| 3-D radiotherapy plan dose-volume histograms (77295) |
$12,144.55 |
$22,081 |
6.8× |
| Abdomen 1 View (74018) |
$243.10 |
$442 |
2.2× |
| Abdomen 2 views (74019) |
$279.40 |
$508 |
2.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,093.40 |
$1,988 |
2.1× |
| Acute venous thrombosis imaging, peptide Non-Facility (78456) |
$1,464.10 |
$2,662 |
0.9× |
| Adrenal Cortex & Medulla Img (78075) |
$1,464.10 |
$2,662 |
0.9× |
| Angio internal mammary (75756) |
$2,833.05 |
$5,151 |
0.7× |
| Angio pulmonary bilat (75743) |
$3,527.70 |
$6,414 |
0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,286.25 |
$5,975 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$3,379.75 |
$6,145 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,157.65 |
$3,923 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,963.40 |
$5,388 |
0.7× |
| Ankle 2 views (73600) |
$288.20 |
$524 |
2.6× |
| Aortography thoracic serialography rs&i (75605) |
$5,974.65 |
$10,863 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,462.25 |
$6,295 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$5,178.80 |
$9,416 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,833.05 |
$5,151 |
0.7× |
| Artery X-Rays Pelvis (75736) |
$5,040.20 |
$9,164 |
0.7× |
| Artery X-Rays Spine (75705) |
$4,888.40 |
$8,888 |
0.7× |
| Arthrogram ankle (73615) |
$513.70 |
$934 |
1.1× |
| Arthrogram hip (73525) |
$861.30 |
$1,566 |
1.9× |
| Arthrogram Wrist (73115) |
$704 |
$1,280 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$1,345.30 |
$2,446 |
7.8× |
| Bone age studies (77072) |
$319.55 |
$581 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$2,918.85 |
$5,307 |
5.7× |
| Bone Imaging Limited Area (78300) |
$1,008.15 |
$1,833 |
2.0× |
| Bone Imaging Multiple Areas (78305) |
$1,300.20 |
$2,364 |
2.5× |
| Bone Imaging Whole Body (78306) |
$2,644.40 |
$4,808 |
5.1× |
| Bone marrow imaging limited area (78102) |
$696.85 |
$1,267 |
1.4× |
| Bone marrow imaging; multiple areas (78103) |
$1,154.45 |
$2,099 |
2.2× |
| Bone marrow imaging; whole body (78104) |
$1,265 |
$2,300 |
2.5× |
| Bone survey infant (77076) |
$928.95 |
$1,689 |
6.9× |
Brachytx isodose complex (77318)
range across 2 matching MRF lines |
$2,557.50–$3,897.30 |
$4,650–$7,086 |
varies |
| Brachytx isodose intermed (77317) |
$2,270.40 |
$4,128 |
4.7× |
| Brachytx Isodose Plan Simple (77316) |
$1,861.75 |
$3,385 |
3.9× |
| Brain Flow Imaging Only (78610) |
$1,123.10 |
$2,042 |
1.6× |
| Brain Image W/Flow < 4 Views (78601) |
$519.75 |
$945 |
1.0× |
| Brain imaging < 4 static views (78600) |
$425.70 |
$774 |
0.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,934.35 |
$3,517 |
2.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$673.20 |
$1,224 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,035.35 |
$7,337 |
2.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,568.60 |
$2,852 |
3.1× |
| Cardiac blood pool imaging, first pass technique; multiple studies, resting and with stress (exercise and/or… (78483) |
$578.60 |
$1,052 |
0.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$4,323 |
$7,860 |
9.6× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,538.60 |
$8,252 |
4.5× |
| Cardiac Shunt Detection (78428) |
$577.50 |
$1,050 |
1.1× |
| Cat Scan Follow-Up Study (76380) |
$415.80 |
$756 |
3.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$831.05 |
$1,511 |
1.2× |
| Cerebrospinal fluid flow, imaging (not including introduction of material); ventriculography Non-Facility (78635) |
$1,753.40 |
$3,188 |
2.5× |
| Cerebrospinal Fluid Scan (78630) |
$1,449.25 |
$2,635 |
2.1× |
| Chest 1 view (71045) |
$405.90 |
$738 |
3.6× |
| Chest 2 views (71046) |
$425.15 |
$773 |
3.8× |
| Chest 3 views (71047) |
$467.50 |
$850 |
4.2× |
| Chest 4 or more views (71048) |
$631.40 |
$1,148 |
4.7× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$254.65 |
$463 |
1.9× |
| Cholecystography Oral Contrast (74290) |
$243.65 |
$443 |
1.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$254.65 |
$463 |
1.9× |
| Clavicle complete (73000) |
$519.75 |
$945 |
4.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,450.35 |
$2,637 |
10.8× |
| Continuing medical physics consltj pr wk (77336) |
$1,149.50 |
$2,090 |
6.6× |
| Contrast Exam Abdominl Aorta (75625) |
$3,428.15 |
$6,233 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$719.40 |
$1,308 |
1.6× |
| Contrast X-Ray Of Elbow (73085) |
$843.70 |
$1,534 |
1.9× |
| Contrast X-Ray Of Knee Joint (73580) |
$730.40 |
$1,328 |
1.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$243.65 |
$443 |
1.1× |
