| Abdomen 2 views (74019) |
$328.27 |
$820.67 |
3.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$589.78 |
$1,474.43 |
1.6× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,718.58 |
$6,796.45 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,886.75 |
$7,216.87 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$2,488.08 |
$6,220.18 |
0.8× |
| Angiography internal mammary rs&i (75756) |
$2,461.70 |
$6,154.25 |
0.8× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,012.91 |
$5,032.26 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,386.78 |
$10,966.95 |
1.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,369.24 |
$8,423.09 |
1.1× |
| Angiography Spinal Selective Rs&I (75705) |
$2,718.58 |
$6,796.45 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,905.90 |
$12,264.73 |
0.9× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$539.10 |
$1,347.75 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,521.90 |
$3,804.74 |
0.5× |
| Ankle 2 views (73600) |
$173.38 |
$433.45 |
2.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$410.82 |
$1,027.03 |
1.2× |
| Aortogram thoracic (75605) |
$4,544.31 |
$11,360.76 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,555.63 |
$6,389.06 |
0.9× |
| Aortography abdominal serialography rs&i (75625) |
$2,009.41 |
$5,023.51 |
0.7× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,635.45 |
$9,088.62 |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$2,718.58 |
$6,796.45 |
0.9× |
| Arthrogram elbow (73085) |
$701.64 |
$1,754.08 |
2.1× |
| Arthrogram hip (73525) |
$829.56 |
$2,073.89 |
2.5× |
| Arthrogram shoulder (73040) |
$1,389 |
$3,472.49 |
4.2× |
| Arthrogram wrist (73115) |
$584.73 |
$1,461.81 |
1.8× |
| Arthrography knee lt (73580) |
$495.23 |
$1,238.06 |
1.5× |
| Basic radiation dosimetry calculation (77300) |
$117.46 |
$293.65 |
0.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,093.31 |
$2,733.26 |
2.9× |
| Bone &/joint imaging whole body (78306) |
$1,342.96 |
$3,357.40 |
3.5× |
| Bone age studies (77072) |
$87.08 |
$217.68 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$1,371.55 |
$3,428.87 |
3.6× |
| Bone Marrow Imaging Limited Area (78102) |
$343.37 |
$858.42 |
0.9× |
| Bone survey complete (77075) |
$223.41 |
$558.51 |
2.2× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,083.29 |
$2,708.22 |
2.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,637.94 |
$9,094.85 |
2.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,607.70 |
$9,019.23 |
10.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$425.47 |
$1,063.66 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$210.07 |
$525.16 |
2.5× |
| Chest 1 view (71045) |
$156.18 |
$390.45 |
1.9× |
| Chest 3 views (71047) |
$164.20 |
$410.50 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$594.16 |
$1,485.38 |
3.6× |
| Clavicle complete (73000) |
$165.80 |
$414.49 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$133.05 |
$332.61 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,733.17 |
$6,832.91 |
8.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,062.89 |
$5,157.21 |
9.1× |
| CT abdomen w contrast (74160) |
$1,320.20 |
$3,300.48 |
7.9× |
| CT abdomen w wo contrast (74170) |
$1,680.74 |
$4,201.85 |
10.1× |
| CT abdomen w/o contrast (74150) |
$1,033.01 |
$2,582.51 |
10.4× |
| CT angio hrt w/3d image (75574) |
$1,119.87 |
$2,799.67 |
3.4× |
| CT angiography upper extremity lt (73206) |
$418.10 |
$1,045.24 |
2.5× |
| CT c-spine w/o contrast (72125) |
$1,216.80 |
$3,042 |
12.2× |
| CT cervical spine w&w/o contrast (72127) |
$1,295.15 |
$3,237.87 |
7.8× |
| CT cervical spine with contrast (72126) |
$1,266.07 |
$3,165.16 |
3.8× |
| CT chest w/wo contrast (71270) |
$1,306.90 |
$3,267.25 |
7.8× |
| CT chest with contrast (71260) |
$1,201.28 |
$3,003.18 |
7.2× |
| CT colonography screening (74263) |
$235.82 |
$589.55 |
1.0× |
| CT colonography w/dye (74262) |
$567.89 |
$1,419.72 |
3.4× |
| CT colonography w/o cntrst (74261) |
$317.26 |
$793.14 |
3.2× |
| CT head/brain with contrast (70460) |
$1,179.19 |
$2,947.96 |
7.1× |
| CT head/brain without and with contrast (70470) |
$1,492.64 |
$3,731.59 |
8.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$895.90 |
$2,239.74 |
2.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$43.94 |
$109.84 |
0.5× |
| CT iac w contrast (70481) |
$1,209.72 |
$3,024.28 |
7.2× |
| CT limited/localized follow up study (76380) |
$171.66 |
$429.13 |
2.1× |
| CT lower ext w/o (73700) |
$843.69 |
$2,109.21 |
8.5× |
| CT lower extremity w wo contrast (73702) |
