| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$5,064 |
— |
| Abdomen 2 views (74019) |
— |
$956 |
— |
| Acute gastrointestinal blood loss imaging (78278) |
— |
$8,172 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$19,326 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$7,547 |
— |
| Angiography internal mammary rs&i (75756) |
— |
$7,739 |
— |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
— |
$12,282 |
— |
| Angiography pulmonary bilateral slctv rs&i (75743) |
— |
$11,876 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$10,562 |
— |
| Angiography Spinal Selective Rs&I (75705) |
— |
$9,734 |
— |
| Angiography visceral slctv/supraslctv rs&i (75726) |
— |
$11,862 |
— |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
— |
$4,004 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$16,225 |
— |
| Ankle 2 views (73600) |
— |
$798 |
— |
| Antegrade urography radiological supvj & interpj (74425) |
— |
$2,519 |
— |
| Aortogram thoracic (75605) |
— |
$10,139 |
— |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
— |
$11,491 |
— |
| Aortography abdominal serialography rs&i (75625) |
— |
$10,242 |
— |
| Aortography thoracic w/o serialography rs&i (75600) |
— |
$13,233 |
— |
| Arthrogram elbow (73085) |
— |
$2,325 |
— |
| Arthrogram hip (73525) |
— |
$2,407 |
— |
| Arthrogram shoulder (73040) |
— |
$2,391 |
— |
| Arthrogram wrist (73115) |
— |
$2,281 |
— |
| Arthrography knee lt (73580) |
— |
$2,438 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$656 |
— |
| Bone &/Joint Imaging Limited Area (78300) |
— |
$4,217 |
— |
| Bone &/Joint Imaging Multiple Areas (78305) |
— |
$5,391 |
— |
| Bone &/joint imaging whole body (78306) |
— |
$5,891 |
— |
| Bone age studies (77072) |
— |
$854 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$8,124 |
— |
| Bone survey complete (77075) |
— |
$2,217 |
— |
| Brachytx isodose complex (77318) |
— |
$6,923 |
— |
| Brachytx isodose intermed (77317) |
— |
$6,287 |
— |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
— |
$4,121 |
— |
| Brain imaging < 4 static views (78600) |
— |
$4,270 |
— |
| Brain Imaging Vascular Flow Only (78610) |
— |
$4,220 |
— |
| Cervical spine 2 or 3 views (72040) |
— |
$1,066 |
— |
| Chest 1 view (71045) |
— |
$735 |
— |
| Chest 3 views (71047) |
— |
$1,060 |
— |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
— |
$1,603 |
— |
| Cisternography Positive Contrast Rs&I (70015) |
— |
$5,131 |
— |
| Clavicle complete (73000) |
— |
$906 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$1,163 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$796 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$7,199 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$4,301 |
— |
| CT abdomen w contrast (74160) |
— |
$3,763 |
— |
| CT abdomen w wo contrast (74170) |
— |
$3,763 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,099 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,763 |
— |
| CT angiography upper extremity lt (73206) |
— |
$3,763 |
— |
| CT c-spine w/o contrast (72125) |
— |
$2,099 |
— |
| CT cervical spine w&w/o contrast (72127) |
— |
$3,763 |
— |
| CT cervical spine with contrast (72126) |
— |
$4,960 |
— |
| CT chest w/wo contrast (71270) |
— |
$3,763 |
— |
| CT chest with contrast (71260) |
— |
$3,763 |
— |
| CT colonography screening (74263) |
— |
$1,253 |
— |
| CT colonography w/dye (74262) |
— |
$3,013 |
— |
| CT head/brain with contrast (70460) |
— |
$3,763 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,763 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$936 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$878 |
— |
| CT hrt w/3d image congen (75573) |
— |
$2,073 |
— |
| CT iac w contrast (70481) |
— |
$3,763 |
— |
| CT limited/localized follow up study (76380) |
— |
$1,163 |
— |
| CT lower ext w/o (73700) |
— |
$2,099 |
— |
| CT lower extremity w wo contrast (73702) |
— |
$3,763 |
— |
| CT lower extremity with contrast (73701) |
— |
$3,763 |
— |
| CT lumbar spine w & w/o contrast (72133) |
— |
$3,763 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,099 |
— |
| CT lumbar spine with contrast (72132) |
— |
$4,647 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,763 |
— |
| CT maxillofacial w/o contrast (70486) |
— |
$2,099 |
— |
| CT maxillofacial w/wo contrast (70488) |
— |
$3,763 |
— |
