| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,438.20 |
$12,397 |
5.1× |
| Abdomen 1 View (74018) |
$334.20 |
$557 |
3.6× |
| Abdomen 2 views (74019) |
$343.80 |
$573 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,492.20 |
$2,487 |
3.5× |
| Adrenal Cortex & Medulla Img (78075) |
$1,618.20 |
$2,697 |
1.2× |
| Angio internal mammary (75756) |
$3,291.60 |
$5,486 |
1.0× |
| Angio pulmonary bilat (75743) |
$6,083.40 |
$10,139 |
1.8× |
| Angiography extremity bilateral rs&i (75716) |
$5,275.20 |
$8,792 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$3,159.60 |
$5,266 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,785.40 |
$6,309 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,004.60 |
$8,341 |
1.5× |
| Ankle 2 views (73600) |
$214.20 |
$357 |
2.3× |
| Aortography thoracic serialography rs&i (75605) |
$3,863.40 |
$6,439 |
0.7× |
| Artery X-Rays Abdomen (75726) |
$5,652 |
$9,420 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$4,881 |
$8,135 |
1.5× |
| Artery X-Rays Pelvis (75736) |
$5,652.60 |
$9,421 |
1.0× |
| Artery X-Rays Spine (75705) |
$3,863.40 |
$6,439 |
0.7× |
| Arthrogram hip (73525) |
$853.80 |
$1,423 |
2.3× |
| Arthrogram Wrist (73115) |
$853.80 |
$1,423 |
2.3× |
| Basic radiation dosimetry calculation (77300) |
$510.60 |
$851 |
3.6× |
| Bone age studies (77072) |
$177.60 |
$296 |
1.6× |
| Bone Imaging 3 Phase (78315) |
$1,809 |
$3,015 |
4.3× |
| Bone Imaging Limited Area (78300) |
$1,140 |
$1,900 |
2.7× |
| Bone Imaging Multiple Areas (78305) |
$1,572 |
$2,620 |
3.7× |
| Bone Imaging Whole Body (78306) |
$1,730.40 |
$2,884 |
4.1× |
| Bone survey infant (77076) |
$522 |
$870 |
4.7× |
| Brachytx isodose complex (77318) |
$1,509 |
$2,515 |
3.8× |
| Brachytx Isodose Plan Simple (77316) |
$929.40 |
$1,549 |
2.3× |
| Brain Flow Imaging Only (78610) |
$1,464 |
$2,440 |
2.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,551.60 |
$7,586 |
3.0× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,774.80 |
$2,958 |
4.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$2,064.60 |
$3,441 |
2.5× |
| Cardiac Shunt Detection (78428) |
$673.80 |
$1,123 |
1.6× |
| Cat Scan Follow-Up Study (76380) |
$853.80 |
$1,423 |
9.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,195.80 |
$1,993 |
2.1× |
| Cerebrospinal Fluid Scan (78630) |
$1,549.20 |
$2,582 |
2.7× |
| Chest 1 view (71045) |
$324.60 |
$541 |
3.5× |
| Chest 2 views (71046) |
$346.20 |
$577 |
3.8× |
| Chest 3 views (71047) |
$379.20 |
$632 |
4.1× |
| Chest 4 or more views (71048) |
$395.40 |
$659 |
3.6× |
| Clavicle complete (73000) |
$264 |
$440 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,050.60 |
$1,751 |
9.5× |
| Continuing medical physics consltj pr wk (77336) |
$948.60 |
$1,581 |
6.7× |
| Contrast Exam Abdominl Aorta (75625) |
$2,480.40 |
$4,134 |
0.7× |
| Contrast X-Ray Bladder (74430) |
$1,228.80 |
$2,048 |
3.3× |
| Contrast X-Ray Of Elbow (73085) |
$853.80 |
$1,423 |
2.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$853.80 |
$1,423 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,236 |
$7,060 |
11.5× |
| CT abdomen and pelvis without contrast (74176) |
$2,721.60 |
$4,536 |
10.8× |
| CT abdomen w contrast (74160) |
$1,588.20 |
$2,647 |
8.6× |
| CT abdomen w wo contrast (74170) |
$1,903.80 |
$3,173 |
10.3× |
| CT abdomen w/o contrast (74150) |
$1,371 |
$2,285 |
12.4× |
| CT Angio Abdomen and Pelvis (74174) |
$4,447.80 |
$7,413 |
12.1× |
| CT Angio Chest (71275) |
$2,693.40 |
$4,489 |
14.5× |
| CT Angio Head (70496) |
$1,843.80 |
$3,073 |
10.0× |
| CT angio hrt w/3d image (75574) |
$1,217.40 |
$2,029 |
