| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,754.99 |
$11,509.98 |
3.5× |
| Abdomen 2 views (74019) |
$461.88 |
$923.74 |
3.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$819.45 |
$1,638.89 |
1.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$5,388.65 |
$10,777.29 |
1.4× |
| Angiography extremity bilateral rs&i (75716) |
$3,385.94 |
$6,771.88 |
0.9× |
| Angiography extremity unilateral rs&i (75710) |
$4,923.33 |
$9,846.65 |
1.3× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$8,937.09 |
$17,874.18 |
1.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,388.65 |
$10,777.29 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,388.65 |
$10,777.29 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$8,937.09 |
$17,874.18 |
1.3× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,937.09 |
$17,874.18 |
1.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,171.66 |
$6,343.31 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,434.88 |
$2,869.75 |
0.4× |
| Ankle 2 views (73600) |
$259.76 |
$519.51 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$396.41 |
$792.81 |
0.9× |
| Aortogram thoracic (75605) |
$8,937.09 |
$17,874.18 |
1.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$5,388.65 |
$10,777.29 |
1.4× |
| Aortography abdominal serialography rs&i (75625) |
$4,007.78 |
$8,015.56 |
1.1× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,635.05 |
$5,270.09 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$1,434.88 |
$2,869.75 |
0.4× |
| Arthrogram elbow (73085) |
$565.15 |
$1,130.29 |
1.4× |
| Arthrogram hip (73525) |
$733.74 |
$1,467.48 |
1.8× |
| Arthrogram shoulder (73040) |
$589.72 |
$1,179.44 |
1.4× |
| Arthrogram wrist (73115) |
$565.15 |
$1,130.29 |
1.4× |
| Arthrography knee lt (73580) |
$733.74 |
$1,467.48 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$568.65 |
$1,137.29 |
3.5× |
| Bone &/Joint Imaging Limited Area (78300) |
$577.78 |
$1,155.55 |
1.2× |
| Bone &/joint imaging whole body (78306) |
$1,740.14 |
$3,480.28 |
3.6× |
| Bone age studies (77072) |
$326.55 |
$653.10 |
2.6× |
| Bone Imaging 3 Phase (78315) |
$1,279.66 |
$2,559.32 |
2.7× |
| Bone Marrow Imaging Limited Area (78102) |
$528.07 |
$1,056.13 |
1.1× |
| Bone survey complete (77075) |
$316.63 |
$633.26 |
2.5× |
| Brain image w/flow 4 + views (78606) |
$874.15 |
$1,748.29 |
1.3× |
| Brain imaging < 4 static views w vascular flow (78601) |
$820.90 |
$1,641.80 |
1.7× |
| Brain Imaging Vascular Flow Only (78610) |
$820.37 |
$1,640.73 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,714.66 |
$3,429.32 |
4.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$2,625.16 |
$5,250.30 |
4.0× |
| Cervical spine 2 or 3 views (72040) |
$331.94 |
$663.87 |
3.2× |
| Chest 1 view (71045) |
$306.73 |
$613.46 |
2.9× |
| Chest 3 views (71047) |
$155.19 |
$310.37 |
1.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$505.92 |
$1,011.83 |
2.4× |
| Clavicle complete (73000) |
$271.05 |
$542.10 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$955.56 |
$1,911.11 |
7.6× |
| Continuing medical physics consltj pr wk (77336) |
$648.10 |
$1,296.19 |
4.0× |
| Corpora cavernosography (74445) |
$184.03 |
$368.06 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,420.24 |
$4,840.48 |
5.8× |
| CT abdomen and pelvis without contrast (74176) |
$1,950.70 |
$3,901.40 |
6.8× |
| CT abdomen w contrast (74160) |
$1,366.58 |
$2,733.15 |
6.5× |
| CT abdomen w wo contrast (74170) |
$2,125.40 |
$4,250.80 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,286.78 |
$2,573.56 |
10.3× |
| CT angio hrt w/3d image (75574) |
$1,406.34 |
$2,812.67 |
3.4× |
| CT angiography upper extremity lt (73206) |
$713.02 |
$1,426.03 |
3.4× |
| CT c-spine w/o contrast (72125) |
$1,708.09 |
$3,416.17 |
13.6× |
| CT cervical spine w&w/o contrast (72127) |
$321.87 |
$643.74 |
1.5× |
| CT cervical spine with contrast (72126) |
$1,715.53 |
$3,431.06 |
4.1× |
| CT chest w/wo contrast (71270) |
$3,335.31 |
$6,670.62 |
15.9× |
| CT chest with contrast (71260) |
$1,303.45 |
$2,606.89 |
6.2× |
| CT colonography screening (74263) |
$374.50 |
$749 |
1.3× |
| CT colonography w/o cntrst (74261) |
$374.50 |
$749 |
3.0× |
| CT head/brain with contrast (70460) |
$1,708.09 |
$3,416.17 |
8.1× |
| CT head/brain without and with contrast (70470) |
$2,516.52 |
$5,033.03 |
