scan of cornea to determine thickness (76514) |
$63 |
$105 |
2.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$98.40 |
$164 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$125.40 |
$209 |
1.2× |
| Umbilical-artery Doppler (OB) (76820) |
$49.50 |
$82.50 |
0.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$232.20 |
$387 |
2.7× |
| Unlisted fluoroscopic procedure (76496) |
$139.20 |
$232 |
1.6× |
| Upper Extremity Infant (73092) |
$84.30 |
$140.50 |
0.8× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$180 |
$300 |
1.9× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$395.40 |
$659 |
1.0× |
| Urethrocystography retrograde rs&i (74450) |
$413.10 |
$688.50 |
1.7× |
| Urethrocystography voiding (74455) |
$81.60 |
$136 |
0.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$195.30 |
$325.50 |
1.1× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$222.60 |
$371 |
1.3× |
| Us abdl aorta screen aaa (76706) |
$133.20 |
$222 |
1.3× |
| Us breast unilateral complete (76641) |
$143.40 |
$239 |
1.4× |
| Us breast unilateral limited (76642) |
$109.80 |
$183 |
1.3× |
| Us chest (76604) |
$124.20 |
$207 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$163.80 |
$273 |
1.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$124.80 |
$208 |
1.2× |
| Us guided compression repair (76936) |
$451.50 |
$752.50 |
2.1× |
| Us infant hips dynamic (76885) |
$219 |
$365 |
2.5× |
| Us infant hips limited static (76886) |
$187.50 |
$312.50 |
2.1× |
| Us kidney transplant (76776) |
$221.70 |
$369.50 |
2.1× |
| Us ob detailed single fetus (76811) |
$187.80 |
$313 |
0.8× |
| Us ob transvaginal (76817) |
$120.60 |
$201 |
1.1× |
| Us pelvic non ob complete (76856) |
$188.40 |
$314 |
1.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$62.40 |
$104 |
0.6× |
| Us pregnancy ltd (76815) |
$138.90 |
$231.50 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$150 |
$250 |
1.4× |
| Us retroperitoneal complete (76770) |
$192 |
$320 |
1.8× |
| Us retroperitoneal limited (76775) |
$95.10 |
$158.50 |
0.9× |
| Us scrotum and contents (76870) |
$108.60 |
$181 |
1.0× |
| Us soft tissue head/neck (76536) |
$178.20 |
$297 |
1.7× |
| Us spinal canal and contents (76800) |
$229.50 |
$382.50 |
2.2× |
| Us transrectal (76872) |
$141 |
$235 |
1.3× |
| Us transrectal prostate volume (76873) |
$191.40 |
$319 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$78 |
$130 |
0.7× |
| Us, eye b-scan (76512) |
$108 |
$180 |
1.0× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$754.20 |
$1,257 |
1.4× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$693 |
$1,155 |
1.8× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$1,345.80 |
$2,243 |
1.9× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$1,855.80 |
$3,093 |
3.3× |
| Vascular flow imaging (78445) |
$325.80 |
$543 |
0.8× |
| Vasogram (74440) |
$124.80 |
$208 |
0.5× |
| Venogram extremity bilateral (75822) |
$169.80 |
$283 |
0.1× |
| Venogram orbital (75880) |
$211.20 |
$352 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$2,474.10 |
$360 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$278.40 |
$464 |
0.2× |
| Venography epidural rs&i (75872) |
$191.40 |
$319 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$1,496.10 |
$269 |
0.9× |
| Venography Renal Bilateral (75833) |
$332.40 |
$432 |
0.1× |
| Venography renal unilateral selective rs&i (75831) |
$171 |
$285 |
0.1× |
| Venography venous sinus/jugular cath rs&i (75860) |
$289.20 |
$388 |
0.1× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$7,788.60 |
$6,643.50 |
1.4× |
| Vertebral fracture assessment via dxa (77086) |
$87 |
$145 |
1.0× |
| Wrist 2 views (73100) |
$85.20 |
$142 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$63 |
$105 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$84.30 |
$140.50 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$99 |
$165 |
1.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$376.20 |
$627 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$99 |
$165 |
1.1× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$85.20 |
$142 |
1.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$102.60 |
$171 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$67.80 |
$113 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$105.60 |
$176 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$74.40 |
$124 |
0.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$123.30 |
$205.50 |
1.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$81 |
$135 |
0.8× |
| X-ray exam of femur 1 (73551) |
$69 |
$115 |
0.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$418.20 |
$697 |
2.4× |
| X-ray eye for foreign body (70030) |
$84 |
$140 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$82.80 |
$138 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$81.30 |
$135.50 |
0.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$99 |
$165 |
1.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$132 |
$220 |
0.1× |
| X-ray head for orthodontia (70350) |
$50.40 |
$84 |
0.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$99 |
$165 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$168.60 |
$281 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$85.20 |
$142 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$84.90 |
$141.50 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86.70 |
$144.50 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$84.30 |
$140.50 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$99 |
$165 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$107.40 |
$179 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$85.20 |
$142 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$72.60 |
$121 |
0.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$81.60 |
$136 |
0.9× |
| X-ray of voice box or throat (70370) |
$119.40 |
$199 |
1.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$82.20 |
$137 |
0.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$99 |
$165 |
0.9× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$444.30 |
$740.50 |
0.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$187.20 |
$312 |
0.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$65.40 |
$109 |
0.7× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$115.80 |
$193 |
1.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$81.60 |
$136 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$84.60 |
$141 |
0.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$83.40 |
$139 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$99 |
$165 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$99 |
$165 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$84.30 |
$140.50 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$79.80 |
$133 |
0.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$81.60 |
$136 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$81.60 |
$136 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$83.40 |
$139 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$81.90 |
$136.50 |
0.9× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$58.80 |
$98 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$99 |
$165 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$84.90 |
$141.50 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$99 |
$165 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$99 |
$165 |
1.1× |
| Xr arthrogram ankle (73615) |
$182.10 |
$303.50 |
0.5× |
| Xr c-spine 6 or more views (72052) |
$150.60 |
$251 |
1.4× |
| Xr chest 4+ views (71048) |
$73.20 |
$122 |
0.7× |
| Xr Cholecystography Oral Contrast (74290) |
$107.40 |
$179 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$88.20 |
$147 |
1.0× |
| Xr internal auditory meati complete (70134) |
$67.80 |
$113 |
0.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$85.20 |
$142 |
0.8× |
| Xr myelogram posterior fossa (70010) |
$106.80 |
$178 |
0.3× |
| Xr optic foramina (70190) |
$67.80 |
$113 |
0.8× |
| Xr shoulder 1 view (73020) |
$81.60 |
$136 |
0.9× |
| Xr spine cervical 4 or 5 views (72050) |
$81.60 |
$136 |
0.8× |
| Xr tibia/fibula 2 views (73590) |
$99 |
$165 |
1.1× |
| Xr tmj bilateral (70330) |
$86.10 |
$143.50 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$99 |
$165 |
1.1× |