| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,430.25 |
$9,845 |
3.0× |
| Abdomen 1 View (74018) |
$328.95 |
$731 |
3.6× |
| Abdomen 2 views (74019) |
$341.55 |
$759 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,338.30 |
$2,974 |
3.2× |
| Angio internal mammary (75756) |
$3,788.10 |
$8,418 |
1.1× |
| Angio pulmonary bilat (75743) |
$8,778.15 |
$19,507 |
2.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$6,873.75 |
$15,275 |
2.1× |
| Angiography extremity bilateral rs&i (75716) |
$4,724.10 |
$10,498 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$3,094.20 |
$6,876 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,582.35 |
$10,183 |
1.4× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$5,348.25 |
$11,885 |
1.6× |
| Ankle 2 views (73600) |
$202.05 |
$449 |
2.2× |
| Aortography thoracic serialography rs&i (75605) |
$4,968.45 |
$11,041 |
0.8× |
| Artery X-Rays Abdomen (75726) |
$8,790.30 |
$19,534 |
1.5× |
| Artery X-Rays Adrenal Gland (75731) |
$4,582.35 |
$10,183 |
1.4× |
| Artery X-Rays Pelvis (75736) |
$7,927.20 |
$17,616 |
1.4× |
| Artery X-Rays Spine (75705) |
$7,643.70 |
$16,986 |
1.3× |
| Arthrogram ankle (73615) |
$888.75 |
$1,975 |
2.4× |
| Arthrogram hip (73525) |
$589.50 |
$1,310 |
1.6× |
| Arthrogram Wrist (73115) |
$611.55 |
$1,359 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$789.30 |
$1,754 |
5.6× |
| Bone age studies (77072) |
$310.50 |
$690 |
2.8× |
| Bone Imaging 3 Phase (78315) |
$1,797.30 |
$3,994 |
4.3× |
| Bone Imaging Limited Area (78300) |
$1,222.65 |
$2,717 |
2.9× |
| Bone Imaging Multiple Areas (78305) |
$1,440.45 |
$3,201 |
3.4× |
| Bone Imaging Whole Body (78306) |
$1,597.05 |
$3,549 |
3.8× |
| Bone marrow imaging limited area (78102) |
$1,815.30 |
$4,034 |
4.3× |
| Bone marrow imaging; whole body (78104) |
$2,549.25 |
$5,665 |
6.0× |
| Bone survey infant (77076) |
$295.65 |
$657 |
2.7× |
| Brachytx isodose complex (77318) |
$2,556.45 |
$5,681 |
6.5× |
| Brachytx isodose intermed (77317) |
$2,258.10 |
$5,018 |
5.7× |
| Brachytx Isodose Plan Simple (77316) |
$2,091.60 |
$4,648 |
5.3× |
| Brain Flow Imaging Only (78610) |
$1,574.10 |
$3,498 |
2.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,211.65 |
$7,137 |
2.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,912.05 |
$4,249 |
4.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,826.55 |
$4,059 |
5.0× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$1,904.85 |
$4,233 |
2.3× |
| Cat Scan Follow-Up Study (76380) |
$552.15 |
$1,227 |
6.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,400.85 |
$3,113 |
2.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,809.90 |
$4,022 |
3.2× |
| Chest 1 view (71045) |
$282.15 |
$627 |
3.1× |
| Chest 2 views (71046) |
$310.50 |
$690 |
3.4× |
| Chest 3 views (71047) |
$341.55 |
$759 |
3.7× |
| Chest 4 or more views (71048) |
$357.30 |
$794 |
3.2× |
| Clavicle complete (73000) |
$310.50 |
$690 |
3.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$429.75 |
$955 |
3.9× |
| Continuing medical physics consltj pr wk (77336) |
$787.05 |
$1,749 |
5.6× |
| Contrast Exam Abdominl Aorta (75625) |
$3,956.85 |
$8,793 |
1.2× |
| Contrast X-Ray Bladder (74430) |
$782.55 |
$1,739 |
2.1× |
| Contrast X-Ray Of Elbow (73085) |
$888.75 |
$1,975 |
2.4× |
| Contrast X-Ray Of Knee Joint (73580) |
$888.75 |
$1,975 |
2.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,328.55 |
$9,619 |
11.8× |
| CT abdomen and pelvis without contrast (74176) |
$2,612.25 |
$5,805 |