12.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$547.06 |
$1,094.12 |
1.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$99 |
$198 |
0.9× |
| CT hrt w/3d image congen (75573) |
$547.06 |
$1,094.12 |
1.3× |
| CT iac w contrast (70481) |
$695.50 |
$1,391 |
3.3× |
| CT lower ext w/o (73700) |
$1,237.62 |
$2,475.24 |
9.9× |
| CT lower extremity w wo contrast (73702) |
$1,148.85 |
$2,297.69 |
5.5× |
| CT lower extremity with contrast (73701) |
$857.77 |
$1,715.54 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$1,738.77 |
$3,477.54 |
8.3× |
| CT lumbar spine w/o contrast (72131) |
$1,708.09 |
$3,416.17 |
13.6× |
| CT lumbar spine with contrast (72132) |
$2,066.84 |
$4,133.67 |
4.9× |
| CT maxillofacial w contrast (70487) |
$2,066.84 |
$4,133.67 |
9.8× |
| CT maxillofacial w/o contrast (70486) |
$1,708.09 |
$3,416.17 |
13.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,386.59 |
$4,773.17 |
11.4× |
| CT neck soft tissue w contrast (70491) |
$2,066.84 |
$4,133.67 |
9.8× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$695.50 |
$1,391 |
3.3× |
| CT orbits w/o contrast (70480) |
$695.50 |
$1,391 |
5.5× |
| CT pelvis w & w/o contrast (72194) |
$2,104.31 |
$4,208.61 |
10.0× |
| CT pelvis w/o contrast (72192) |
$1,126.33 |
$2,252.66 |
9.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,214.63 |
$4,429.25 |
10.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,708.09 |
$3,416.17 |
13.6× |
| CT thoracic spine w/contrast (72129) |
$1,715.52 |
$3,431.03 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$2,612.88 |
$5,225.76 |
20.8× |
| CT thoracic spine w/wo contrast (72130) |
$823.07 |
$1,646.14 |
3.9× |
| CT thorax w/o contrast (71250) |
$2,066.78 |
$4,133.55 |
16.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$857.77 |
$1,715.54 |
4.1× |
| CT upper extremity w/o contrast rt (73200) |
$978.70 |
$1,957.40 |
7.8× |
| CT upper extremity with contrast (73201) |
$857.77 |
$1,715.54 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,190.01 |
$4,380.01 |
10.4× |
| Cta Abdomen (74175) |
$2,103.74 |
$4,207.48 |
10.0× |
| CTA abdomen pelvis (74174) |
$2,240.72 |
$4,481.44 |
5.4× |
| CTA chest (71275) |
$1,814.49 |
$3,628.97 |
8.6× |
| Cta Head (70496) |
$2,530.17 |
$5,060.33 |
12.0× |
| CTA lwr ext w&w/o contrast (73706) |
$641.90 |
$1,283.80 |
3.1× |
| Cta Neck (70498) |
$2,530.79 |
$5,061.57 |
12.0× |
| Cta Pelvis (72191) |
$578.72 |
$1,157.42 |
2.8× |
| Cystography minimum 3 views rs&i (74430) |
$843.86 |
$1,687.72 |
2.0× |
| Diskogram cervical (72285) |
$2,589.34 |
$5,178.67 |
1.1× |
| Diskography lumbar (72295) |
$1,604.99 |
$3,209.98 |
0.7× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$220.83 |
$441.66 |
1.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$350.60 |
$701.20 |
2.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$314.81 |
$629.62 |
2.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$386.86 |
$773.72 |
3.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$154.19 |
$308.38 |
1.5× |
| Echo exam of fetal heart (76825) |
$691.20 |
$1,382.40 |
1.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$445.56 |
$891.10 |
1.6× |
| Echoencephalography real time imaging (76506) |
$633.45 |
$1,266.89 |
5.1× |
| Esophagus (74220) |
$521.27 |
$1,042.53 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$431.08 |
$862.16 |
3.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$327.15 |
$654.30 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$736.68 |
$1,473.35 |
2.6× |
| Foot 2 views (73620) |
$259.76 |
$519.51 |
2.5× |
| Forearm 2 views (73090) |
$282.76 |
$565.51 |
2.7× |
| Gastric mucosa imaging (78261) |
$626.01 |
$1,252.02 |
1.3× |
| Gated Heart Planar Single (78472) |
$621.32 |
$1,242.63 |
1.3× |
| Hand 2 views (73120) |
$259.76 |
$519.51 |
2.1× |
| Hand 3 views (73130) |
$309.36 |
$618.72 |
3.0× |
| Heart Infarct Image (78466) |
$674.18 |
$1,348.36 |
1.4× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,975.68 |
$3,951.36 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$874.15 |
$1,748.29 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,170.46 |
$2,340.92 |
2.4× |
| Ht muscle image spect sing (78451) |
$2,260.48 |
$4,520.95 |
1.5× |
| Humerus Min 2 Views Left (73060) |
$328.13 |
$656.25 |
3.1× |
| Hysterosalpingogram (74740) |
$726.38 |
$1,452.75 |
