| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,524.80 |
$9,208 |
3.3× |
| Abdomen 2 views (74019) |
$371.10 |
$618.50 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$780.60 |
$1,301 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$6,028.80 |
$10,048 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$4,542.60 |
$7,571 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$6,943.80 |
$11,573 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$6,464.40 |
$10,774 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$6,028.80 |
$10,048 |
1.6× |
| Angiography Spinal Selective Rs&I (75705) |
$9,679.80 |
$16,133 |
1.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$9,205.80 |
$15,343 |
1.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$1,287 |
$2,145 |
0.3× |
| Ankle 2 views (73600) |
$196.50 |
$327.50 |
1.9× |
| Antegrade urography radiological supvj & interpj (74425) |
$684 |
$1,140 |
1.6× |
| Aortogram thoracic (75605) |
$6,028.80 |
$10,048 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$4,542.60 |
$7,571 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$4,542.60 |
$7,571 |
1.2× |
| Arthrogram hip (73525) |
$900.60 |
$1,501 |
2.2× |
| Basic radiation dosimetry calculation (77300) |
$315 |
$525 |
2.0× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,308.60 |
$2,181 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,461 |
$2,435 |
3.0× |
| Bone age studies (77072) |
$164.10 |
$273.50 |
1.3× |
| Bone Imaging 3 Phase (78315) |
$1,021.20 |
$1,702 |
2.1× |
| Bone Marrow Imaging Limited Area (78102) |
$666 |
$1,110 |
1.4× |
| Bone survey complete (77075) |
$283.20 |
$472 |
2.3× |
| Brachytx isodose complex (77318) |
$1,363.20 |
$2,272 |
3.0× |
| Brachytx isodose intermed (77317) |
$981 |
$1,635 |
2.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$527.40 |
$879 |
1.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,693.20 |
$7,822 |
2.7× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$59.40 |
$99 |
5.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,833 |
$3,055 |
4.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$898.80 |
$1,498 |
1.4× |
| Cervical spine 2 or 3 views (72040) |
$279.60 |
$466 |
2.7× |
| Chest 1 view (71045) |
$262.80 |
$438 |
2.5× |
| Chest 3 views (71047) |
$250.50 |
$417.50 |
2.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$558.60 |
$931 |
2.7× |
| Clavicle complete (73000) |
$234.90 |
$391.50 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$523.80 |
$873 |
4.2× |
| Continuing medical physics consltj pr wk (77336) |
$696.60 |
$1,161 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,526 |
$4,210 |
6.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,791.60 |
$2,986 |
6.3× |
| CT abdomen w contrast (74160) |
$1,727.40 |
$2,879 |
8.2× |
| CT abdomen w wo contrast (74170) |
$2,022.60 |
$3,371 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,432.20 |
$2,387 |
11.4× |
| CT angio hrt w/3d image (75574) |
$1,171.80 |
$1,953 |
2.8× |
| CT angiography upper extremity lt (73206) |
$1,900.80 |
$3,168 |
9.0× |
| CT c-spine w/o contrast (72125) |
$1,338.60 |
$2,231 |
10.7× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$1,168.80 |
$1,948 |
5.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,663.20 |
$2,772 |
7.9× |
| CT cervical spine with contrast (72126) |
$1,518.60 |
$2,531 |
3.6× |
| CT chest w/wo contrast (71270) |
$1,551 |
$2,585 |
7.4× |
| CT chest with contrast (71260) |
$1,412.40 |
$2,354 |
6.7× |
| CT head/brain with contrast (70460) |
$1,168.80 |
$1,948 |
5.6× |
| CT head/brain without and with contrast (70470) |
$1,374 |
$2,290 |
6.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$819 |
$1,365 |
2.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$78 |
$130 |
0.7× |
| CT hrt w/3d image congen (75573) |
$819 |
$1,365 |
2.0× |
| CT iac w contrast (70481) |
$1,402.80 |
$2,338 |
6.7× |
| CT limited/localized follow up study (76380) |
$558 |
$930 |
5.3× |
| CT lower ext w/o (73700) |
$1,271.40 |
$2,119 |
10.1× |
| CT lower extremity w wo contrast (73702) |
$1,608.60 |
$2,681 |
7.7× |
| CT lower extremity with contrast (73701) |