10.4× |
| CT abdomen w contrast (74160) |
$1,299.60 |
$2,888 |
7.0× |
| CT abdomen w wo contrast (74170) |
$1,465.65 |
$3,257 |
7.9× |
| CT abdomen w/o contrast (74150) |
$1,147.05 |
$2,549 |
10.4× |
| CT Angio Abdomen and Pelvis (74174) |
$4,545 |
$10,100 |
12.3× |
| CT Angio Chest (71275) |
$2,799.90 |
$6,222 |
15.1× |
| CT Angio Head (70496) |
$2,545.20 |
$5,656 |
13.8× |
| CT angio hrt w/3d image (75574) |
$1,357.65 |
$3,017 |
3.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,236.50 |
$4,970 |
12.1× |
| CT Angio Neck (70498) |
$2,110.05 |
$4,689 |
11.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,236.50 |
$4,970 |
12.1× |
| CT cervical spine w/ contrast (72126) |
$1,899 |
$4,220 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,739.70 |
$3,866 |
15.8× |
| CT cervical spine w/wo cont (72127) |
$2,009.25 |
$4,465 |
10.9× |
| CT chest w contrast (71260) |
$1,413.90 |
$3,142 |
7.6× |
| CT chest w/wo contrast (71270) |
$1,730.25 |
$3,845 |
9.4× |
| CT head/brain with contrast (70460) |
$1,941.30 |
$4,314 |
10.5× |
| CT head/brain without and with contrast (70470) |
$2,057.85 |
$4,573 |
11.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$840.60 |
$1,868 |
2.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$271.80 |
$604 |
3.0× |
| CT hrt w/3d image congen (75573) |
$1,292.85 |
$2,873 |
3.5× |
| CT iac w contrast (70481) |
$1,941.30 |
$4,314 |
10.5× |
| CT l-spine w&w/o contrast (72133) |
$2,129.85 |
$4,733 |
11.5× |
| CT lower ext w/o (73700) |
$1,045.80 |
$2,324 |
9.5× |
| CT lower extremity w/contrast material (73701) |
$1,941.30 |
$4,314 |
10.5× |
| CT lumbar spine w contrast (72132) |
$1,807.20 |
$4,016 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,498.95 |
$3,331 |
13.6× |
| CT maxillofacial w contrast (70487) |
$1,941.30 |
$4,314 |
10.5× |
| CT maxillofacial wo contrast (70486) |
$1,377 |
$3,060 |
12.5× |
| CT neck tissue combo (70492) |
$1,890.45 |
$4,201 |
10.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,009.25 |
$4,465 |
10.9× |
| CT orbits w/o contrast (70480) |
$1,609.20 |
$3,576 |
14.6× |
| CT pelvis w&w/o contrast (72194) |
$1,889.10 |
$4,198 |
10.2× |
| CT pelvis w/o contrast (72192) |
$1,453.05 |
$3,229 |
13.2× |
| CT scan of leg combo (73702) |
$2,129.85 |
$4,733 |
11.5× |
| CT scans face/jaw combo (70488) |
$2,057.85 |
$4,573 |
11.1× |
| CT soft tissue neck w contrast (70491) |
$1,554.75 |
$3,455 |
8.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,121.85 |
$2,493 |
10.2× |
| CT thoracic spine w contrast (72129) |
$1,234.35 |
$2,743 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$1,194.75 |
$2,655 |
10.8× |
| CT thoracic spine w/wo cont (72130) |
$2,009.25 |
$4,465 |
10.9× |
| CT thorax w/o contrast (71250) |
$1,256.40 |
$2,792 |
11.4× |
| CT unlisted procedure (76497) |
$794.23 |
$1,764.95 |
8.7× |
| CT upper ext wo (73200) |
$1,609.20 |
$3,576 |
14.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,129.85 |
$4,733 |
11.5× |
| CT upper extremity with contrast (73201) |
$1,941.30 |
$4,314 |
5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,534.50 |
$3,410 |
8.3× |
| Cta Abdomen (74175) |
$1,654.20 |
$3,676 |
8.9× |
| CTA pelvis (72191) |
$1,983.60 |
$4,408 |
10.7× |
| Dilation ureters/urethra rs&i (74485) |
$2,873.25 |
$6,385 |
1.3× |
| Discography Cerv/Thor Spine (72285) |
$2,811.15 |
$6,247 |
1.4× |
| Diskography lumbar (72295) |
$2,490.75 |
$5,535 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$189 |
$420 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$304.65 |