| Corpora cavernosography (74445) |
$333.30 |
$606 |
2.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,310.45 |
$6,019 |
7.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,702.25 |
$3,095 |
5.5× |
| CT abdomen w contrast (74160) |
$2,082.85 |
$3,787 |
9.2× |
| CT abdomen w wo contrast (74170) |
$2,294.60 |
$4,172 |
10.2× |
| CT abdomen w/o contrast (74150) |
$1,150.60 |
$2,092 |
8.6× |
| CT Angio Abdomen and Pelvis (74174) |
$3,708.10 |
$6,742 |
8.3× |
| CT Angio Chest (71275) |
$2,539.90 |
$4,618 |
11.3× |
| CT Angio Head (70496) |
$2,135.65 |
$3,883 |
9.5× |
| CT angio hrt w/3d image (75574) |
$1,628 |
$2,960 |
3.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,883.65 |
$5,243 |
12.8× |
| CT Angio Neck (70498) |
$2,139.50 |
$3,890 |
9.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$4,530.90 |
$8,238 |
20.1× |
| CT bone density (77078) |
$161.70 |
$294 |
1.4× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$312.95 |
$569 |
1.4× |
| CT cervical spine w/ contrast (72126) |
$2,145.55 |
$3,901 |
4.8× |
| CT cervical spine w/o contrast (72125) |
$2,043.80 |
$3,716 |
15.2× |
| CT cervical spine w/wo cont (72127) |
$2,253.35 |
$4,097 |
10.0× |
| CT chest w contrast (71260) |
$3,797.75 |
$6,905 |
16.8× |
| CT chest w/wo contrast (71270) |
$4,177.80 |
$7,596 |
18.5× |
| CT colonography screening (74263) |
$828.85 |
$1,507 |
2.7× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$954.25 |
$1,735 |
4.2× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$856.90 |
$1,558 |
6.4× |
| CT head/brain with contrast (70460) |
$1,725.90 |
$3,138 |
7.7× |
| CT head/brain without and with contrast (70470) |
$1,941.50 |
$3,530 |
8.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$928.95 |
$1,689 |
2.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$519.20 |
$944 |
4.6× |
| CT hrt w/3d image congen (75573) |
$1,432.20 |
$2,604 |
3.2× |
| CT iac w contrast (70481) |
$2,966.70 |
$5,394 |
13.2× |
| CT l-spine w&w/o contrast (72133) |
$1,818.85 |
$3,307 |
8.1× |
| CT lower ext w/o (73700) |
$1,355.20 |
$2,464 |
10.1× |
| CT lower extremity w/contrast material (73701) |
$3,077.80 |
$5,596 |
13.6× |
| CT lumbar spine w contrast (72132) |
$1,754.50 |
$3,190 |
3.9× |
| CT lumbar spine w/o contrast (72131) |
$1,672.55 |
$3,041 |
12.4× |
| CT maxillofacial w contrast (70487) |
$2,433.20 |
$4,424 |
10.8× |
| CT maxillofacial wo contrast (70486) |
$2,159.85 |
$3,927 |
16.1× |
| CT neck tissue combo (70492) |
$2,033.90 |
$3,698 |
9.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$3,088.25 |
$5,615 |
13.7× |
| CT orbits w/o contrast (70480) |
$2,825.90 |
$5,138 |
21.0× |
| CT pelvis w&w/o contrast (72194) |
$1,951.95 |
$3,549 |
8.7× |
| CT pelvis w/o contrast (72192) |
$1,353.55 |
$2,461 |
10.1× |
| CT scan of leg combo (73702) |
$3,731.20 |
$6,784 |
16.5× |
| CT scans face/jaw combo (70488) |
$2,554.75 |
$4,645 |
11.3× |
| CT soft tissue neck w contrast (70491) |
$1,937.10 |
$3,522 |
8.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,180.30 |
$2,146 |
8.8× |
| CT thoracic spine w contrast (72129) |
$1,723.70 |
$3,134 |
7.6× |
| CT thoracic spine w/o contrast (72128) |
$1,641.20 |
$2,984 |
12.2× |
| CT thoracic spine w/wo cont (72130) |
$1,809.50 |
$3,290 |
8.0× |
| CT thorax w/o contrast (71250) |
$1,450.35 |
$2,637 |
10.8× |
CT unlisted procedure (76497)
range across 4 matching MRF lines |
$41.25–$825 |
$75–$1,500 |
varies |
| CT upper ext wo (73200) |
$3,735.60 |
$6,792 |
27.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$4,315.30 |
$7,846 |
19.1× |
| CT upper extremity with contrast (73201) |
$3,923.15 |
$7,133 |
8.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,114.30 |
$2,026 |
4.9× |
| Cta Abdomen (74175) |
$1,987.15 |
$3,613 |
8.8× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$622.60 |
$1,132 |
1.4× |
| CTA pelvis (72191) |
$2,049.30 |
$3,726 |
9.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$333.30 |
$606 |
1.1× |
| Dilation ureters/urethra rs&i (74485) |
$2,156 |
$3,920 |
0.8× |
| Discography Cerv/Thor Spine (72285) |
$2,219.25 |
$4,035 |
0.9× |
| Diskography lumbar (72295) |
$2,857.80 |
$5,196 |
1.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$338.25 |
$615 |
2.5× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$724.90 |
$1,318 |
5.4× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$647.90 |
$1,178 |
4.8× |
| Dxa Bone Density Axial (77080) |
$721.05 |
$1,311 |
5.4× |
| Dxa bone density study (77085) |
$227.70 |
$414 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$197.45 |
$359 |
1.8× |
| Echo exam of fetal heart (76825) |