$1,441.80 |
$2,403 |
6.9× |
| CT lumbar spine w & w/o contrast (72133) |
$1,663.20 |
$2,772 |
7.9× |
| CT lumbar spine w/o contrast (72131) |
$1,338.60 |
$2,231 |
10.7× |
| CT lumbar spine with contrast (72132) |
$1,518.60 |
$2,531 |
3.6× |
| CT maxillofacial w contrast (70487) |
$1,361.40 |
$2,269 |
6.5× |
| CT maxillofacial w/o contrast (70486) |
$940.80 |
$1,568 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,695 |
$2,825 |
8.1× |
| CT neck soft tissue w contrast (70491) |
$1,537.80 |
$2,563 |
7.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,624.80 |
$2,708 |
7.7× |
| CT orbits w/o contrast (70480) |
$1,271.40 |
$2,119 |
10.1× |
| CT pelvis w & w/o contrast (72194) |
$1,410 |
$2,350 |
6.7× |
| CT pelvis w/o contrast (72192) |
$1,062.60 |
$1,771 |
8.5× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$147.60 |
$246 |
1.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,618.20 |
$2,697 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,271.40 |
$2,119 |
10.1× |
| CT thoracic spine w/contrast (72129) |
$1,518.60 |
$2,531 |
7.2× |
| CT thoracic spine w/o contrast (72128) |
$1,338.60 |
$2,231 |
10.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,663.20 |
$2,772 |
7.9× |
| CT thorax w/o contrast (71250) |
$523.80 |
$873 |
4.2× |
| CT unlisted procedure (76497) |
$368.40 |
$614 |
3.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,608 |
$2,680 |
7.6× |
| CT upper extremity w/o contrast rt (73200) |
$1,271.40 |
$2,119 |
10.1× |
| CT upper extremity with contrast (73201) |
$1,441.80 |
$2,403 |
3.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,371 |
$2,285 |
6.5× |
| Cta Abdomen (74175) |
$2,051.40 |
$3,419 |
9.8× |
| CTA abdomen pelvis (74174) |
$2,677.20 |
$4,462 |
6.4× |
| CTA chest (71275) |
$1,689 |
$2,815 |
8.0× |
| Cta Head (70496) |
$1,377.60 |
$2,296 |
6.6× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,067.60 |
$3,446 |
4.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,878 |
$3,130 |
8.9× |
| Cta Neck (70498) |
$1,377.60 |
$2,296 |
6.6× |
| Cta Pelvis (72191) |
$1,618.20 |
$2,697 |
7.7× |
| Cystography minimum 3 views rs&i (74430) |
$591 |
$985 |
1.4× |
| Diskogram cervical (72285) |
$5,184 |
$8,640 |
2.2× |
| Diskography lumbar (72295) |
$5,184 |
$8,640 |
2.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$243.60 |
$406 |
1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$244.20 |
$407 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$574.80 |
$958 |
4.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$270 |
$450 |
2.6× |
| Dxa bone density study axial skeleton (77085) |
$574.80 |
$958 |
4.6× |
| Echo exam of fetal heart (76825) |
$1,066.80 |
$1,778 |
1.6× |
| Echoencephalography real time imaging (76506) |
$321 |
$535 |
2.6× |
| Esophageal motility (78258) |
$575.40 |
$959 |
1.2× |
| Esophagus (74220) |
$577.80 |
$963 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$315 |
$525 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$285 |
$475 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$394.80 |
$658 |
1.4× |
| Foot 2 views (73620) |
$267.90 |
$446.50 |
2.6× |
| Forearm 2 views (73090) |
$265.20 |
$442 |
2.5× |
| Functional MRI brain by phys/psych (70555) |
$2,125.20 |
$3,542 |
7.4× |
| Functional MRI brain by tech (70554) |
$1,505.40 |
$2,509 |
5.3× |
| Gated Heart Planar Single (78472) |
$772.80 |
$1,288 |
1.6× |
| Hand 2 views (73120) |
$223.80 |
$373 |
1.8× |
| Hand 3 views (73130) |
$286.20 |
$477 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,223.20 |
$5,372 |
3.9× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$3,223.20 |
$5,372 |
3.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,030.80 |
$1,718 |
1.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$802.80 |
$1,338 |
1.7× |
| Ht muscle image spect sing (78451) |
$2,793 |
$4,655 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$265.20 |
$442 |
2.5× |
| Hysterosalpingogram (74740) |
$658.20 |
$1,097 |
2.3× |
| Interstitial radiation source applic complex (77778) |
$1,841.40 |
$3,069 |
2.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$898.80 |
$1,498 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$898.80 |