2.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$250.61 |
$501.21 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$749.59 |
$1,499.17 |
1.2× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$749.59 |
$1,499.17 |
1.2× |
| Knee 3 views (73562) |
$293.89 |
$587.78 |
2.8× |
| Liver & spleen imaging static only (78215) |
$587.48 |
$1,174.96 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$822.83 |
$1,645.66 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$988.74 |
$1,977.47 |
1.5× |
| Lung perfusion differential (78597) |
$674.18 |
$1,348.36 |
1.4× |
| Lung Ventilation Imaging (78579) |
$674.18 |
$1,348.36 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,225.15 |
$2,450.29 |
1.9× |
| Mammary ductogram or galactogram multiple (77054) |
$443.08 |
$886.15 |
1.5× |
| Mammary ductogram or galactogram single (77053) |
$376.97 |
$753.94 |
1.3× |
| Meckels Diverticulum (78290) |
$678.32 |
$1,356.63 |
1.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$8,834.98 |
$17,669.96 |
19.7× |
| Mr safety determination physician/other qhp (76016) |
$157.88 |
$315.75 |
1.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$106.50 |
$213 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$43.91 |
$87.81 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$164.58 |
$329.16 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$433.40 |
$866.79 |
1.5× |
| MRA head w & w/o contrast (70546) |
$1,862.90 |
$3,725.79 |
4.5× |
| MRA head w/o contrast (70544) |
$1,635.55 |
$3,271.10 |
5.7× |
| MRA head with contrast (70545) |
$1,373.48 |
$2,746.95 |
3.3× |
| MRA neck w contrast (70548) |
$1,373.48 |
$2,746.95 |
3.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,635.55 |
$3,271.10 |
3.9× |
| MRA neck w/o contrast (70547) |
$1,036.28 |
$2,072.55 |
3.6× |
| MRI abdomen w contrast (74182) |
$1,226.12 |
$2,452.24 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,704.58 |
$5,409.16 |
6.5× |
| MRI abdomen w/o contrast (74181) |
$1,463.20 |
$2,926.40 |
5.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,705 |
$3,409.99 |
1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,705 |
$3,409.99 |
1.8× |
| MRI breast w/o contrast bilateral (77047) |
$535 |
$1,070 |
1.9× |
| MRI breast w/o contrast unilat (77046) |
$1,056.41 |
$2,112.81 |
3.7× |
| MRI c-spine with contrast (72142) |
$1,579.15 |
$3,158.29 |
3.8× |
| MRI cardiac w/o contrast (75557) |
$444.38 |
$888.75 |
1.6× |
| MRI cervical spine w/o contrast (72141) |
$2,180.42 |
$4,360.84 |
7.6× |
| MRI chest w/o & w/contrast material (71552) |
$1,579.15 |
$3,158.29 |
3.8× |
| MRI chest w/o contrast (71550) |
$1,471.86 |
$2,943.72 |
5.1× |
| MRI chest with contrast (71551) |
$1,312.78 |
$2,625.56 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$975.99 |
$1,951.98 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,309.29 |
$2,618.58 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,179.08 |
$4,358.15 |
7.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,850.58 |
$3,701.15 |
6.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,704.58 |
$5,409.16 |
6.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,978.86 |
$3,957.71 |
4.7× |
| MRI pelvis w contrast (72196) |
$1,471.86 |
$2,943.72 |
3.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,493.84 |
$6,987.68 |
8.4× |
| MRI pelvis w/o contrast (72195) |
$1,602.84 |
$3,205.67 |
5.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,780.57 |
$3,561.13 |
4.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,780.57 |
$3,561.13 |
4.3× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,798.48 |
$5,596.95 |
6.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,962.78 |
$3,925.55 |
4.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,798.48 |
$5,596.95 |
6.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,433.89 |
$4,867.77 |
5.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,798.48 |
$5,596.95 |
6.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,180.42 |
$4,360.84 |
7.6× |
| MRI tmj (70336) |
$847.49 |
$1,694.97 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,179.08 |
$4,358.15 |
7.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,472.06 |
$2,944.13 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,057.62 |
$2,115.23 |
3.7× |
| Myelogram thoracic (72255) |
$1,096.31 |