$677 |
2.8× |
| Dxa Bone Density Axial (77080) |
$422.10 |
$938 |
3.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$199.80 |
$444 |
2.2× |
| Echo exam uterus (76831) |
$536.85 |
$1,193 |
2.1× |
| Echo Guide For Artery Repair (76936) |
$610.20 |
$1,356 |
2.7× |
| Echograp Trans R Pros Study (76873) |
$531.90 |
$1,182 |
4.8× |
| Esophageal Motility Study (78258) |
$993.60 |
$2,208 |
2.4× |
| Esophagram (74220) |
$279 |
$620 |
1.5× |
| Fetal Biophys Profile W/Nst (76818) |
$279 |
$620 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$242.10 |
$538 |
2.2× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$2,331 |
$5,180 |
9.3× |
| Fluoroscopy up to 1 hr (76000) |
$622.35 |
$1,383 |
2.5× |
| Follow-Up Angiography (75898) |
$5,273.10 |
$11,718 |
1.6× |
| Foot 2 views (73620) |
$310.50 |
$690 |
3.4× |
| Forearm 2 views (73090) |
$283.05 |
$629 |
3.1× |
| Gastric emptying imaging study (78264) |
$1,856.25 |
$4,125 |
4.4× |
| Gastroesophageal Reflux Exam (78262) |
$993.60 |
$2,208 |
2.4× |
| Gated Heart Planar Single (78472) |
$2,117.25 |
$4,705 |
5.0× |
| Hand 2 views (73120) |
$310.50 |
$690 |
2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$7,317 |
$16,260 |
10.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$6,804.90 |
$15,122 |
9.3× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,597.95 |
$3,551 |
2.2× |
| Heart Image (Pet) Multiple (78492) |
$5,585.85 |
$12,413 |
3.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,370.50 |
$7,490 |
1.0× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,585.50 |
$10,190 |
1.4× |
| Hepatobil Syst Image W/Drug (78227) |
$2,657.70 |
$5,906 |
4.6× |
| Hepatobiliary System Imaging (78226) |
$1,696.95 |
$3,771 |
4.0× |
| Ht Muscle Image Spect Sing (78451) |
$2,421 |
$5,380 |
1.8× |
| Hysterosalpingogram (74740) |
$636.30 |
$1,414 |
2.5× |
| Image fusion (77399) |
$481.84 |
$1,070.74 |
3.4× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$531.90 |
$1,182 |
5.8× |
| Infant hip ultrasound, limited static exam (76886) |
$334.35 |
$743 |
3.6× |
| Interstitial radiation source applic complex (77778) |
$7,521.75 |
$16,715 |
10.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$7,521.75 |
$16,715 |
10.2× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$6,354 |
$14,120 |
10.9× |
| Intracavitary radiation source applic simple (77761) |
$5,186.70 |
$11,526 |
8.9× |
| K Flow/Funct Image Multiple (78709) |
$1,965.60 |
$4,368 |
3.4× |
| K Flow/Funct Image W/Drug (78708) |
$1,794.60 |
$3,988 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,880.10 |
$4,178 |
3.3× |
| Kidney Imaging Morphol (78700) |
$1,323 |
$2,940 |
3.1× |
| Knee 3 Views (73562) |
$335.25 |
$745 |
3.7× |
| Liver & Spleen Imaging Static Only (78215) |
$1,621.80 |
$3,604 |
3.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,431 |
$3,180 |
3.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,524.15 |
$3,387 |
2.7× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,524.15 |
$3,387 |
2.7× |
| Lung Ventilation Imaging (78579) |
$841.05 |
$1,869 |
2.0× |
| Lymph System Imaging (78195) |
$1,682.10 |
$3,738 |
2.9× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$7,107.30 |
$15,794 |
2.1× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$5,273.10 |
$11,718 |
1.6× |
| Magnetic Image Jaw Joint (70336) |
$1,629.45 |
$3,621 |
6.5× |
| Magnetic Resonance Elastography (76391) |
$561.60 |
$1,248 |
2.2× |
| Mammary ductogram or galactogram multiple (77054) |
$569.70 |