$1,498 |
1.4× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$855.60 |
$1,426 |
1.3× |
| Knee 3 views (73562) |
$273.90 |
$456.50 |
2.6× |
| Liver & spleen imaging static only (78215) |
$850.80 |
$1,418 |
1.8× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$937.80 |
$1,563 |
2.0× |
| Liver imaging static only (78201) |
$1,482 |
$2,470 |
2.3× |
| Liver imaging w/vascular flow (78202) |
$885.60 |
$1,476 |
1.4× |
| Lung perf&ventilat diferentl (78598) |
$817.20 |
$1,362 |
1.3× |
| Lung perfusion differential (78597) |
$661.80 |
$1,103 |
1.4× |
| Lung Ventilation Imaging (78579) |
$522 |
$870 |
1.1× |
| Lymphoscintigraphy (78195) |
$931.20 |
$1,552 |
1.4× |
| Mammary ductogram or galactogram multiple (77054) |
$524.40 |
$874 |
1.8× |
| Mammary ductogram or galactogram single (77053) |
$524.40 |
$874 |
1.8× |
| Meckels Diverticulum (78290) |
$780.60 |
$1,301 |
1.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$960 |
$1,600 |
2.1× |
| Mr elastography (76391) |
$517.20 |
$862 |
1.8× |
| Mr safety determination physician/other qhp (76016) |
$217.20 |
$362 |
2.1× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$148.80 |
$248 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$61.80 |
$103 |
1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$227.40 |
$379 |
2.0× |
| Mr safety med physics xm customization plng&mntr (76017) |
$598.20 |
$997 |
2.1× |
| MRA head w & w/o contrast (70546) |
$3,085.20 |
$5,142 |
7.4× |
| MRA head w/o contrast (70544) |
$2,122.20 |
$3,537 |
7.4× |
| MRA head with contrast (70545) |
$2,317.80 |
$3,863 |
5.5× |
| MRA neck w contrast (70548) |
$2,436.60 |
$4,061 |
5.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,085.20 |
$5,142 |
7.4× |
| MRA neck w/o contrast (70547) |
$1,801.20 |
$3,002 |
6.3× |
| MRI abdomen w contrast (74182) |
$1,773 |
$2,955 |
4.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,472 |
$4,120 |
5.9× |
| MRI abdomen w/o contrast (74181) |
$1,698.60 |
$2,831 |
5.9× |
| MRI any jnt lwr ext with con lt (73722) |
$2,317.80 |
$3,863 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,317.80 |
$3,863 |
2.5× |
| MRI breast w/o contrast bilateral (77047) |
$517.20 |
$862 |
1.8× |
| MRI breast w/o contrast unilat (77046) |
$394.80 |
$658 |
1.4× |
| MRI c-spine with contrast (72142) |
$2,317.80 |
$3,863 |
5.5× |
| MRI cardiac w/o cont stress (75559) |
$1,745.40 |
$2,909 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$1,236 |
$2,060 |
4.3× |
| MRI cervical spine w/o contrast (72141) |
$2,122.20 |
$3,537 |
7.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,472 |
$4,120 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,698.60 |
$2,831 |
5.9× |
| MRI chest with contrast (71551) |
$2,082.60 |
$3,471 |
2.2× |
| MRI fetal sngl/1st gestation (74712) |
$2,065.20 |
$3,442 |
7.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,212.80 |
$3,688 |
5.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,122.20 |
$3,537 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,698.60 |
$2,831 |
5.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,085.20 |
$5,142 |
7.4× |
| MRI orbit/face/neck w/contrast (70542) |
$1,855.80 |
$3,093 |
4.4× |
| MRI pelvis w contrast (72196) |
$2,065.20 |
$3,442 |
4.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,472 |
$4,120 |
5.9× |
| MRI pelvis w/o contrast (72195) |
$1,698.60 |
$2,831 |
5.9× |
| MRI scan of arm joint before and after contrast (73223) |
$2,619.60 |
$4,366 |
6.3× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,683.20 |
$4,472 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$2,963.40 |
$4,939 |
7.1× |
| MRI spectroscopy (76390) |
$562.20 |
$937 |
5.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,472 |
$4,120 |
5.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,317.80 |
$3,863 |
5.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,085.20 |
$5,142 |
7.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,317.80 |
$3,863 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,085.20 |
$5,142 |
7.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,122.20 |
$3,537 |
7.4× |