$1,445.40 |
$2,628 |
2.1× |
| Echo exam uterus (76831) |
$814.55 |
$1,481 |
2.7× |
| Echo Guide For Artery Repair (76936) |
$554.40 |
$1,008 |
2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$535.70 |
$974 |
1.7× |
| Echograp Trans R Pros Study (76873) |
$292.60 |
$532 |
2.2× |
| Esophageal Motility Study (78258) |
$425.70 |
$774 |
0.8× |
| Esophagram (74220) |
$491.70 |
$894 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$1,397 |
$2,540 |
10.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$1,115.40 |
$2,028 |
8.3× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$1,358.50 |
$2,470 |
4.4× |
| Follow-Up Angiography (75898) |
$2,743.40 |
$4,988 |
0.7× |
| Foot 2 views (73620) |
$479.60 |
$872 |
4.3× |
| Forearm 2 views (73090) |
$548.35 |
$997 |
4.9× |
| Gastric emptying imaging study (78264) |
$2,720.85 |
$4,947 |
5.3× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$3,571.15 |
$6,493 |
6.9× |
| Gastric Mucosa Imaging (78261) |
$661.65 |
$1,203 |
1.3× |
| Gastroesophageal Reflux Exam (78262) |
$493.90 |
$898 |
1.0× |
| Gastrointestinal Protein Loss (78282) |
$425.70 |
$774 |
0.8× |
| Gated Heart Planar Single (78472) |
$1,018.60 |
$1,852 |
2.0× |
| Gated Heart, Multiple (78473) |
$1,030.70 |
$1,874 |
2.0× |
| GI Endoscopic US S&I (76975) |
$558.25 |
$1,015 |
1.8× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$4,094.20 |
$7,444 |
5.9× |
| Hand 2 views (73120) |
$559.35 |
$1,017 |
4.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$6,166.05 |
$11,211 |
6.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$4,687.65 |
$8,523 |
5.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$4,586.45 |
$8,339 |
5.1× |
| Heart first pass single,planar (78481) |
$563.75 |
$1,025 |
0.8× |
| Heart Image (Pet) Multiple (78492) |
$5,262.95 |
$9,569 |
2.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,241.15 |
$5,893 |
0.8× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$2,846.25 |
$5,175 |
0.7× |
| Hepatobil Syst Image W/Drug (78227) |
$3,652 |
$6,640 |
5.2× |
| Hepatobiliary System Imaging (78226) |
$1,376.10 |
$2,502 |
2.7× |
| Ht Musc Image Planar Mult (78454) |
$1,826.55 |
$3,321 |
1.1× |
| Ht Muscle Image Spect Sing (78451) |
$2,627.35 |
$4,777 |
1.6× |
| Hysterosalpingogram (74740) |
$1,169.85 |
$2,127 |
3.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$477.95 |
$869 |
4.3× |
| Infant hip ultrasound, limited static exam (76886) |
$212.30 |
$386 |
1.9× |
| Infusion Ivp (74410) |
$466.40 |
$848 |
2.1× |
| Interstitial radiation source applic complex (77778) |
$4,106.30 |
$7,466 |
4.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,191.30 |
$2,166 |
1.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$842.60 |
$1,532 |
1.2× |
| Intracavitary radiation source applic simple (77761) |
$645.15 |
$1,173 |
0.9× |
| Intraop radiaj tx deliver electrons sngl tx sess (77425) |
$11,000 |
$20,000 |
1.2× |
| Joint Survey Single View (77077) |
$110.55 |
$201 |
0.8× |
| K Flow/Funct Image Multiple (78709) |
$2,037.75 |
$3,705 |
2.9× |
| K Flow/Funct Image W/Drug (78708) |
$2,927.10 |
$5,322 |
4.2× |
| K Flow/Funct Image W/O Drug (78707) |
$2,764.85 |
$5,027 |
4.0× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$1,811.70 |
$3,294 |
3.5× |
| Kidney Imaging Morphol (78700) |
$1,706.65 |
$3,103 |
3.3× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$2,234.10 |
$4,062 |
4.3× |
| Knee 3 Views (73562) |
$356.40 |
$648 |
3.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$608.30 |
$1,106 |
1.2× |
| Leveen/Shunt Patency Exam (78291) |
$911.90 |
$1,658 |
1.8× |
| Liver & Spleen Imaging Static Only (78215) |
$827.75 |
$1,505 |
1.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$887.15 |
$1,613 |
1.7× |
| Liver imaging static only (78201) |
$1,181.95 |
$2,149 |
1.7× |
| Liver imaging w/vascular flow (78202) |
$1,612.05 |
$2,931 |
2.3× |
| Lung Perf&Ventilat Diferentl (78598) |
$3,373.15 |
$6,133 |
4.8× |
| Lung perfusion differential (78597) |
$1,261.70 |
$2,294 |
2.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,504.25 |
$2,735 |
2.2× |
| Lung Ventilation Imaging (78579) |
$829.95 |
$1,509 |
1.6× |
| Lymph System Imaging (78195) |
$3,554.65 |
$6,463 |
5.1× |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
$1,233.65 |
$2,243 |
0.6× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$927.30 |
$1,686 |
1.1× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,132.25 |
$5,695 |
0.8× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,308.90 |
$4,198 |
0.6× |
| Magnetic Image Jaw Joint (70336) |
$1,706.10 |
$3,102 |