$1,266 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$495.45 |
$1,101 |
2.0× |
| Meckels Divert Exam (78290) |
$1,072.80 |
$2,384 |
2.5× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$562.95 |
$1,251 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,521.45 |
$3,381 |
3.9× |
| Mr safety determination physician/other qhp (76016) |
$119.70 |
$266 |
1.3× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$33.30 |
$74 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$143.10 |
$318 |
1.4× |
| Mr safety implt pos&/immoblj (76019) |
$93.15 |
$207 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$377.10 |
$838 |
1.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,946.70 |
$4,326 |
5.3× |
| MRA head w/o contrast (70544) |
$1,566.45 |
$3,481 |
6.2× |
| MRA head with contrast (70545) |
$1,685.25 |
$3,745 |
4.6× |
| MRA neck w contrast (70548) |
$1,632.60 |
$3,628 |
4.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,380.50 |
$5,290 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,480.95 |
$3,291 |
5.9× |
| MRI abdomen w contrast (74182) |
$1,512.90 |
$3,362 |
4.1× |
| MRI abdomen w/o contrast (74181) |
$1,276.20 |
$2,836 |
5.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,159.10 |
$4,798 |
2.6× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,880 |
$6,400 |
7.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,507.95 |
$3,351 |
1.8× |
| MRI bone marrow blood supply (77084) |
$1,694.70 |
$3,766 |
6.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$627.75 |
$1,395 |
2.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$511.20 |
$1,136 |
2.0× |
| MRI cardiac w/o contrast (75557) |
$1,632.60 |
$3,628 |
6.5× |
| MRI cervical spine w contrast (72142) |
$2,043.45 |
$4,541 |
5.6× |
| MRI cervical spine w/o cont (72141) |
$1,548 |
$3,440 |
6.2× |
| MRI chest w/o contrast (71550) |
$1,854 |
$4,120 |
7.4× |
| MRI chest with contrast (71551) |
$2,200.05 |
$4,889 |
2.7× |
| MRI chest wo w contrast (71552) |
$2,324.25 |
$5,165 |
6.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,061.90 |
$4,582 |
5.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,600.10 |
$5,778 |
7.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,758.60 |
$3,908 |
7.0× |
| MRI lumbar spine w contrast (72149) |
$2,043.45 |
$4,541 |
5.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,135.70 |
$4,746 |
5.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,227.15 |
$2,727 |
4.9× |
| MRI orbit face neck w contrast (70542) |
$2,043.45 |
$4,541 |
5.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,604.60 |
$5,788 |
7.1× |
| MRI pelvis w contrast (72196) |
$1,385.55 |
$3,079 |
3.8× |
| MRI pelvis w/o & w contrast (72197) |
$1,702.35 |
$3,783 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$1,178.10 |
$2,618 |
4.7× |
| MRI spectroscopy (76390) |
$2,171.70 |
$4,826 |
23.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,662.75 |
$3,695 |
6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,178.10 |
$2,618 |
4.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,627.65 |
$3,617 |
4.4× |
| MRI, abdomen, combo (74183) |
$1,604.70 |
$3,566 |
4.4× |
| MRI, dorsal spine combo (72157) |
$2,118.15 |
$4,707 |
5.8× |
| MRI, dorsal spine contrast (72147) |
$2,043.45 |
$4,541 |
5.6× |
| MRI, joint upper extrem (73221) |
$1,178.10 |
$2,618 |
4.7× |
| MRI, joint upper extrem combo (73223) |
$1,821.60 |
$4,048 |
4.9× |
| MRI, lumbar spine combo (72158) |
$2,128.95 |
$4,731 |
5.8× |
| Myelogram cervical (72240) |