| MRI tmj (70336) |
$1,775.40 |
$2,959 |
6.2× |
| MRI upper ext joint w/o contrast (73221) |
$2,122.20 |
$3,537 |
7.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,472 |
$4,120 |
5.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,801.20 |
$3,002 |
6.3× |
| Myelogram Cervical (72240) |
$1,419.60 |
$2,366 |
1.5× |
| Myelography 2 or more regions (72270) |
$1,879.20 |
$3,132 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,953.20 |
$4,922 |
1.9× |
| Neck soft tissue (70360) |
$247.50 |
$412.50 |
2.4× |
| Nm adrenal scan (78075) |
$2,154 |
$3,590 |
1.4× |
| Nm bone marrow multiple (78103) |
$742.20 |
$1,237 |
1.5× |
| Nm bone marrow wb (78104) |
$822 |
$1,370 |
1.7× |
| Nm cisternogram (78630) |
$1,033.20 |
$1,722 |
1.6× |
| Nm csf leak detection (78650) |
$1,863 |
$3,105 |
1.2× |
| Nm gastric emptying study (78264) |
$696.60 |
$1,161 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,220 |
$8,700 |
3.1× |
| Nuclear Rx Oral Admin (79005) |
$940.80 |
$1,568 |
3.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$343.80 |
$573 |
2.7× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$220.20 |
$367 |
1.4× |
| Osseous survey infant (77076) |
$222.90 |
$371.50 |
1.8× |
| Osseous survey limited (77074) |
$218.70 |
$364.50 |
1.7× |
| Parathyroid imaging (78070) |
$886.20 |
$1,477 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$212.40 |
$354 |
1.7× |
| Peritoneogram rs&i (74190) |
$1,382.40 |
$2,304 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$5,727 |
$9,545 |
3.3× |
| PET imaging CT for attenuation limited area (78814) |
$3,618 |
$6,030 |
2.1× |
| PET imaging for CT attenuation whole body (78816) |
$5,727 |
$9,545 |
3.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,085.20 |
$5,142 |
7.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$6,028.80 |
$10,048 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$575.40 |
$959 |
1.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$898.80 |
$1,498 |
1.4× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$2,151 |
$3,585 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$786.60 |
$1,311 |
1.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$434.10 |
$723.50 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$478.50 |
$797.50 |
3.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$574.80 |
$958 |
4.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$12,185.40 |
$20,309 |
1.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$2,145 |
$3,575 |
3.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$498 |
$830 |
4.1× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$1,608.60 |
$2,681 |
3.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$373.50 |
$622.50 |
3.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$218.70 |
$364.50 |
2.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$231.60 |
$386 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$260.40 |
$434 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$1,005 |
$1,675 |
4.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$577.80 |
$963 |
2.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$741.60 |
$1,236 |
3.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$828.60 |
$1,381 |
3.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$462 |
$770 |
4.4× |
| Radiological examination surgical specimen (76098) |
$786.60 |
$1,311 |
1.2× |
| Radiopharm Dacryocystography (78660) |
$497.40 |
$829 |
1.0× |
| Ribs bilateral 3 views (71110) |
$552.60 |
$921 |
4.4× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,308.60 |
$2,181 |
2.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,340.60 |
$3,901 |
3.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,497.80 |
$4,163 |
1.6× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,655.60 |
$4,426 |
1.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,343 |
$3,905 |
1.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$456 |
$760 |
1.6× |
| Rp Therapy Intravenous Administration (79101) |
$558.60 |
$931 |
2.0× |
| Sacroiliac Joints < 3 Views (72200) |
$330 |
$550 |
2.6× |
| Salivary gland imaging serial images (78231) |
$508.80 |