5.6× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$3,157 |
$5,740 |
14.0× |
| Magnetic Resonance Elastography (76391) |
$5,397.15 |
$9,813 |
17.6× |
| Mammary ductogram or galactogram multiple (77054) |
$759 |
$1,380 |
2.5× |
| Mammary ductogram or galactogram single (77053) |
$503.25 |
$915 |
1.6× |
| Meckels Divert Exam (78290) |
$1,512.50 |
$2,750 |
2.9× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$1,551.55 |
$2,821 |
3.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$3,418.80 |
$6,216 |
7.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$51.15 |
$93 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,369.40 |
$4,308 |
5.3× |
| MRA head w/o contrast (70544) |
$1,974.50 |
$3,590 |
6.4× |
| MRA head with contrast (70545) |
$2,115.30 |
$3,846 |
4.7× |
| MRA neck w contrast (70548) |
$1,854.60 |
$3,372 |
4.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,204.85 |
$5,827 |
7.1× |
| MRA neck w/o contrast (70547) |
$1,506.45 |
$2,739 |
4.9× |
MRI abdomen w contrast (74182)
range across 2 matching MRF lines |
$772.20–$2,218.15 |
$1,404–$4,033 |
varies |
| MRI abdomen w/o contrast (74181) |
$2,025.65 |
$3,683 |
6.6× |
| MRI any jt lower extrem w/contrast material (73722) |
$3,006.30 |
$5,466 |
3.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,214.75 |
$5,845 |
7.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$5,383.40 |
$9,788 |
5.3× |
| MRI bone marrow blood supply (77084) |
$503.25 |
$915 |
1.6× |
| MRI brain functional w/o physician admnistration (70554) |
$881.10 |
$1,602 |
2.9× |
| MRI brain functional w/physician admnistration (70555) |
$1,337.60 |
$2,432 |
4.4× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,720.85 |
$4,947 |
8.9× |
MRI Breast Without Contrast Material Unilateral (77046)
range across 2 matching MRF lines |
$2,591.05–$2,620.20 |
$4,711–$4,764 |
varies |
| MRI cardiac w/o cont stress (75559) |
$1,675.85 |
$3,047 |
2.4× |
| MRI cardiac w/o contrast (75557) |
$1,813.35 |
$3,297 |
5.9× |
| MRI cervical spine w contrast (72142) |
$2,875.40 |
$5,228 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$2,739 |
$4,980 |
8.9× |
| MRI chest w/o contrast (71550) |
$2,443.10 |
$4,442 |
8.0× |
| MRI chest with contrast (71551) |
$2,981 |
$5,420 |
3.0× |
| MRI chest wo w contrast (71552) |
$5,056.70 |
$9,194 |
11.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,777.05 |
$3,231 |
4.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,831.40 |
$5,148 |
6.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,637.90 |
$2,978 |
5.3× |
| MRI lumbar spine w contrast (72149) |
$2,665.85 |
$4,847 |
5.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,876.95 |
$7,049 |
8.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,655.50 |
$3,010 |
5.4× |
| MRI orbit face neck w contrast (70542) |
$1,794.10 |
$3,262 |
4.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$5,171.65 |
$9,403 |
11.5× |
| MRI pelvis w contrast (72196) |
$3,827.45 |
$6,959 |
8.5× |
| MRI pelvis w/o & w contrast (72197) |
$6,164.95 |
$11,209 |
13.7× |
| MRI pelvis w/o contrast (72195) |
$3,641.55 |
$6,621 |
11.9× |
| MRI spectroscopy (76390) |
$1,111 |
$2,020 |
9.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,326.50 |
$4,230 |
7.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$4,263.05 |
$7,751 |
9.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$4,060.10 |
$7,382 |
13.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$6,512.55 |
$11,841 |
14.5× |
| MRI, abdomen, combo (74183) |
$6,070.35 |
$11,037 |
13.5× |
| MRI, dorsal spine combo (72157) |
$3,663.55 |
$6,661 |
8.2× |
| MRI, dorsal spine contrast (72147) |
$2,693.90 |
$4,898 |
6.0× |
| MRI, joint upper extrem (73221) |
$4,831.75 |
$8,785 |
15.7× |
| MRI, joint upper extrem combo (73223) |
$6,474.05 |
$11,771 |
14.4× |
| MRI, lumbar spine combo (72158) |
$3,046.45 |
$5,539 |
6.8× |
| Myelogram cervical (72240) |
$1,481.70 |
$2,694 |
1.5× |
| Myelogram Lumbar (72265) |
$1,247.40 |
$2,268 |
1.2× |
| Myelography thoracic (72255) |
$1,543.85 |
$2,807 |
1.5× |
| Myelograpy 2/more regions rs&i (72270) |
$1,387.65 |
$2,523 |
1.4× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$656.15 |
$1,193 |
1.3× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,059.55 |
$7,381 |
2.4× |
| Myocardial imaging, infarct avid, planar; with ejection fraction by first pass technique Non-Facility (78468) |
$744.15 |
$1,353 |
1.1× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,595 |
$2,900 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,901.80 |
$5,276 |