| CT neck soft tissue w contrast (70491) |
— |
$3,763 |
— |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
— |
$3,763 |
— |
| CT orbits w/o contrast (70480) |
— |
$2,099 |
— |
| CT pelvis w & w/o contrast (72194) |
— |
$3,763 |
— |
| CT pelvis w/o contrast (72192) |
— |
$2,099 |
— |
| CT soft tissue neck w/o & w/contrast material (70492) |
— |
$3,763 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,099 |
— |
| CT thoracic spine w/contrast (72129) |
— |
$3,763 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,099 |
— |
| CT thoracic spine w/wo contrast (72130) |
— |
$3,763 |
— |
| CT thorax w/o contrast (71250) |
— |
$2,099 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$3,763 |
— |
| CT upper extremity w/o contrast rt (73200) |
— |
$2,099 |
— |
| CT upper extremity with contrast (73201) |
— |
$4,350 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$3,763 |
— |
| Cta Abdomen (74175) |
— |
$3,763 |
— |
| CTA abdomen pelvis (74174) |
— |
$7,199 |
— |
| CTA chest (71275) |
— |
$983 |
— |
| Cta Head (70496) |
— |
$3,763 |
— |
| CTA lwr ext w&w/o contrast (73706) |
— |
$3,763 |
— |
| Cta Neck (70498) |
— |
$3,763 |
— |
| Cta Pelvis (72191) |
— |
$3,763 |
— |
| Cystography minimum 3 views rs&i (74430) |
— |
$1,864 |
— |
| Diskogram cervical (72285) |
— |
$10,832 |
— |
| Diskography lumbar (72295) |
— |
$7,668 |
— |
| Dxa bone density study 1/> sites axial skel (77080) |
— |
$1,307 |
— |
| Echoencephalography real time imaging (76506) |
— |
$1,731 |
— |
| Esophagus (74220) |
— |
$1,569 |
— |
| Fetal biophysical profile non-stress testing (76818) |
— |
$2,149 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,656 |
— |
| Foot 2 views (73620) |
— |
$856 |
— |
| Forearm 2 views (73090) |
— |
$890 |
— |
| Gated Heart Planar Single (78472) |
— |
$5,377 |
— |
| Hand 2 views (73120) |
— |
$798 |
— |
| Hand 3 views (73130) |
— |
$871 |
— |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
— |
$4,995 |
— |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
— |
$9,295 |
— |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
— |
$28,526 |
— |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
— |
$11,020 |
— |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
— |
$7,031 |
— |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
— |
$15,324 |
— |
| Hepatobiliary syst imaging including gallbladder (78226) |
— |
$11,306 |
— |
| Ht muscle image spect sing (78451) |
— |
$7,092 |
— |
| Humerus Min 2 Views Left (73060) |
— |
$837 |
— |
| Hysterosalpingogram (74740) |
— |
$2,367 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$8,036 |
— |
| Intracavitary Radiation Source Applic Complex (77763) |
— |
$8,737 |
— |
| Intracavitary Radiation Source Applic Intermed (77762) |
— |
$6,156 |
— |
| Intracavitary radiation source applic simple (77761) |
— |
$4,652 |
— |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
— |
$679 |
— |
| Kidney imaging morphology (78700) |
— |
$4,058 |
— |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
— |
$5,422 |
— |
| Kidney img morphology vascular flow 1 w/rx (78708) |
— |
$4,201 |
— |
| Knee 3 views (73562) |
— |
$1,011 |
— |
| Liver & spleen imaging static only (78215) |
— |
$4,537 |
— |
| Liver imaging static only (78201) |
— |
$4,361 |
— |
| Lung perf&ventilat diferentl (78598) |
— |
$8,061 |
— |
| Lung Ventilation Imaging (78579) |
— |
$6,518 |
— |
| Lymphoscintigraphy (78195) |
— |
$8,325 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$1,803 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$1,402 |
— |
| Meckels Diverticulum (78290) |
— |
$7,786 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$5,239 |
— |
| Mr safety determination physician/other qhp (76016) |
— |
$458 |
— |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
— |
$309 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$128 |
— |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
— |
$477 |
— |
| Mr safety med physics xm customization plng&mntr (76017) |
— |
$1,256 |
— |
| MRA head w & w/o contrast (70546) |
— |
$8,610 |
— |
| MRA head w/o contrast (70544) |
— |
$5,144 |
— |
| MRA head with contrast (70545) |
— |
$7,463 |
— |
| MRA neck w contrast (70548) |
— |
$6,855 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$8,200 |
— |
| MRA neck w/o contrast (70547) |
— |
$5,144 |
— |