$2,009.70 |
$4,466 |
2.4× |
| Myelogram Lumbar (72265) |
$1,895.85 |
$4,213 |
2.3× |
| Myelography thoracic (72255) |
$1,318.05 |
$2,929 |
1.6× |
| Myelograpy 2/more regions rs&i (72270) |
$3,091.95 |
$6,871 |
3.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,791.25 |
$8,425 |
2.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,889.55 |
$4,199 |
1.4× |
| Myocardial Spect Multiple Studies (78452) |
$4,150.35 |
$9,223 |
3.0× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$4,024.35 |
$8,943 |
2.7× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$4,135.50 |
$9,190 |
2.7× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,846.95 |
$10,771 |
2.1× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$6,624.90 |
$14,722 |
2.9× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$5,333.40 |
$11,852 |
3.3× |
| N-invas est c ffr sw aly CTA (75580) |
$1,555.20 |
$3,456 |
1.7× |
| Neck soft tissue (70360) |
$310.50 |
$690 |
3.4× |
| Nm csf leak detection (78650) |
$2,294.55 |
$5,099 |
1.7× |
| Nonvascular Shunt X-Ray (75809) |
$320.40 |
$712 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,151.85 |
$15,893 |
4.9× |
| Nuclear Rx Intra-Arterial (79445) |
$645.75 |
$1,435 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$1,229.40 |
$2,732 |
5.0× |
| Ob us nuchal meas 1 gest (76813) |
$205.20 |
$456 |
1.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$339.30 |
$754 |
3.1× |
| Panoramic X-ray of jaws (70355) |
$310.50 |
$690 |
3.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$879.75 |
$1,955 |
1.5× |
| Parathyroid Planar Imaging (78070) |
$1,139.85 |
$2,533 |
2.7× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$2,388.15 |
$5,307 |
5.7× |
| Pelvis 1 or 2 views (72170) |
$282.15 |
$627 |
2.6× |
| Perineogram (74775) |
$767.25 |
$1,705 |
3.0× |
| Peritoneogram Rs&I (74190) |
$961.20 |
$2,136 |
1.7× |
| Pet Image W/Ct Lmtd (78814) |
$3,211.65 |
$7,137 |
2.1× |
| PET image w/CT, full body (78816) |
$4,950.45 |
$11,001 |
3.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,921.20 |
$10,936 |
3.3× |
| Pet Myocardial Sngl Study (78491) |
$3,720.60 |
$8,268 |
2.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,585.50 |
$10,190 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,147.50 |
$2,550 |
2.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$372.60 |
$828 |
3.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$744.30 |
$1,654 |
1.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$310.50 |
$690 |
3.4× |
| Radex Calcaneus Minimum 2 Views (73650) |
$305.55 |
$679 |
3.3× |
| Radex elbow complete minimum 3 views (73080) |
$310.50 |
$690 |
3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$357.30 |
$794 |
3.2× |
| Radex fingr minimum 2 views (73140) |
$222.75 |
$495 |
2.4× |
| Radex foot complete minimum 3 views (73630) |
$334.80 |
$744 |
3.6× |
| Radex Hand Minimum 3 Views (73130) |
$315 |
$700 |
3.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$310.50 |
$690 |
3.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$357.30 |
$794 |
3.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$310.50 |
$690 |
3.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$310.50 |
$690 |
3.4× |
| Radex shoulder complete minimum 2 views (73030) |
$310.50 |
$690 |
3.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$310.50 |
$690 |
3.4× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$563.85 |
$1,253 |
3.0× |
| Radex Spine 1 View Specify Level (72020) |
$279.45 |