1.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$7,264.40 |
$13,208 |
3.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,182.75 |
$7,605 |
2.3× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,857.60 |
$8,832 |
1.7× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,569.85 |
$10,127 |
2.0× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$6,050 |
$11,000 |
3.1× |
| N-invas est c ffr sw aly CTA (75580) |
$907.50 |
$1,650 |
0.8× |
| Neck soft tissue (70360) |
$218.90 |
$398 |
2.0× |
| Nervous system nuclear exam (78699) |
$223.30 |
$406 |
0.4× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,162.70 |
$2,114 |
2.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$421.85 |
$767 |
0.8× |
| Nm csf leak detection (78650) |
$2,189 |
$3,980 |
1.3× |
| Nm myocard infarct spect (78469) |
$1,585.65 |
$2,883 |
2.3× |
| Nm red cell survival study (78130) |
$608.30 |
$1,106 |
1.2× |
| Nm unlisted gi procedure (78299) |
$216.15 |
$393 |
0.4× |
| Nm whole blood volume (78122) |
$942.15 |
$1,713 |
1.3× |
| Nonvascular Shunt X-Ray (75809) |
$348.15 |
$633 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$11,955.90 |
$21,738 |
6.7× |
| Nuclear medicine study of endocrine organs (78099) |
$344.30 |
$626 |
0.7× |
| Nuclear Rx Intra-Arterial (79445) |
$937.20 |
$1,704 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$2,185.70 |
$3,974 |
7.3× |
| Ob us nuchal meas 1 gest (76813) |
$724.35 |
$1,317 |
5.4× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$188.10 |
$342 |
1.4× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$383.35 |
$697 |
2.9× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$250.25 |
$455 |
1.5× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$165.55 |
$301 |
1.5× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$283.80 |
$516 |
2.1× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$59.95 |
$109 |
1.6× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$182.60 |
$332 |
1.4× |
| Optic foramina (70190) |
$126.50 |
$230 |
1.1× |
| Panoramic X-ray of jaws (70355) |
$107.80 |
$196 |
1.0× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$3,275.80 |
$5,956 |
4.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,334.30 |
$2,426 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$351.45 |
$639 |
2.6× |
| Peritoneogram Rs&I (74190) |
$772.20 |
$1,404 |
1.1× |
| Pet Image Skull-Thigh (78812) |
$3,449.60 |
$6,272 |
1.9× |
| Pet Image W/Ct Lmtd (78814) |
$3,726.80 |
$6,776 |
2.0× |
| PET image w/CT, full body (78816) |
$10,129.35 |
$18,417 |
5.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$9,915.40 |
$18,028 |
5.4× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$2,910.60 |
$5,292 |
1.7× |
| Pet Myocardial Sngl Study (78491) |
$3,648.15 |
$6,633 |
2.0× |
| PET whole body (78813) |
$4,505.60 |
$8,192 |
2.4× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,503.15 |
$2,733 |
0.9× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Non-Facility (78110) |
$1,464.10 |
$2,662 |
0.9× |
| Platelet survival study Non-Facility (78191) |
$425.70 |
$774 |
0.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,462.25 |
$6,295 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,993.20 |
$3,624 |
3.9× |
| Quan&Charac C Atherosclerotc Plaq Asses Sev C Ds (75577) |
$1,660.45 |
$3,019 |
1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$333.30 |
$606 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$575.30 |
$1,046 |
0.8× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$398.20 |
$724 |
3.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$307.45 |
$559 |
2.7× |
| Radex elbow complete minimum 3 views (73080) |
$622.60 |
$1,132 |
5.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$468.05 |
$851 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$564.30 |
$1,026 |
5.0× |
| Radex foot complete minimum 3 views (73630) |
$580.80 |
$1,056 |
5.2× |
| Radex Hand Minimum 3 Views (73130) |
$591.25 |
$1,075 |
5.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$323.95 |
$589 |
2.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$391.60 |
$712 |
3.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$449.90 |
$818 |
4.0× |
| Radex Ribs Unilateral 2 Views (71100) |
$355.30 |
$646 |
3.2× |
| Radex shoulder complete minimum 2 views (73030) |
$400.40 |
$728 |
3.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$209 |
$380 |
1.9× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$625.90 |
$1,138 |
2.8× |
| Radex Spine 1 View Specify Level (72020) |
$218.90 |
$398 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$359.70 |
$654 |