3.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,834.20 |
$3,057 |
9.9× |
| CT Angio Neck (70498) |
$1,843.80 |
$3,073 |
10.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,776 |
$2,960 |
9.6× |
| CT bone density (77078) |
$801 |
$1,335 |
8.7× |
| CT cervical spine w/ contrast (72126) |
$1,999.80 |
$3,333 |
5.4× |
| CT cervical spine w/o contrast (72125) |
$1,497 |
$2,495 |
13.6× |
| CT cervical spine w/wo cont (72127) |
$2,241.60 |
$3,736 |
12.1× |
| CT chest w contrast (71260) |
$1,845 |
$3,075 |
10.0× |
| CT chest w/wo contrast (71270) |
$2,257.80 |
$3,763 |
12.2× |
| CT head/brain with contrast (70460) |
$1,957.20 |
$3,262 |
10.6× |
| CT head/brain without and with contrast (70470) |
$2,302.20 |
$3,837 |
12.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$974.40 |
$1,624 |
2.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$178.80 |
$298 |
1.9× |
| CT hrt w/3d image congen (75573) |
$1,151.40 |
$1,919 |
3.1× |
| CT iac w contrast (70481) |
$2,368.80 |
$3,948 |
12.8× |
| CT l-spine w&w/o contrast (72133) |
$1,757.40 |
$2,929 |
9.5× |
| CT lower ext w/o (73700) |
$1,050.60 |
$1,751 |
9.5× |
| CT lower extremity w/contrast material (73701) |
$1,417.20 |
$2,362 |
7.6× |
| CT lumbar spine w contrast (72132) |
$1,465.20 |
$2,442 |
4.0× |
| CT lumbar spine w/o contrast (72131) |
$1,354.20 |
$2,257 |
12.3× |
| CT maxillofacial w contrast (70487) |
$1,485.60 |
$2,476 |
8.0× |
| CT maxillofacial wo contrast (70486) |
$1,050 |
$1,750 |
9.5× |
| CT neck tissue combo (70492) |
$1,663.80 |
$2,773 |
9.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,724 |
$4,540 |
14.7× |
| CT orbits w/o contrast (70480) |
$2,040 |
$3,400 |
18.5× |
| CT pelvis w&w/o contrast (72194) |
$1,625.40 |
$2,709 |
8.8× |
| CT pelvis w/o contrast (72192) |
$1,426.80 |
$2,378 |
12.9× |
| CT scan of leg combo (73702) |
$1,746.60 |
$2,911 |
9.4× |
| CT scans face/jaw combo (70488) |
$1,866.60 |
$3,111 |
10.1× |
| CT soft tissue neck w contrast (70491) |
$1,409.40 |
$2,349 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,354.20 |
$2,257 |
12.3× |
| CT thoracic spine w contrast (72129) |
$1,600.20 |
$2,667 |
8.6× |
| CT thoracic spine w/o contrast (72128) |
$1,384.20 |
$2,307 |
12.5× |
| CT thoracic spine w/wo cont (72130) |
$1,877.40 |
$3,129 |
10.1× |
| CT thorax w/o contrast (71250) |
$1,053 |
$1,755 |
9.5× |
| CT upper ext wo (73200) |
$1,226.40 |
$2,044 |
11.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,496.40 |
$2,494 |
8.1× |
| CT upper extremity with contrast (73201) |
$1,409.40 |
$2,349 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,522.20 |
$2,537 |
8.2× |
| Cta Abdomen (74175) |
$1,999.20 |
$3,332 |
10.8× |
| CTA pelvis (72191) |
$2,418.60 |
$4,031 |
13.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$722.40 |
$1,204 |
2.9× |
| Dilation ureters/urethra rs&i (74485) |
$2,311.80 |
$3,853 |
1.0× |
| Discography Cerv/Thor Spine (72285) |
$3,580.20 |
$5,967 |
1.7× |
| Diskography lumbar (72295) |
$3,345.60 |
$5,576 |
1.6× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$571.80 |
$953 |
5.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$741 |
$1,235 |
6.7× |
| Dxa Bone Density Axial (77080) |
$520.80 |
$868 |
4.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$260.40 |
$434 |
2.8× |
| Echo exam of fetal heart (76825) |
$853.20 |
$1,422 |
1.5× |
| Echo exam uterus (76831) |
$612.60 |
$1,021 |
2.4× |
| Echo Guide For Artery Repair (76936) |
$1,439.40 |
$2,399 |
6.3× |
| Echograp Trans R Pros Study (76873) |
$915 |
$1,525 |
8.3× |
| Esophagram (74220) |
$523.80 |
$873 |
2.8× |
| Fetal Biophys Profile W/Nst (76818) |
$612.60 |