$621 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$310.50 |
$690 |
3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$357.30 |
$794 |
3.9× |
| Radex Toe Minimum 2 Views (73660) |
$310.50 |
$690 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$310.50 |
$690 |
2.8× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$310.50 |
$690 |
3.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$357.30 |
$794 |
3.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,269.80 |
$25,044 |
1.5× |
| Radiation treatment delivery level 1 (77402) |
$561.15 |
$1,247 |
5.2× |
| Radiation treatment delivery level 2 (77407) |
$862.65 |
$1,917 |
2.1× |
| Radiation treatment delivery level 3 (77412) |
$1,302.30 |
$2,894 |
2.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$357.30 |
$794 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$357.30 |
$794 |
3.2× |
| Radiologic exam colon double contrast study (74280) |
$493.65 |
$1,097 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$357.30 |
$794 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$461.25 |
$1,025 |
2.5× |
| Radiologic exam knee complete 4/more views (73564) |
$357.30 |
$794 |
3.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$357.30 |
$794 |
3.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$539.55 |
$1,199 |
2.9× |
| Radiologic exam swallow function contrast study (74230) |
$563.85 |
$1,253 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$493.65 |
$1,097 |
2.7× |
| Radiologic examination femur 1 view (73551) |
$202.05 |
$449 |
2.2× |
| Radiologic examination femur minimum 2 views (73552) |
$252 |
$560 |
2.7× |
| Radiologic examination knee 1/2 views (73560) |
$306.45 |
$681 |
3.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$221.85 |
$493 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$298.35 |
$663 |
3.3× |
| Ribs bilateral 3 views (71110) |
$341.10 |
$758 |
3.1× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,365.75 |
$3,035 |
3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,630.80 |
$3,624 |
3.9× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,741.85 |
$6,093 |
4.8× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,294.55 |
$5,099 |
4.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,333.25 |
$5,185 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,895.75 |
$6,435 |
2.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,132.45 |
$6,961 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,757.60 |
$6,128 |
2.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,427.40 |
$3,172 |
5.8× |
| Rp Therapy Intravenous Administration (79101) |
$1,204.20 |
$2,676 |
4.9× |
| Scapula (73010) |
$233.10 |
$518 |
2.1× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$80.10 |
$178 |
3.4× |
| Shoulder 1 view (73020) |
$252 |
$560 |
2.7× |
| Shoulder Arthrography (73040) |
$1,021.95 |
$2,271 |
2.8× |
| Sialogram (70390) |
$1,517.85 |
$3,373 |
6.0× |
| Skull less than 4 views (70250) |
$310.50 |
$690 |
2.8× |
| Special dosimetry (77331) |
$863.55 |
$1,919 |
6.1× |
| Special Physics Consult (77370) |
$463.05 |
$1,029 |
3.3× |
| Special teletherapy port plan (77321) |
$1,627.65 |
$3,617 |
4.1× |
| Special treatment procedure (77470) |
$2,327.40 |
$5,172 |
4.0× |
| Stereotactic Body Radiation Delivery (77373) |
$8,852.85 |
$19,673 |
4.7× |
| Sternoclavicular joints (71130) |
$357.30 |
$794 |
3.9× |
| Superior sagittal sinus venogram (75870) |
$4,585.50 |
$10,190 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,351.25 |
$5,225 |