$2,192.62 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$2,559.90 |
$5,119.79 |
1.6× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,351.63 |
$8,703.26 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,779.80 |
$3,559.59 |
1.7× |
| Neck soft tissue (70360) |
$237.17 |
$474.34 |
2.3× |
| Nm bone marrow multiple (78103) |
$561.82 |
$1,123.64 |
1.2× |
| Nm cisternogram (78630) |
$1,133.09 |
$2,266.17 |
1.7× |
| Nm csf leak detection (78650) |
$2,473.72 |
$4,947.44 |
1.6× |
| Nm gastric emptying study (78264) |
$1,185.19 |
$2,370.38 |
2.5× |
| Nm gastroesophageal reflux study (78262) |
$599.93 |
$1,199.86 |
1.3× |
| Nm peritoneal-venous shunt patency (78291) |
$1,301.55 |
$2,603.10 |
2.7× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,177.57 |
$14,355.13 |
4.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$2,320.38 |
$4,640.76 |
1.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$2,320.38 |
$4,640.76 |
1.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$336.61 |
$673.21 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$949.40 |
$1,898.80 |
3.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$401.19 |
$802.37 |
3.2× |
| Osseous survey infant (77076) |
$271.95 |
$543.89 |
2.2× |
| Osseous survey limited (77074) |
$222.45 |
$444.90 |
1.8× |
| Parathyrd planar w/wo subtrj (78071) |
$638.02 |
$1,276.03 |
1.3× |
| Parathyroid imaging (78070) |
$958.86 |
$1,917.72 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$326.55 |
$653.10 |
2.6× |
| Peritoneogram rs&i (74190) |
$332.07 |
$664.13 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$6,427.27 |
$12,854.54 |
3.7× |
| PET imaging for CT attenuation whole body (78816) |
$6,427.27 |
$12,854.54 |
3.7× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,142.64 |
$2,285.28 |
2.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,388.65 |
$10,777.29 |
1.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,580.41 |
$3,160.81 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$777.13 |
$1,554.25 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,311.32 |
$2,622.63 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$1,341.38 |
$2,682.76 |
2.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$155.19 |
$310.37 |
1.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$162.78 |
$325.55 |
1.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$260.33 |
$520.66 |
2.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,116.86 |
$2,233.72 |
1.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$328.32 |
$656.64 |
2.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$369.18 |
$738.36 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$556.88 |
$1,113.75 |
4.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$326.55 |
$653.10 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$328.03 |
$656.05 |
3.1× |
| Radiologic exam colon single contrast study (74270) |
$499.80 |
$999.60 |
2.4× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$354.32 |
$708.64 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$743.28 |
$1,486.55 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$516.41 |
$1,032.82 |
2.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$310.53 |
$621.05 |
3.0× |
| Radiological examination surgical specimen (76098) |
$1,496.53 |
$2,993.06 |
2.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$5,388.65 |
$10,777.29 |
1.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,933.59 |
$3,867.17 |
0.5× |
| Ribs bilateral 3 views (71110) |
$216.85 |
$433.70 |
1.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,499.23 |
$2,998.46 |
2.3× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,320.38 |
$4,640.76 |
3.6× |
| Rp Therapy Intravenous Administration (79101) |
$790.03 |
$1,580.06 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$326.55 |
$653.10 |
2.6× |
| Scanogram (77073) |
$385.22 |
$770.44 |
3.1× |
| Scapula complete (73010) |
$340.74 |
$681.47 |
2.7× |
| Screening digital breast tomosynthesis (77063) |
$278.91 |
$557.82 |
11.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$184.03 |
$368.06 |
1.5× |
| Sialogram (70390) |
$373.59 |
$747.18 |
1.3× |
| Simulation intermediate (77285) |
$512.49 |
$1,024.97 |
1.1× |
| Small bowel series (74250) |
$374.50 |
$749 |
1.8× |
| Spec medical radj physics consltj (77370) |
$812.81 |
$1,625.62 |
5.0× |