$1,021 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$459.60 |
$766 |
4.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$3,093.60 |
$5,156 |
12.3× |
| Fluoroscopy up to 1 hr (76000) |
$601.80 |
$1,003 |
2.4× |
| Follow-Up Angiography (75898) |
$2,302.20 |
$3,837 |
0.7× |
| Foot 2 views (73620) |
$215.40 |
$359 |
2.3× |
| Forearm 2 views (73090) |
$217.80 |
$363 |
2.4× |
| Gastric emptying imaging study (78264) |
$2,021.40 |
$3,369 |
4.8× |
| Gated Heart Planar Single (78472) |
$2,901 |
$4,835 |
6.9× |
| Hand 2 views (73120) |
$288 |
$480 |
2.6× |
| Heart Image (Pet) Multiple (78492) |
$5,442.60 |
$9,071 |
3.6× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,674.40 |
$6,124 |
1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,268.80 |
$5,448 |
1.0× |
| Hepatobil Syst Image W/Drug (78227) |
$2,021.40 |
$3,369 |
3.5× |
| Hepatobiliary System Imaging (78226) |
$1,974.60 |
$3,291 |
4.7× |
| Ht Muscle Image Spect Sing (78451) |
$3,460.80 |
$5,768 |
2.5× |
| Hysterosalpingogram (74740) |
$1,281 |
$2,135 |
5.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$612.60 |
$1,021 |
6.7× |
| Infant hip ultrasound, limited static exam (76886) |
$325.20 |
$542 |
3.5× |
| Joint Survey Single View (77077) |
$301.20 |
$502 |
2.7× |
| K Flow/Funct Image W/Drug (78708) |
$2,029.80 |
$3,383 |
3.5× |
| K Flow/Funct Image W/O Drug (78707) |
$2,029.80 |
$3,383 |
3.5× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,477.80 |
$2,463 |
3.5× |
| Knee 3 Views (73562) |
$276.60 |
$461 |
3.0× |
| Leveen/Shunt Patency Exam (78291) |
$718.20 |
$1,197 |
1.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,278.60 |
$2,131 |
3.0× |
| Liver imaging static only (78201) |
$1,186.20 |
$1,977 |
2.1× |
| Lung Perf&Ventilat Diferentl (78598) |
$2,242.80 |
$3,738 |
3.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$2,404.80 |
$4,008 |
4.2× |
| Lymph System Imaging (78195) |
$1,373.40 |
$2,289 |
2.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,302.20 |
$3,837 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$1,780.80 |
$2,968 |
7.1× |
| Mammary ductogram or galactogram single (77053) |
$619.20 |
$1,032 |
2.5× |
| Meckels Divert Exam (78290) |
$1,492.20 |
$2,487 |
3.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$433.80 |
$723 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,467.60 |
$2,446 |
3.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,992.80 |
$4,988 |
8.1× |
| MRA head w/o contrast (70544) |
$2,665.20 |
$4,442 |
10.6× |
| MRA head with contrast (70545) |
$2,785.20 |
$4,642 |
7.6× |
| MRA neck w contrast (70548) |
$2,992.80 |
$4,988 |
8.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,453.60 |
$5,756 |
9.4× |
| MRA neck w/o contrast (70547) |
$2,665.20 |
$4,442 |
10.6× |
| MRI abdomen w contrast (74182) |
$2,377.80 |
$3,963 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,846.80 |
$3,078 |
7.3× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,649.40 |
$2,749 |
2.0× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,227.80 |
$3,713 |
6.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,017.20 |
$3,362 |
2.4× |
| MRI bone marrow blood supply (77084) |
$2,161.80 |
$3,603 |
8.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,191.60 |
$1,986 |
4.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$441.60 |
$736 |
1.8× |
| MRI cardiac w/o contrast (75557) |
$1,159.80 |
$1,933 |
4.6× |
| MRI cervical spine w contrast (72142) |
$2,349.60 |
$3,916 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$1,808.40 |
$3,014 |
7.2× |
| MRI chest w/o contrast (71550) |
$1,969.20 |
$3,282 |
7.8× |