3.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$261.80 |
$476 |
2.3× |
| Radex Toe Minimum 2 Views (73660) |
$210.10 |
$382 |
1.9× |
| Radex upper extremity infant minimum 2 views (73092) |
$337.70 |
$614 |
2.5× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$565.95 |
$1,029 |
5.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$748.55 |
$1,361 |
5.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$34,038.95 |
$61,889 |
3.6× |
Radiation treatment delivery level 1 (77402)
range across 2 matching MRF lines |
$304.70–$2,044.90 |
$554–$3,718 |
varies |
Radiation treatment delivery level 2 (77407)
range across 2 matching MRF lines |
$320.10–$3,287.90 |
$582–$5,978 |
varies |
Radiation treatment delivery level 3 (77412)
range across 2 matching MRF lines |
$1,754.50–$6,175.40 |
$3,190–$11,228 |
varies |
| Radiolog exam mandible compl minimum 4 views (70110) |
$320.65 |
$583 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$312.40 |
$568 |
2.3× |
| Radiologic exam colon double contrast study (74280) |
$716.10 |
$1,302 |
3.2× |
| Radiologic exam colon single contrast study (74270) |
$592.90 |
$1,078 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$908.60 |
$1,652 |
4.0× |
| Radiologic exam knee complete 4/more views (73564) |
$547.25 |
$995 |
4.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$612.15 |
$1,113 |
4.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$497.75 |
$905 |
2.2× |
| Radiologic exam swallow function contrast study (74230) |
$482.35 |
$877 |
2.1× |
| Radiologic exam teeth complete full mouth (70320) |
$253.55 |
$461 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$944.90 |
$1,718 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$169.40 |
$308 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$270.60 |
$492 |
2.4× |
| Radiologic examination knee 1/2 views (73560) |
$271.15 |
$493 |
2.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$366.30 |
$666 |
2.7× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$108.90 |
$198 |
1.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$345.95 |
$629 |
3.1× |
| Radiopharm Dacryocystography (78660) |
$1,141.25 |
$2,075 |
2.2× |
| Radiopharmaceutical therapy, by interstitial radioactive colloid administration Facility (79300) |
$357.50 |
$650 |
1.2× |
| Radiopharmaceutical therapy, by intra-articular administration Non-Facility (79440) |
$268.40 |
$488 |
0.9× |
| Radiopharmaceutical therapy, by intracavitary administration Non-Facility (79200) |
$1,069.20 |
$1,944 |
3.6× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$608.30 |
$1,106 |
1.2× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$699.60 |
$1,272 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$755.70 |
$1,374 |
1.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$574.75 |
$1,045 |
1.2× |
| Ribs bilateral 3 views (71110) |
$409.75 |
$745 |
3.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$585.75 |
$1,065 |
1.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,082.40 |
$1,968 |
2.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,851.20 |
$5,184 |
4.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,173.15 |
$2,133 |
1.7× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,232 |
$2,240 |
1.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,295.60 |
$5,992 |
2.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,460.60 |
$6,292 |
1.9× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,784.65 |
$5,063 |
1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$821.15 |
$1,493 |
2.7× |
| Rp Therapy Intravenous Administration (79101) |
$954.80 |
$1,736 |
3.2× |
| Rp Therapy Unlisted Procedure (79999) |
$178.75 |
$325 |
0.6× |
| Salivary Gland Function Study (78232) |
$425.70 |
$774 |
0.8× |
| Salivary Gland Imaging (78230) |
$425.70 |
$774 |
0.8× |
| Salivary Gland Imaging Serial Images (78231) |
$633.05 |
$1,151 |
1.2× |
| Scapula (73010) |
$386.65 |
$703 |
2.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$149.05 |
$271 |
6.4× |
| Sella turcica (70240) |
$92.40 |
$168 |
0.8× |
| Shoulder 1 view (73020) |
$325.05 |
$591 |
2.9× |
| Shoulder Arthrography (73040) |
$932.80 |
$1,696 |
2.1× |
| Sialogram (70390) |
$425.70 |
$774 |
1.4× |
| Skull less than 4 views (70250) |
$333.30 |
$606 |
2.5× |
| Special dosimetry (77331) |
$889.90 |
$1,618 |
5.1× |
| Special Physics Consult (77370) |
$873.95 |
$1,589 |
5.1× |
| Special teletherapy port plan (77321) |
$2,633.95 |
$4,789 |
5.5× |
| Special treatment procedure (77470) |
$3,842.85 |
$6,987 |
5.4× |
| Speech evaluation, complex (70371) |