6.0× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$2,218.05 |
$4,929 |
5.6× |
| Testicular Imaging W/Flow (78761) |
$1,247.85 |
$2,773 |
3.0× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,878.75 |
$4,175 |
4.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,407.15 |
$3,127 |
3.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,061.55 |
$2,359 |
7.5× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$607.05 |
$1,349 |
3.3× |
| Thoracic spine 2 views (72070) |
$202.05 |
$449 |
1.8× |
| Thoracic spine 3 views (72072) |
$263.25 |
$585 |
2.4× |
| Thoracolumbar 2 views (72080) |
$226.35 |
$503 |
2.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$698.85 |
$1,553 |
1.7× |
| Thyroid Met Imaging Body (78018) |
$2,247.75 |
$4,995 |
3.9× |
| Thyroid Uptake Measurement (78012) |
$617.40 |
$1,372 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$828 |
$1,840 |
2.0× |
| Tx Devices Design & Construction Complex (77334) |
$1,449 |
$3,220 |
3.7× |
| Tx devices design & construction intermediate (77333) |
$930.15 |
$2,067 |
6.6× |
| Tx devices design & construction simple (77332) |
$517.50 |
$1,150 |
3.6× |
| Ultrasound Breast Limited (76642) |
$197.10 |
$438 |
2.1× |
| Ultrasound Elastography Parenchyma (76981) |
$191.70 |
$426 |
1.7× |
| Ultrasound Exam Aaa Screen (76706) |
$347.85 |
$773 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$460.80 |
$1,024 |
4.2× |
| Umbilical-artery Doppler (OB) (76820) |
$198 |
$440 |
1.8× |
| Unlisted Dx Radiographic Procedure (76499) |
$502.26 |
$1,116.13 |
5.5× |
| Unlisted fluoroscopic procedure (76496) |
$247.25 |
$549.44 |
2.7× |
| Unlisted magnetic resonance procedure (76498) |
$561.62 |
$1,248.04 |
6.1× |
| Unlisted us procedure (76999) |
$339.33 |
$754.05 |
3.7× |
| Upper gi w/o kub (74240) |
$359.10 |
$798 |
1.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$135.90 |
$302 |
12.3× |
| Urea breath test c-14 isotopic analysis (78268) |
$430.65 |
$957 |
4.6× |
| Ureteral Reflux Study (78740) |
$1,247.85 |
$2,773 |
3.0× |
| Urethrocystogram voiding (74455) |
$992.70 |
$2,206 |
3.9× |
| Urethrocystography retrograde (74450) |
$767.25 |
$1,705 |
3.0× |
| Us breast unilateral complete (76641) |
$230.40 |
$512 |
2.1× |
| Us chest (76604) |
$328.05 |
$729 |
3.0× |
| Us complete joint (76881) |
$350.55 |
$779 |
3.2× |
| Us exam, pelvic, limited (76857) |
$481.95 |
$1,071 |
4.4× |
| Us head (76506) |
$673.20 |
$1,496 |
6.1× |
| Us kidney transplant (76776) |
$531 |
$1,180 |
4.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$297.45 |
$661 |
2.7× |
| Us ob detailed single fetus (76811) |
$551.70 |
$1,226 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$323.10 |
$718 |
2.9× |
| Us ob transvaginal (76817) |
$390.15 |
$867 |
3.5× |
| Us pelvic non ob complete (76856) |
$688.95 |
$1,531 |
6.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$545.85 |
$1,213 |
4.9× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$255.60 |
$568 |
2.3× |
| Us retroperitoneal complete (76770) |
$667.35 |
$1,483 |
6.1× |
| Us retroperitoneal limited (76775) |
$618.75 |
$1,375 |
5.6× |
| Us scrotum and contents (76870) |
$537.75 |
$1,195 |
4.9× |
| Us spinal canal and contents (76800) |
$511.65 |
$1,137 |
4.6× |
| Us thyroid (76536) |
$310.95 |
$691 |
2.8× |
| Us transrectal (76872) |
$301.05 |
$669 |
2.7× |
| Vein X-Ray Chest (75827) |
$2,591.10 |
$5,758 |
1.6× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$4,585.50 |
$10,190 |
1.4× |
| Venogram Sinus/Jugular (75860) |