| MRI chest wo w contrast (71552) |
$2,820.60 |
$4,701 |
7.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,139.60 |
$3,566 |
5.8× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,437.20 |
$4,062 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,377 |
$2,295 |
5.5× |
| MRI lumbar spine w contrast (72149) |
$2,349.60 |
$3,916 |
6.4× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,467.20 |
$4,112 |
6.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,969.20 |
$3,282 |
7.8× |
| MRI orbit face neck w contrast (70542) |
$2,313 |
$3,855 |
6.3× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,546.40 |
$4,244 |
6.9× |
| MRI pelvis w contrast (72196) |
$2,459.40 |
$4,099 |
6.7× |
| MRI pelvis w/o & w contrast (72197) |
$2,804.40 |
$4,674 |
7.6× |
| MRI pelvis w/o contrast (72195) |
$2,091 |
$3,485 |
8.3× |
| MRI spectroscopy (76390) |
$939.60 |
$1,566 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$1,912.80 |
$3,188 |
7.6× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,437 |
$2,395 |
3.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,344 |
$2,240 |
5.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,643 |
$4,405 |
7.2× |
| MRI, abdomen, combo (74183) |
$2,521.80 |
$4,203 |
6.8× |
| MRI, dorsal spine combo (72157) |
$2,467.20 |
$4,112 |
6.7× |
| MRI, dorsal spine contrast (72147) |
$2,349.60 |
$3,916 |
6.4× |
| MRI, joint upper extrem (73221) |
$1,574.40 |
$2,624 |
6.2× |
| MRI, joint upper extrem combo (73223) |
$2,437.20 |
$4,062 |
6.6× |
| MRI, lumbar spine combo (72158) |
$2,467.20 |
$4,112 |
6.7× |
| Myelogram cervical (72240) |
$1,444.80 |
$2,408 |
1.7× |
| Myelogram Lumbar (72265) |
$1,452 |
$2,420 |
1.8× |
| Myelography thoracic (72255) |
$1,345.80 |
$2,243 |
1.6× |
| Myelograpy 2/more regions rs&i (72270) |
$1,834.20 |
$3,057 |
2.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,587.60 |
$7,646 |
3.4× |
| N-invas est c ffr sw aly CTA (75580) |
$1,920.60 |
$3,201 |
2.1× |
| Neck soft tissue (70360) |
$219.60 |
$366 |
2.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$777 |
$1,295 |
1.8× |
| Nonvascular Shunt X-Ray (75809) |
$931.80 |
$1,553 |
8.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$8,676.60 |
$14,461 |
5.9× |
| Nuclear medicine study of endocrine organs (78099) |
$705.27 |
$1,175.45 |
1.7× |
| Nuclear Rx Intra-Arterial (79445) |
$690 |
$1,150 |
2.8× |
| Nuclear Rx Oral Admin (79005) |
$1,950 |
$3,250 |
7.9× |
| Ob us nuchal meas 1 gest (76813) |
$652.80 |
$1,088 |
5.9× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$151.80 |
$253 |
1.7× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$253.20 |
$422 |
2.3× |
| Panoramic X-ray of jaws (70355) |
$195.60 |
$326 |
2.1× |
| Parathyroid Planar Imaging (78070) |
$939 |
$1,565 |
2.2× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$941.40 |
$1,569 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$290.40 |
$484 |
2.6× |
| Peritoneogram Rs&I (74190) |
$1,428 |
$2,380 |
2.5× |
| Pet Image W/Ct Lmtd (78814) |
$4,320.60 |
$7,201 |
2.9× |
| PET image w/CT, full body (78816) |
$5,007 |
$8,345 |
3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,551.60 |
$7,586 |
3.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,674.40 |
$6,124 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,200 |
$2,000 |
2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$427.80 |
$713 |
3.9× |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines |
$1,540.20–$1,545.60 |
$2,567–$2,576 |
varies |
| Radex Ankle Complete Minimum 3 Views (73610) |
$261 |
$435 |
2.8× |
| Radex Calcaneus Minimum 2 Views (73650) |
$225.60 |
$376 |
2.5× |