$345.40 |
$628 |
1.1× |
| Spleen Imaging (78185) |
$657.25 |
$1,195 |
1.3× |
| Stereotactic Body Radiation Delivery (77373) |
$12,066.45 |
$21,939 |
5.2× |
| Sternoclavicular joints (71130) |
$529.10 |
$962 |
4.7× |
| Superior sagittal sinus venogram (75870) |
$3,418.25 |
$6,215 |
0.8× |
| Surf radj ther orthvlt dlvr>150-500 kv per fxj (77438) |
$182.05 |
$331 |
1.4× |
| Surf radj ther supfc dlvr<=150 kv per fraction (77437) |
$182.05 |
$331 |
1.4× |
| Surf radj ther supfc/orthvlt treatment planning (77436) |
$66.55 |
$121 |
1.4× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$202.95 |
$369 |
1.5× |
| Tbs techl prep&transmis data alys pfrmd elsewhr (77090) |
$139.15 |
$253 |
1.2× |
| Tbs technical calculation only (77091) |
$139.15 |
$253 |
1.2× |
Telethx isodose pln cplx w/basic dosimetry (77307)
range across 2 matching MRF lines |
$4,710.75–$6,404.75 |
$8,565–$11,645 |
varies |
Telethx isodose pln smpl w/dosimetry calculation (77306)
range across 2 matching MRF lines |
$628.10–$884.95 |
$1,142–$1,609 |
varies |
| Temporomandble Jt Arthrography Rs&I (70332) |
$328.35 |
$597 |
1.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$3,511.20 |
$6,384 |
7.3× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$3,099.80 |
$5,636 |
6.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,818.20 |
$5,124 |
16.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$243.65 |
$443 |
1.1× |
| Thoracic spine 2 views (72070) |
$303.60 |
$552 |
2.3× |
| Thoracic spine 3 views (72072) |
$477.95 |
$869 |
3.6× |
| Thoracolumbar 2 views (72080) |
$325.05 |
$591 |
2.9× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$1,911.80 |
$3,476 |
3.7× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$1,466.30 |
$2,666 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,105.50 |
$2,010 |
2.2× |
| Thyroid Met Imaging Body (78018) |
$3,263.15 |
$5,933 |
4.7× |
| Thyroid Uptake Measurement (78012) |
$830.50 |
$1,510 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,711.50 |
$4,930 |
5.3× |
| Tx Devices Design & Construction Complex (77334) |
$2,581.15 |
$4,693 |
5.4× |
| Tx devices design & construction intermediate (77333) |
$815.65 |
$1,483 |
4.7× |
| Tx devices design & construction simple (77332) |
$660 |
$1,200 |
3.8× |
| Ultrasound Breast Limited (76642) |
$569.80 |
$1,036 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$132.55 |
$241 |
1.0× |
| Ultrasound Elastography Parenchyma (76981) |
$312.40 |
$568 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$239.80 |
$436 |
1.8× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$517.55 |
$941 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$451.55 |
$821 |
3.4× |
| Umbilical-artery Doppler (OB) (76820) |
$613.80 |
$1,116 |
4.6× |
| Unlis px ther radiol clinical tx planning (77299) |
$1,198.45 |
$2,179 |
6.9× |
| Unlisted Dx Radiographic Procedure (76499) |
$26,348 |
$47,905.45 |
235.4× |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
$238.70 |
$434 |
0.5× |
| Unlisted magnetic resonance procedure (76498) |
$2,803.46 |
$5,097.20 |
25.0× |
Unlisted Miscellaneous Px Dx Nuclear Medicine (78999)
range across 5 matching MRF lines |
$22.14–$186.45 |
$40.25–$339 |
varies |
Unlisted Procedure Clinical Brachytherapy (77799)
range across 3 matching MRF lines |
$781–$950.40 |
$1,420–$1,728 |
varies |
| Unlisted respiratory px dx nuclear medicine (78599) |
$1,353.55 |
$2,461 |
2.6× |
| Unlisted us procedure (76999) |
$3,093.20 |
$5,624 |
27.6× |
| Upper gi w/o kub (74240) |
$574.20 |
$1,044 |
2.5× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$77 |
$140 |
7.0× |
| Urea breath test c-14 isotopic analysis (78268) |
$234.30 |
$426 |
2.5× |
| Urethrocystogram voiding (74455) |
$635.80 |
$1,156 |
2.1× |
| Urethrocystography retrograde (74450) |
$421.85 |
$767 |
1.4× |
| Us breast unilateral complete (76641) |
$983.95 |
$1,789 |
7.3× |
| Us chest (76604) |
$551.10 |
$1,002 |
4.1× |
| Us complete joint (76881) |
$1,192.40 |
$2,168 |
8.9× |
| Us exam, pelvic, limited (76857) |
$798.05 |
$1,451 |
5.9× |
| Us head (76506) |
$328.35 |
$597 |
2.4× |
| Us kidney transplant (76776) |
$476.85 |
$867 |
3.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$832.15 |
$1,513 |
6.2× |
| Us ob detailed single fetus (76811) |
$953.15 |
$1,733 |
3.1× |
| Us ob limited 1 or more fetuses (76815) |
$947.65 |
$1,723 |
7.0× |
| Us ob transvaginal (76817) |
$1,033.45 |
$1,879 |
7.7× |
| Us pelvic non ob complete (76856) |
$1,327.15 |
$2,413 |
9.9× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$1,025.75 |
$1,865 |