$848 |
1.1× |
| Scanogram (77073) |
$179.10 |
$298.50 |
1.4× |
| Scapula complete (73010) |
$290.40 |
$484 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$42 |
$70 |
1.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$742.80 |
$1,238 |
5.9× |
| Sialogram (70390) |
$524.40 |
$874 |
1.8× |
| Small bowel series (74250) |
$661.80 |
$1,103 |
3.1× |
| Spec medical radj physics consltj (77370) |
$757.80 |
$1,263 |
4.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$661.80 |
$1,103 |
1.5× |
| Special dosimetry (77331) |
$193.80 |
$323 |
1.2× |
| Special treatment procedure (77470) |
$2,244 |
$3,740 |
3.4× |
| Spine thoracic 3 views (72072) |
$325.50 |
$542.50 |
2.6× |
| Stereotactic body radiation delivery (77373) |
$9,752.40 |
$16,254 |
4.5× |
| Tbs Technical Calculation Only (77091) |
$215.40 |
$359 |
2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,194.60 |
$1,991 |
2.7× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$527.40 |
$879 |
1.2× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,540.80 |
$2,568 |
3.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$671.40 |
$1,119 |
4.2× |
| Thoracolumbar 2 views (72080) |
$237.60 |
$396 |
2.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$898.80 |
$1,498 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$728.40 |
$1,214 |
1.5× |
| Thyroid uptake measurement (78012) |
$367.80 |
$613 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$661.80 |
$1,103 |
1.4× |
| Treatment device intermediate (77333) |
$244.20 |
$407 |
1.5× |
| Treatment devices simple (77332) |
$681 |
$1,135 |
4.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,442.60 |
$4,071 |
3.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$815.40 |
$1,359 |
1.7× |
| Tx devices design & construction complex (77334) |
$2,276.40 |
$3,794 |
5.1× |
| Ultrasound elastography first target lesion (76982) |
$208.80 |
$348 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$456 |
$760 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$279.60 |
$466 |
2.2× |
| Unlisted fluoroscopic procedure (76496) |
$186 |
$310 |
1.8× |
| Unlisted magnetic resonance procedure (76498) |
$4,116.90 |
$6,861.50 |
39.5× |
| Upper Extremity Infant (73092) |
$192.60 |
$321 |
1.5× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$303.60 |
$506 |
3.2× |
| Urethrocystography retrograde rs&i (74450) |
$546 |
$910 |
1.9× |
| Urethrocystography voiding (74455) |
$414.60 |
$691 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$192.60 |
$321 |
1.5× |
| Us breast unilateral complete (76641) |
$250.80 |
$418 |
2.0× |
| Us breast unilateral limited (76642) |
$250.80 |
$418 |
2.4× |
| Us chest (76604) |
$388.80 |
$648 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$270 |
$450 |
2.2× |
| Us elastography parenchyma (76981) |
$208.80 |
$348 |
1.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$364.80 |
$608 |
2.9× |
| Us infant hips limited static (76886) |
$388.80 |
$648 |
3.7× |
| Us kidney transplant (76776) |
$249 |
$415 |
2.0× |
| Us ob detailed single fetus (76811) |
$513.60 |
$856 |
1.8× |
| Us ob transvaginal (76817) |
$405 |
$675 |
3.2× |
| Us pelvic non ob complete (76856) |
$436.80 |
$728 |
3.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$270 |
$450 |
2.2× |
| Us pregnancy ltd (76815) |
$260.40 |
$434 |
2.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$366 |
$610 |
2.9× |
| Us retroperitoneal complete (76770) |
$420.60 |
$701 |
3.4× |
| Us retroperitoneal limited (76775) |
$459.60 |
$766 |
3.7× |
| Us scrotum and contents (76870) |
$745.20 |
$1,242 |
5.9× |
| Us soft tissue head/neck (76536) |
$543 |
$905 |
4.3× |
| Us spinal canal and contents (76800) |
$308.40 |
$514 |
2.5× |
| Us transrectal (76872) |
$260.40 |
$434 |
2.1× |
| Us xtr non-vasc lmtd (76882) |
$173.40 |
$289 |
1.4× |
| Vascular flow imaging (78445) |
$524.40 |
$874 |
1.1× |
| Venogram extremity bilateral (75822) |
$1,499.40 |
$2,499 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$6,028.80 |
$10,048 |
1.6× |
| Venography caval superior serialography rs&i (75827) |
$2,092.80 |
$3,488 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$2,265 |