| Radex elbow complete minimum 3 views (73080) |
$266.40 |
$444 |
2.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$242.40 |
$404 |
2.2× |
| Radex fingr minimum 2 views (73140) |
$301.20 |
$502 |
3.3× |
| Radex foot complete minimum 3 views (73630) |
$276.60 |
$461 |
3.0× |
| Radex Hand Minimum 3 Views (73130) |
$346.20 |
$577 |
3.8× |
| Radex lower extremity infant minimum 2 views (73592) |
$339.60 |
$566 |
3.7× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$373.20 |
$622 |
3.4× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$301.20 |
$502 |
3.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$301.20 |
$502 |
3.3× |
| Radex shoulder complete minimum 2 views (73030) |
$217.80 |
$363 |
2.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$304.20 |
$507 |
3.3× |
| Radex Spine 1 View Specify Level (72020) |
$250.20 |
$417 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$301.20 |
$502 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$429 |
$715 |
4.7× |
| Radex Toe Minimum 2 Views (73660) |
$247.20 |
$412 |
2.7× |
| Radex upper extremity infant minimum 2 views (73092) |
$301.20 |
$502 |
2.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$266.40 |
$444 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$238.20 |
$397 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$14,512.80 |
$24,188 |
1.9× |
| Radiation treatment delivery level 1 (77402) |
$371.40 |
$619 |
3.4× |
| Radiation treatment delivery level 2 (77407) |
$379.20 |
$632 |
0.9× |
| Radiation treatment delivery level 3 (77412) |
$1,123.80 |
$1,873 |
1.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$343.20 |
$572 |
3.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$373.20 |
$622 |
3.4× |
| Radiologic exam colon double contrast study (74280) |
$922.80 |
$1,538 |
5.0× |
| Radiologic exam colon single contrast study (74270) |
$774 |
$1,290 |
4.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$673.20 |
$1,122 |
3.6× |
| Radiologic exam knee complete 4/more views (73564) |
$346.20 |
$577 |
3.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$299.40 |
$499 |
2.7× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$673.20 |
$1,122 |
3.6× |
| Radiologic exam swallow function contrast study (74230) |
$437.40 |
$729 |
2.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$774 |
$1,290 |
4.2× |
| Radiologic examination femur 1 view (73551) |
$196.20 |
$327 |
2.1× |
| Radiologic examination femur minimum 2 views (73552) |
$244.20 |
$407 |
2.7× |
| Radiologic examination knee 1/2 views (73560) |
$236.40 |
$394 |
2.6× |
| Radiologic Examination Osseous Survey Limited (77074) |
$271.80 |
$453 |
2.5× |
| Radiologic examination tibia & fibula 2 views (73590) |
$217.80 |
$363 |
2.4× |
| Ribs bilateral 3 views (71110) |
$369 |
$615 |
3.3× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$710.40 |
$1,184 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,561.20 |
$2,602 |
3.7× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$3,465 |
$5,775 |
6.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,698.60 |
$2,831 |
3.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$3,316.20 |
$5,527 |
5.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,361.80 |
$5,603 |
2.5× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,210.40 |
$3,684 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$4,257.60 |
$7,096 |
17.3× |
| Scapula (73010) |
$301.20 |
$502 |
2.7× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$51 |
$85 |
2.2× |
| Sella turcica (70240) |
$114 |
$190 |
1.2× |
| Shoulder 1 view (73020) |
$213.60 |
$356 |
2.3× |
| Shoulder Arthrography (73040) |