| MRI abdomen w/o & w/contrast material (74183) |
— |
$8,427 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$5,144 |
— |
| MRI any jnt lwr ext with con lt (73722) |
— |
$7,581 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$7,476 |
— |
| MRI breast w/o contrast bilateral (77047) |
— |
$10,286 |
— |
| MRI breast w/o contrast unilat (77046) |
— |
$5,144 |
— |
| MRI c-spine with contrast (72142) |
— |
$8,277 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$5,144 |
— |
| MRI cervical spine w/o contrast (72141) |
— |
$5,144 |
— |
| MRI chest w/o & w/contrast material (71552) |
— |
$8,610 |
— |
| MRI chest w/o contrast (71550) |
— |
$5,144 |
— |
| MRI chest with contrast (71551) |
— |
$9,423 |
— |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
— |
$8,073 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$7,130 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$5,144 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$5,144 |
— |
| MRI orbit/face/neck w&w/o cont (70543) |
— |
$8,610 |
— |
| MRI orbit/face/neck w/contrast (70542) |
— |
$8,023 |
— |
| MRI pelvis w contrast (72196) |
— |
$8,030 |
— |
| MRI pelvis w/o & w/contrast material (72197) |
— |
$8,610 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$5,144 |
— |
| MRI scan of arm joint before and after contrast (73223) |
— |
$8,610 |
— |
| MRI scan of leg joint before and after contrast (73723) |
— |
$8,610 |
— |
| MRI spectroscopy (76390) |
— |
$5,201 |
— |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
— |
$8,610 |
— |
| MRI spinal canal lumbar w/contrast material (72149) |
— |
$8,133 |
— |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
— |
$8,610 |
— |
| MRI spinal canal thoracic w/contrast matrl (72147) |
— |
$8,243 |
— |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
— |
$8,610 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$5,144 |
— |
| MRI tmj (70336) |
— |
$5,144 |
— |
| MRI upper ext joint w/o contrast (73221) |
— |
$5,144 |
— |
| MRI upper extrem other than jt w/o & w/contras (73220) |
— |
$8,604 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$5,144 |
— |
| Myelogram Cervical (72240) |
— |
$4,753 |
— |
| Myelogram Lumbar (72265) |
— |
$4,922 |
— |
| Myelogram thoracic (72255) |
— |
$5,911 |
— |
| Myelography 2 or more regions (72270) |
— |
$5,564 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$11,049 |
— |
| Neck soft tissue (70360) |
— |
$829 |
— |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
— |
$7,659 |
— |
| Nm bone marrow wb (78104) |
— |
$4,683 |
— |
| Nm cisternogram (78630) |
— |
$7,947 |
— |
| Nm csf leak detection (78650) |
— |
$8,103 |
— |
| Nm gastric emptying study (78264) |
— |
$6,770 |
— |
| Nm gastroesophageal reflux study (78262) |
— |
$5,687 |
— |
| Nm peritoneal-venous shunt patency (78291) |
— |
$5,857 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$20,091 |
— |
| Nuclear medicine study of kidney and blood flow (78701) |
— |
$5,097 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$824 |
— |
| Nuclr Rx Interstit Colloid (79300) |
— |
$4,857 |
— |
| Osseous survey infant (77076) |
— |
$1,355 |
— |
| Osseous survey limited (77074) |
— |
$900 |
— |
| Parathyroid imaging (78070) |
— |
$7,028 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$888 |
— |
| Pr heart first pass single,planar (78481) |
— |
$4,228 |
— |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
— |
$8,494 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$5,576 |
— |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
— |
$11,423 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$2,340 |
— |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
— |
$996 |
— |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
— |
$1,363 |
— |
| Radex hips bilateral with pelvis 2 views (73521) |
— |
$1,153 |
— |
| Radex mastoids compl minimum 3 views pr side (70130) |
— |
$1,062 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$14,833 |
— |
| Radiation treatment delivery 1 mev >= complex (77412) |
— |
$1,511 |
— |
| Radiation treatment delivery 1 mev >= simple (77402) |
— |
$828 |
— |
| Radiation tx delivery 1 mev >= intermediate (77407) |
— |
$906 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$1,261 |
— |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
— |
$786 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$1,220 |