| Special dosimetry (77331) |
$274.15 |
$548.29 |
1.7× |
| Spine thoracic 3 views (72072) |
$324.62 |
$649.23 |
2.6× |
| Spleen imaging only (78185) |
$674.18 |
$1,348.36 |
1.4× |
| Splenoportograpy rs&i (75810) |
$1,477.07 |
$2,954.14 |
0.4× |
| Stereotactic body radiation delivery (77373) |
$3,090.57 |
$6,181.14 |
1.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,326.01 |
$4,652.02 |
5.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$217.75 |
$435.49 |
0.5× |
| Testicular Imaging With Vascular Flow (78761) |
$674.18 |
$1,348.36 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,247.65 |
$4,495.29 |
5.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,056.08 |
$2,112.16 |
6.6× |
| Thoracolumbar 2 views (72080) |
$197.47 |
$394.93 |
1.9× |
| Thyroid carcinoma metastases img whole body (78018) |
$780.04 |
$1,560.06 |
1.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$455.15 |
$910.30 |
0.9× |
| Thyroid uptake measurement (78012) |
$715.82 |
$1,431.63 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$604.95 |
$1,209.90 |
1.3× |
| Tmj unilateral (70328) |
$107.63 |
$215.25 |
1.0× |
| Treatment device intermediate (77333) |
$223.01 |
$446.01 |
1.4× |
| Treatment devices simple (77332) |
$768.87 |
$1,537.74 |
4.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,473.31 |
$4,946.61 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,251.58 |
$2,503.16 |
2.6× |
| Tx devices design & construction complex (77334) |
$2,220.01 |
$4,440.01 |
4.9× |
| Ultrasound elastography first target lesion (76982) |
$216.85 |
$433.70 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$707.14 |
$1,414.28 |
5.6× |
| Umbilical-artery Doppler (OB) (76820) |
$419.74 |
$839.48 |
3.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$116.28 |
$232.56 |
1.1× |
| Upper Extremity Infant (73092) |
$322.70 |
$645.39 |
2.6× |
| Urethrocystography retrograde rs&i (74450) |
$444.38 |
$888.75 |
1.6× |
| Urethrocystography voiding (74455) |
$373.51 |
$747.02 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$428.32 |
$856.62 |
2.0× |
| Us abdl aorta screen aaa (76706) |
$509.61 |
$1,019.22 |
4.1× |
| Us breast unilateral complete (76641) |
$525.50 |
$1,050.99 |
4.2× |
| Us breast unilateral limited (76642) |
$726.33 |
$1,452.66 |
7.0× |
| Us chest (76604) |
$625.12 |
$1,250.24 |
5.0× |
| Us compl joint r-t w/image documentation (76881) |
$710.61 |
$1,421.21 |
5.7× |
| Us elastography parenchyma (76981) |
$216.85 |
$433.70 |
1.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$269.01 |
$538.02 |
2.1× |
| Us guided compression repair (76936) |
$1,782.44 |
$3,564.88 |
6.9× |
| Us infant hips dynamic (76885) |
$537.24 |
$1,074.48 |
5.1× |
| Us infant hips limited static (76886) |
$408.27 |
$816.54 |
3.9× |
| Us kidney transplant (76776) |
$439.75 |
$879.49 |
3.5× |
| Us ob detailed single fetus (76811) |
$852.02 |
$1,704.04 |
3.0× |
| Us ob transvaginal (76817) |
$519.66 |
$1,039.32 |
4.1× |
| Us pelvic non ob complete (76856) |
$872.69 |
$1,745.37 |
7.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$904.69 |
$1,809.38 |
7.2× |
| Us pregnancy ltd (76815) |
$425.15 |
$850.29 |
3.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$470.20 |
$940.39 |
3.8× |
| Us retroperitoneal complete (76770) |
$1,113.17 |
$2,226.34 |
8.9× |
| Us retroperitoneal limited (76775) |
$1,004.13 |
$2,008.25 |
8.0× |
| Us scrotum and contents (76870) |
$706.90 |
$1,413.80 |
5.6× |
| Us soft tissue head/neck (76536) |
$620.79 |
$1,241.57 |
5.0× |
| Us spinal canal and contents (76800) |
$1,067.58 |
$2,135.16 |
8.5× |
| Us transrectal (76872) |
$227.17 |
$454.34 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$334.33 |
$668.66 |
2.7× |
| Vasogram (74440) |
$330.68 |
$661.36 |
1.2× |
| Venogram extremity bilateral (75822) |
$3,171.66 |
$6,343.31 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$5,388.65 |
$10,777.29 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$1,334.58 |
$2,669.16 |
0.7× |
| Venography extremity unilateral rs&i (75820) |
$910.89 |
$1,821.77 |
0.5× |
| Venography Renal Bilateral (75833) |
$5,388.65 |
$10,777.29 |
1.4× |
| Venography renal unilateral selective rs&i (75831) |
$5,388.65 |
$10,777.29 |
1.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,934.90 |
$3,869.79 |
0.5× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$8,937.09 |