$853.80 |
$1,423 |
2.3× |
| Sialogram (70390) |
$1,030.20 |
$1,717 |
4.1× |
| Skull less than 4 views (70250) |
$301.20 |
$502 |
2.7× |
| Special dosimetry (77331) |
$1,049.40 |
$1,749 |
7.4× |
| Special Physics Consult (77370) |
$448.20 |
$747 |
3.2× |
| Special teletherapy port plan (77321) |
$1,262.40 |
$2,104 |
3.2× |
| Special treatment procedure (77470) |
$1,762.80 |
$2,938 |
3.0× |
| Stereotactic Body Radiation Delivery (77373) |
$9,505.80 |
$15,843 |
5.0× |
| Sternoclavicular joints (71130) |
$346.20 |
$577 |
3.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,291.80 |
$2,153 |
3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$688.20 |
$1,147 |
1.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,677.60 |
$2,796 |
4.2× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,119 |
$1,865 |
2.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$887.40 |
$1,479 |
6.3× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$673.20 |
$1,122 |
3.6× |
| Thoracic spine 2 views (72070) |
$310.20 |
$517 |
2.8× |
| Thoracic spine 3 views (72072) |
$343.80 |
$573 |
3.1× |
| Thoracolumbar 2 views (72080) |
$287.40 |
$479 |
3.1× |
| Thyroid Met Imaging Body (78018) |
$1,953 |
$3,255 |
3.4× |
| Thyroid Uptake Measurement (78012) |
$669.60 |
$1,116 |
1.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,251.60 |
$2,086 |
3.0× |
| Tx Devices Design & Construction Complex (77334) |
$1,467.60 |
$2,446 |
3.7× |
| Tx devices design & construction intermediate (77333) |
$1,036.20 |
$1,727 |
7.3× |
| Tx devices design & construction simple (77332) |
$821.40 |
$1,369 |
5.8× |
| Ultrasound Breast Limited (76642) |
$389.40 |
$649 |
4.2× |
| Ultrasound elastography first target lesion (76982) |
$204 |
$340 |
1.8× |
| Ultrasound Elastography Parenchyma (76981) |
$219.60 |
$366 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$630 |
$1,050 |
5.7× |
| Ultrasound, abdomen limited (76705) |
$528.60 |
$881 |
4.8× |
| Umbilical-artery Doppler (OB) (76820) |
$741 |
$1,235 |
6.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$1,221.61 |
$2,036.01 |
13.3× |
| Unlisted fluoroscopic procedure (76496) |
$480 |
$800 |
5.2× |
Unlisted magnetic resonance procedure (76498)
range across 5 matching MRF lines |
$2,161.98–$3,056.74 |
$3,603.30–$5,094.56 |
varies |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$646.78 |
$1,077.96 |
1.5× |
| Unlisted us procedure (76999) |
$177.19 |
$295.31 |
1.9× |
| Upper gi w/o kub (74240) |
$581.40 |
$969 |
3.1× |
| Urethrocystogram voiding (74455) |
$1,068.60 |
$1,781 |
4.2× |
| Urethrocystography retrograde (74450) |
$1,068.60 |
$1,781 |
4.2× |
| Us breast unilateral complete (76641) |
$430.20 |
$717 |
3.9× |
| Us chest (76604) |
$705 |
$1,175 |
6.4× |
| Us complete joint (76881) |
$705 |
$1,175 |
6.4× |
| Us exam, pelvic, limited (76857) |
$453.60 |
$756 |
4.1× |
| Us head (76506) |
$612.60 |
$1,021 |
5.5× |
| Us kidney transplant (76776) |
$705 |
$1,175 |
6.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$550.80 |
$918 |
5.0× |
| Us ob detailed single fetus (76811) |
$1,068.60 |
$1,781 |
4.2× |
| Us ob limited 1 or more fetuses (76815) |
$356.40 |
$594 |
3.2× |
| Us ob transvaginal (76817) |
$705 |
$1,175 |
6.4× |
| Us pelvic non ob complete (76856) |
$612.60 |
$1,021 |
5.5× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$705 |
$1,175 |
6.4× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$453.60 |
$756 |
4.1× |
| Us retroperitoneal complete (76770) |
$597.60 |
$996 |
5.4× |
| Us retroperitoneal limited (76775) |
$531 |
$885 |
4.8× |
| Us scrotum and contents (76870) |
$705 |
$1,175 |