— |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
— |
$901 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$2,267 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$2,127 |
— |
| Radiologic exam upr gi trc single contrast study (74240) |
— |
$1,817 |
— |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
— |
$1,007 |
— |
| Radiological examination surgical specimen (76098) |
— |
$1,106 |
— |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
— |
$3,649 |
— |
| Ribs bilateral 3 views (71110) |
— |
$1,249 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$5,840 |
— |
| Rp loclzj tum plnr whole body single day imaging (78802) |
— |
$8,448 |
— |
| Rp loclzj tum spect 1 area single day imaging (78803) |
— |
$9,293 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$14,953 |
— |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
— |
$4,467 |
— |
| Rp therapy intra-arterial particulate admn (79445) |
— |
$2,547 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$3,205 |
— |
| Sacroiliac Joints < 3 Views (72200) |
— |
$619 |
— |
| Salivary gland imaging (78230) |
— |
$4,186 |
— |
| Scanogram (77073) |
— |
$992 |
— |
| Scapula complete (73010) |
— |
$887 |
— |
| Screening digital breast tomosynthesis (77063) |
— |
$272 |
— |
| Sella turcica (70240) |
— |
$486 |
— |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
— |
$1,468 |
— |
| Sialogram (70390) |
— |
$2,228 |
— |
| Simulation intermediate (77285) |
— |
$8,892 |
— |
| Small bowel series (74250) |
— |
$1,826 |
— |
| Spec medical radj physics consltj (77370) |
— |
$1,211 |
— |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
— |
$851 |
— |
| Special dosimetry (77331) |
— |
$663 |
— |
| Special treatment procedure (77470) |
— |
$1,614 |
— |
| Spine thoracic 3 views (72072) |
— |
$1,284 |
— |
| Spleen imaging only (78185) |
— |
$4,908 |
— |
| Stereotactic body radiation delivery (77373) |
— |
$18,856 |
— |
| Tbs Technical Calculation Only (77091) |
— |
$1,956 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$2,952 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$1,508 |
— |
| Temporomandble Jt Arthrography Rs&I (70332) |
— |
$3,892 |
— |
| Testicular Imaging With Vascular Flow (78761) |
— |
$5,104 |
— |
| Ther rad simulaj-aided field setting complex (77290) |
— |
$5,291 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$2,810 |
— |
| Thoracolumbar 2 views (72080) |
— |
$1,108 |
— |
| Thyroid carcinoma metastases img whole body (78018) |
— |
$7,283 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$4,443 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$5,632 |
— |
| Tmj unilateral (70328) |
— |
$856 |
— |
| Tomogram (76100) |
— |
$1,957 |
— |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
— |
$1,956 |
— |
| Treatment device intermediate (77333) |
— |
$717 |
— |
| Treatment devices simple (77332) |
— |
$856 |
— |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
— |
$13,334 |
— |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
— |
$4,613 |
— |
| Tx devices design & construction complex (77334) |
— |
$1,578 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$1,828 |
— |
| Unlisted Diagnostic Radiographic Procedure (76499) |
— |
$1,390 |
— |
| Unlisted Ultrasound Procedure (76999) |
— |
$1,390 |
— |
| Upper Extremity Infant (73092) |
— |
$779 |
— |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
— |
$5,128 |
— |
| Urethrocystography retrograde rs&i (74450) |
— |
$1,838 |
— |
| Urethrocystography voiding (74455) |
— |
$2,228 |
— |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
— |
$2,578 |
— |
| Us abdl aorta screen aaa (76706) |
— |
$616 |
— |
| Us breast unilateral complete (76641) |
— |
$1,462 |
— |
| Us breast unilateral limited (76642) |
— |
$1,203 |
— |
| Us chest (76604) |
— |
$1,297 |
— |
| Us compl joint r-t w/image documentation (76881) |
— |
$1,981 |
— |
| Us elastography parenchyma (76981) |
— |
$550 |
— |
| Us guided compression repair (76936) |
— |
$2,463 |
— |
| Us infant hips dynamic (76885) |
— |
$1,390 |
— |
| Us ob transvaginal (76817) |
— |
$1,557 |
— |
| Us pelvic non ob complete (76856) |
— |
$2,197 |
— |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
— |
$1,614 |
— |
| Us pregnancy ltd (76815) |
— |
$1,311 |
— |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
— |
$1,736 |