$4,585.50 |
$10,190 |
1.4× |
| Venography Adrenal Unilateral (75840) |
$4,582.35 |
$10,183 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$2,980.35 |
$6,623 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$2,591.10 |
$5,758 |
1.6× |
| Venography extremity unilateral rs&i (75820) |
$2,253.15 |
$5,007 |
1.4× |
| Venography Renal Bilateral (75833) |
$7,240.50 |
$16,090 |
2.2× |
| Venography Renal Unilateral (75831) |
$4,217.85 |
$9,373 |
1.3× |
| Venous sampling by catheter (75893) |
$6,269.40 |
$13,932 |
1.1× |
| Wrist 2 views (73100) |
$288 |
$640 |
3.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$202.05 |
$449 |
2.2× |
| X-ray antegrade pyelogram tube (74425) |
$745.65 |
$1,657 |
2.0× |
| X-Ray Aorta Leg Arteries (75630) |
$3,465 |
$7,700 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$236.70 |
$526 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$279.90 |
$622 |
3.0× |
| X-Ray Exam Breast Specimen (76098) |
$503.10 |
$1,118 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$310.50 |
$690 |
3.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$326.25 |
$725 |
3.0× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$341.55 |
$759 |
3.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$202.05 |
$449 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$281.25 |
$625 |
3.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$341.55 |
$759 |
3.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$233.10 |
$518 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$304.20 |
$676 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$357.30 |
$794 |
3.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$357.30 |
$794 |
3.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$288.45 |
$641 |
3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$357.30 |
$794 |
3.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$333.45 |
$741 |
3.0× |
| X-ray eye for foreign body (70030) |
$310.50 |
$690 |
3.4× |
| X-ray humerus (73060) |
$301.95 |
$671 |
3.3× |
| X-ray IV pyelogram (ivp) (74400) |
$914.85 |
$2,033 |
4.9× |
| X-ray IV pyelogram+tomography (74415) |
$914.85 |
$2,033 |
4.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$310.50 |
$690 |
3.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$310.50 |
$690 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$229.05 |
$509 |
2.1× |
| X-ray nose-rectum child f.b. (76010) |
$310.50 |
$690 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$357.30 |
$794 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$357.30 |
$794 |
3.2× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$315.90 |
$702 |
2.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$303.30 |
$674 |
3.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$357.30 |
$794 |
3.9× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$357.30 |
$794 |
3.2× |
| X-ray thoracic spine 4 vw (72074) |
$302.85 |
$673 |
2.7× |
| X-Ray Tmj Unilat (70328) |
$310.50 |
$690 |
3.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$743.85 |
$1,653 |
2.0× |
| X-Rays Bone Length Studies (77073) |
$211.50 |
$470 |
1.9× |
| X-Rays Bone Survey Complete (77075) |
$245.70 |
$546 |
2.2× |
| Xr c-spine 4 or 5 views (72050) |
$307.35 |
$683 |
2.8× |
| Xr facial bones less than 3 views (70140) |
$209.25 |
$465 |
2.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$310.50 |
$690 |
2.8× |
| Xr orbits complete 4 views (70200) |
$310.50 |
$690 |
2.8× |
| Xr Tomogram Single Plane (76100) |
$380.70 |
$846 |
3.5× |