6.4× |
| Us spinal canal and contents (76800) |
$612.60 |
$1,021 |
5.5× |
| Us thyroid (76536) |
$715.20 |
$1,192 |
6.5× |
| Vein X-Ray Chest (75827) |
$3,015 |
$5,025 |
1.8× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,159.60 |
$5,266 |
0.9× |
| Vein X-Ray Spleen/Liver (75810) |
$3,295.80 |
$5,493 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$3,268.80 |
$5,448 |
1.0× |
| Venography Adrenal Unilateral (75840) |
$3,159.60 |
$5,266 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$2,844 |
$4,740 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,944.60 |
$3,241 |
1.2× |
| Venography extremity unilateral rs&i (75820) |
$1,612.80 |
$2,688 |
1.0× |
| Venography Renal Bilateral (75833) |
$3,785.40 |
$6,309 |
1.1× |
| Venography Renal Unilateral (75831) |
$3,522.60 |
$5,871 |
1.1× |
| Venous sampling by catheter (75893) |
$3,863.40 |
$6,439 |
0.7× |
| Wrist 2 views (73100) |
$207.60 |
$346 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$346.20 |
$577 |
3.8× |
| X-ray antegrade pyelogram tube (74425) |
$694.80 |
$1,158 |
1.9× |
| X-Ray Aorta Leg Arteries (75630) |
$3,237 |
$5,395 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$346.20 |
$577 |
3.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$207.60 |
$346 |
2.3× |
| X-Ray Exam Breast Specimen (76098) |
$388.20 |
$647 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$175.20 |
$292 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$199.80 |
$333 |
1.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$227.40 |
$379 |
2.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$264 |
$440 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$401.40 |
$669 |
4.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$513.60 |
$856 |
4.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$333 |
$555 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$433.80 |
$723 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$510 |
$850 |
4.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$600.60 |
$1,001 |
5.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$346.20 |
$577 |
3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$600.60 |
$1,001 |
5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$343.80 |
$573 |
3.1× |
| X-ray eye for foreign body (70030) |
$336 |
$560 |
3.7× |
| X-ray humerus (73060) |
$217.80 |
$363 |
2.4× |
| X-ray IV pyelogram (ivp) (74400) |
$694.80 |
$1,158 |
3.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$325.20 |
$542 |
3.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$148.20 |
$247 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$321.60 |
$536 |
2.9× |
| X-ray nose-rectum child f.b. (76010) |
$290.40 |
$484 |
3.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$522 |
$870 |
4.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$346.20 |
$577 |
3.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$244.20 |
$407 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$223.80 |
$373 |
2.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$346.20 |
$577 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$460.80 |
$768 |
4.2× |
| X-ray thoracic spine 4 vw (72074) |
$492 |
$820 |
4.5× |
| X-Ray Tmj Unilat (70328) |
$372.60 |
$621 |
4.1× |
| X-Rays Bone Length Studies (77073) |
$346.20 |
$577 |
3.1× |
| X-Rays Bone Survey Complete (77075) |
$496.80 |
$828 |
4.5× |
| Xr c-spine 4 or 5 views (72050) |
$526.20 |
$877 |
4.8× |
| Xr facial bones less than 3 views (70140) |
$232.80 |
$388 |
2.5× |
| Xr orbits complete 4 views (70200) |
$346.20 |
$577 |
3.1× |
| Xr Tomogram Single Plane (76100) |
$522 |
$870 |
4.7× |