— |
| Us retroperitoneal complete (76770) |
— |
$2,092 |
— |
| Us retroperitoneal limited (76775) |
— |
$1,623 |
— |
| Us scrotum and contents (76870) |
— |
$1,694.50 |
— |
| Us soft tissue head/neck (76536) |
— |
$1,742 |
— |
| Us spinal canal and contents (76800) |
— |
$1,602 |
— |
| Us transrectal (76872) |
— |
$1,980 |
— |
| Us xtr non-vasc lmtd (76882) |
— |
$1,261 |
— |
| Venogram extremity bilateral (75822) |
— |
$4,809 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$10,769 |
— |
| Venography caval superior serialography rs&i (75827) |
— |
$6,014 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$3,561 |
— |
| Venography Renal Bilateral (75833) |
— |
$13,114 |
— |
| Venography renal unilateral selective rs&i (75831) |
— |
$8,764 |
— |
| Venography venous sinus/jugular cath rs&i (75860) |
— |
$6,424 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$513 |
— |
| Wrist 2 views (73100) |
— |
$814 |
— |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
— |
$1,372 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$937 |
— |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
— |
$970 |
— |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
— |
$2,712 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$815 |
— |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
— |
$990 |
— |
| X-ray exam hip uni 1 view (73501) |
— |
$778 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$577 |
— |
| X-ray exam hip uni 4/> views (73503) |
— |
$720 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$1,291 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$1,761 |
— |
| X-ray exam of femur 1 (73551) |
— |
$782 |
— |
| X-ray eye for foreign body (70030) |
— |
$772 |
— |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
— |
$1,182 |
— |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
— |
$904 |
— |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
— |
$970 |
— |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
— |
$5,265 |
— |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
— |
$798 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$791 |
— |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
— |
$1,216 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$947 |
— |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
— |
$720 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$1,149 |
— |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
— |
$1,071 |
— |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
— |
$891 |
— |
| X-ray of voice box or throat (70370) |
— |
$948 |
— |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
— |
$1,222 |
— |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
— |
$2,343 |
— |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
— |
$986 |
— |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
— |
$1,207 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$2,413 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$992 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$1,018 |
— |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
— |
$996 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$1,215 |
— |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
— |
$824 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$1,558 |
— |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
— |
$955 |
— |
| X-Ray Spine One View - Xr Spine (72020) |
— |
$846 |
— |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
— |
$901 |
— |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
— |
$904 |
— |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
— |
$1,113 |
— |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
— |
$703 |
— |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
— |
$976 |
— |
| Xr arthrogram ankle (73615) |
— |
$2,757 |
— |
| Xr c-spine 6 or more views (72052) |
— |
$1,761 |
— |
| Xr chest 4+ views (71048) |
— |
$1,321 |
— |
| Xr Cholecystography Oral Contrast (74290) |
— |
$1,914 |
— |
| Xr finger(s) 2+ views (73140) |
— |
$702 |
— |
| Xr optic foramina (70190) |
— |
$727 |
— |
| Xr shoulder 1 view (73020) |
— |
$822 |
— |
| Xr spine cervical 4 or 5 views (72050) |
— |
$1,512 |
— |
| Xr tibia/fibula 2 views (73590) |
— |
$1,140.50 |
— |
| Xr tmj bilateral (70330) |
— |
$1,712 |
— |
| Xray knee 1 or 2 views rt (73560) |
— |
$851 |
— |