7.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$804.10 |
$1,462 |
6.0× |
| Us retroperitoneal complete (76770) |
$535.15 |
$973 |
4.0× |
| Us retroperitoneal limited (76775) |
$374.55 |
$681 |
2.8× |
| Us scrotum and contents (76870) |
$1,331 |
$2,420 |
9.9× |
| Us spinal canal and contents (76800) |
$339.90 |
$618 |
2.5× |
| Us thyroid (76536) |
$1,119.80 |
$2,036 |
8.3× |
| Us transrectal (76872) |
$526.35 |
$957 |
3.9× |
| Vascular Flow Imaging (78445) |
$426.80 |
$776 |
0.8× |
| Vein X-Ray Chest (75827) |
$2,673 |
$4,860 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,957.90 |
$5,378 |
0.7× |
| Vein X-Ray Skull Epidural (75872) |
$2,198.35 |
$3,997 |
2.7× |
| Vein X-Ray Spleen/Liver (75810) |
$2,833.05 |
$5,151 |
0.7× |
| Venogram Sinus/Jugular (75860) |
$3,462.25 |
$6,295 |
0.9× |
| Venography Adrenal Unilateral (75840) |
$3,147.65 |
$5,723 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$2,862.20 |
$5,204 |
0.7× |
| Venography extremity bilateral rs&i (75822) |
$1,788.60 |
$3,252 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,415.15 |
$2,573 |
0.7× |
| Venography Orbital Rs&I (75880) |
$2,198.35 |
$3,997 |
2.7× |
| Venography Renal Bilateral (75833) |
$3,286.25 |
$5,975 |
0.8× |
| Venography Renal Unilateral (75831) |
$2,824.25 |
$5,135 |
0.7× |
| Venous sampling by catheter (75893) |
$5,974.65 |
$10,863 |
0.8× |
| Venous thrombosis imaging (78457) |
$1,250.70 |
$2,274 |
1.8× |
| Venous Thrombosis Imaging Venogram Bilateral (78458) |
$1,538.35 |
$2,797 |
3.0× |
| Vertebral fracture assessment via dxa (77086) |
$278.30 |
$506 |
2.5× |
| Wrist 2 views (73100) |
$279.40 |
$508 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$337.15 |
$613 |
3.0× |
| X-ray antegrade pyelogram tube (74425) |
$481.25 |
$875 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$3,800.50 |
$6,910 |
0.9× |
| X-Ray Bend Only L-S Spine (72120) |
$498.30 |
$906 |
3.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$466.95 |
$849 |
4.2× |
| X-Ray Exam Breast Specimen (76098) |
$585.75 |
$1,065 |
0.8× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$151.80 |
$276 |
1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$426.80 |
$776 |
3.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$713.90 |
$1,298 |
5.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$221.10 |
$402 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$283.25 |
$515 |
2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$294.25 |
$535 |
2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$386.65 |
$703 |
2.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$503.80 |
$916 |
3.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$919.60 |
$1,672 |
6.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$741.95 |
$1,349 |
5.5× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$418.55 |
$761 |
3.7× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$994.95 |
$1,809 |
7.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$400.95 |
$729 |
3.0× |
| X-ray eye for foreign body (70030) |
$149.05 |
$271 |
1.3× |
| X-ray humerus (73060) |
$274.45 |
$499 |
2.5× |
| X-ray IV pyelogram (ivp) (74400) |
$616.55 |
$1,121 |
2.7× |
| X-ray IV pyelogram+tomography (74415) |
$1,301.85 |
$2,367 |
5.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$223.85 |
$407 |
2.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$356.40 |
$648 |
3.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$243.10 |
$442 |
1.8× |
| X-ray nose-rectum child f.b. (76010) |
$268.95 |
$489 |
2.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$505.45 |
$919 |
3.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$690.80 |
$1,256 |
5.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$381.70 |
$694 |
2.8× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$405.35 |
$737 |
3.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$361.35 |
$657 |
3.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$424.60 |
$772 |
3.2× |
| X-Ray Stress View (77071) |
$117.15 |
$213 |
1.0× |
| X-ray thoracic spine 4 vw (72074) |
$744.15 |
$1,353 |
5.5× |
| X-Ray Tmj Unilat (70328) |
$90.20 |
$164 |
0.8× |
| X-Rays Bone Length Studies (77073) |
$290.95 |
$529 |
2.2× |
| X-Rays Bone Survey Complete (77075) |
$920.15 |
$1,673 |
6.8× |
| Xr c-spine 4 or 5 views (72050) |
$953.70 |
$1,734 |
7.1× |
| Xr facial bones less than 3 views (70140) |
$289.85 |
$527 |
2.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$252.45 |
$459 |
1.9× |
| Xr orbits complete 4 views (70200) |
$398.20 |
$724 |
3.0× |
| Xr Tomogram Single Plane (76100) |
$224.40 |
$408 |
1.7× |