$17,874.18 |
1.3× |
| Wrist 2 views (73100) |
$259.76 |
$519.51 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$337.32 |
$674.64 |
2.7× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$337.32 |
$674.64 |
3.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$326.55 |
$653.10 |
3.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$374.50 |
$749 |
1.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$259.76 |
$519.51 |
2.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$326.55 |
$653.10 |
3.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$351.98 |
$703.95 |
2.8× |
| X-ray exam hip uni 1 view (73501) |
$197.62 |
$395.24 |
1.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$374.43 |
$748.85 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$295.68 |
$591.35 |
2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$385.26 |
$770.52 |
3.1× |
| X-ray exam of femur 1 (73551) |
$212.99 |
$425.97 |
2.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$374.50 |
$749 |
1.8× |
| X-ray eye for foreign body (70030) |
$351.98 |
$703.95 |
3.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$556.88 |
$1,113.75 |
4.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$326.55 |
$653.10 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$326.55 |
$653.10 |
3.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$3,444.70 |
$6,889.40 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$246.03 |
$492.06 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$197.47 |
$394.93 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$336.44 |
$672.87 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$259.76 |
$519.51 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$271.05 |
$542.10 |
2.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$333.89 |
$667.77 |
2.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$321 |
$642 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$337.32 |
$674.64 |
2.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$288.04 |
$576.07 |
2.8× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$120.74 |
$241.48 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$658.58 |
$1,317.16 |
5.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$337.32 |
$674.64 |
2.7× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$373.51 |
$747.02 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$749 |
$1,498 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$326.55 |
$653.10 |
3.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$355.08 |
$710.16 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$216.85 |
$433.70 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$429.36 |
$858.72 |
3.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$324.13 |
$648.25 |
3.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$307.47 |
$614.94 |
2.9× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$556.88 |
$1,113.75 |
5.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$326.55 |
$653.10 |
3.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$556.88 |
$1,113.75 |
4.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$326.55 |
$653.10 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$233.64 |
$467.28 |
2.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$337.32 |
$674.64 |
3.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$326.55 |
$653.10 |
3.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$296.91 |
$593.82 |
2.4× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$267.50 |
$535 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$240.70 |
$481.39 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$326.55 |
$653.10 |
3.1× |
| Xr arthrogram ankle (73615) |
$733.74 |
$1,467.48 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$696.11 |
$1,392.21 |
5.6× |
| Xr chest 4+ views (71048) |
$447.10 |
$894.20 |
3.6× |
| Xr finger(s) 2+ views (73140) |
$238.74 |
$477.47 |
2.3× |
| Xr myelogram posterior fossa (70010) |
$619.58 |
$1,239.15 |
1.5× |
| Xr shoulder 1 view (73020) |
$259.76 |
$519.51 |
2.5× |
| Xr spine cervical 4 or 5 views (72050) |
$379.42 |
$758.84 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$303.14 |
$606.28 |
2.9× |
| Xr tmj bilateral (70330) |
$215.27 |
$430.54 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$259.76 |
$519.51 |
2.5× |