$3,775 |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$4,542.60 |
$7,571 |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$3,002.40 |
$5,004 |
0.8× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$6,943.80 |
$11,573 |
1.0× |
| Vertebral fracture assessment via dxa (77086) |
$270 |
$450 |
2.6× |
| Wrist 2 views (73100) |
$258.90 |
$431.50 |
2.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$410.40 |
$684 |
3.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$270 |
$450 |
2.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$255.60 |
$426 |
2.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,005 |
$1,675 |
4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$356.40 |
$594 |
3.4× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$286.20 |
$477 |
2.7× |
| X-ray exam entire spi 4/5 vw (72083) |
$540.30 |
$900.50 |
4.3× |
| X-ray exam hip uni 1 view (73501) |
$462 |
$770 |
4.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$462 |
$770 |
4.4× |
| X-ray exam hip uni 4/> views (73503) |
$478.20 |
$797 |
3.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$574.80 |
$958 |
4.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$708.90 |
$1,181.50 |
5.7× |
| X-ray eye for foreign body (70030) |
$199.20 |
$332 |
1.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$323.70 |
$539.50 |
2.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$325.80 |
$543 |
3.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$231.60 |
$386 |
2.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,845 |
$3,075 |
0.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$241.20 |
$402 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$325.80 |
$543 |
3.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$311.70 |
$519.50 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$222.90 |
$371.50 |
2.1× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$188.40 |
$314 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$278.10 |
$463.50 |
2.2× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$468 |
$780 |
3.7× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$364.20 |
$607 |
2.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$228.30 |
$380.50 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$243.60 |
$406 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$507 |
$845 |
4.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$815.40 |
$1,359 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$411 |
$685 |
3.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$363.90 |
$606.50 |
2.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$443.10 |
$738.50 |
3.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$262.20 |
$437 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$286.20 |
$477 |
2.7× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$230.10 |
$383.50 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$331.20 |
$552 |
3.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$274.80 |
$458 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$397.80 |
$663 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$216.60 |
$361 |
1.7× |
| X-Ray Spine One View - Xr Spine (72020) |
$311.40 |
$519 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$225.60 |
$376 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$305.40 |
$509 |
2.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$250.80 |
$418 |
2.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$456 |
$760 |
3.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$228.30 |
$380.50 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$286.20 |
$477 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$444.60 |
$741 |
3.5× |
| Xr chest 4+ views (71048) |
$280.20 |
$467 |
2.2× |
| Xr finger(s) 2+ views (73140) |
$249.30 |
$415.50 |
2.4× |
| Xr shoulder 1 view (73020) |
$276.60 |
$461 |
2.7× |
| Xr spine cervical 4 or 5 views (72050) |
$382.20 |
$637 |
3.0× |
| Xr tibia/fibula 2 views (73590) |
$223.50 |
$372.50 |
2.1× |
| Xr tmj bilateral (70330) |
$326.70 |
$544.50 |
3.1× |
| Xray knee 1 or 2 views rt (73560) |
$238.20 |
$397 |
2.3× |