$1,006.81 |
$2,517.02 |
6.0× |
| CT lower extremity with contrast (73701) |
$920.11 |
$2,300.27 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,486.67 |
$3,716.66 |
8.9× |
| CT lumbar spine w/o contrast (72131) |
$1,117.02 |
$2,792.55 |
11.2× |
| CT lumbar spine with contrast (72132) |
$1,208.44 |
$3,021.10 |
3.6× |
| CT maxillofacial w contrast (70487) |
$1,240 |
$3,099.98 |
7.4× |
| CT maxillofacial w/o contrast (70486) |
$1,140.58 |
$2,851.45 |
11.5× |
| CT maxillofacial w/wo contrast (70488) |
$1,317.54 |
$3,293.84 |
7.9× |
| CT neck soft tissue w contrast (70491) |
$1,282.50 |
$3,206.24 |
7.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,513.10 |
$3,782.74 |
9.1× |
| CT orbits w/o contrast (70480) |
$1,044 |
$2,609.99 |
10.5× |
| CT pelvis w & w/o contrast (72194) |
$1,297.38 |
$3,243.44 |
7.8× |
| CT pelvis w/o contrast (72192) |
$1,064.08 |
$2,660.20 |
10.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,417.29 |
$3,543.22 |
8.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,163.02 |
$2,907.53 |
11.7× |
| CT thoracic spine w/contrast (72129) |
$1,111.20 |
$2,778 |
6.7× |
| CT thoracic spine w/o contrast (72128) |
$1,035.07 |
$2,587.66 |
10.4× |
| CT thoracic spine w/wo contrast (72130) |
$1,113.50 |
$2,783.75 |
6.7× |
| CT thorax w/o contrast (71250) |
$1,030.89 |
$2,577.22 |
10.4× |
| CT unlisted procedure (76497) |
$84.79 |
$211.97 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,225.47 |
$3,063.67 |
7.3× |
| CT upper extremity w/o contrast rt (73200) |
$919.10 |
$2,297.74 |
9.2× |
| CT upper extremity with contrast (73201) |
$974.69 |
$2,436.71 |
2.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,515.71 |
$6,289.27 |
15.1× |
| Cta Abdomen (74175) |
$1,479.33 |
$3,698.32 |
8.9× |
| CTA abdomen pelvis (74174) |
$2,236.07 |
$5,590.17 |
6.7× |
| CTA chest (71275) |
$1,403.39 |
$3,508.46 |
8.4× |
| Cta Head (70496) |
$1,471.81 |
$3,679.52 |
8.8× |
| CTA lwr ext w&w/o contrast (73706) |
$835.99 |
$2,089.96 |
5.0× |
| Cta Neck (70498) |
$1,437.75 |
$3,594.36 |
8.6× |
| Cta Pelvis (72191) |
$1,161.70 |
$2,904.25 |
7.0× |
| Cystography minimum 3 views rs&i (74430) |
$533.58 |
$1,333.95 |
1.6× |
| Dacryocystography (70170) |
$317.53 |
$793.81 |
1.4× |
| Diskogram cervical (72285) |
$1,204.07 |
$3,010.17 |
0.6× |
| Diskography lumbar (72295) |
$1,204.07 |
$3,010.17 |
0.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$126.89 |
$317.22 |
1.3× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$376.38 |
$940.94 |
3.8× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$565 |
$1,412.50 |
5.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$259.24 |
$648.10 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$147.30 |
$368.24 |
1.8× |
| Echo exam of fetal heart (76825) |
$862.44 |
$2,156.09 |
1.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$353.20 |
$882.99 |
1.6× |
| Echoencephalography real time imaging (76506) |
$334.47 |
$836.16 |
3.4× |
| Esophagus (74220) |
$495.13 |
$1,237.81 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$376.23 |
$940.57 |
3.8× |
| Fluoroscopy up to 1 hr (76000) |
$810.14 |
$2,025.34 |
3.6× |
| Foot 2 views (73620) |
$157.34 |
$393.33 |
1.9× |
| Forearm 2 views (73090) |
$166.30 |
$415.74 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,775.94 |
$4,439.83 |
4.7× |
| Hand 2 views (73120) |
$145.46 |
$363.64 |
1.5× |
| Hand 3 views (73130) |
$183.64 |
$459.09 |
2.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,213.65 |
$3,034.12 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,122.28 |
$5,305.69 |
4.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,283.20 |
$3,208 |
3.4× |
| Ht muscle image spect sing (78451) |
$1,176.64 |
$2,941.58 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$177.14 |
$442.83 |
2.1× |
| Hysterosalpingogram (74740) |
$343.10 |
$857.74 |
1.5× |
| Interstitial radiation source applic complex (77778) |
$4,143.01 |
$10,357.51 |
6.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,072.40 |
$2,681 |
2.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,340.51 |
$3,351.26 |
2.6× |
| Knee 3 views (73562) |
$189.90 |
$474.75 |
2.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$644.23 |
$1,610.57 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$1,879.90 |
$4,699.75 |
3.6× |
| Lymphoscintigraphy (78195) |
$1,019.51 |
$2,548.76 |
2.0× |
| Mammary ductogram or galactogram multiple (77054) |
$325.63 |
$814.06 |
1.4× |
| Mammary ductogram or galactogram single (77053) |
$216.35 |
$540.86 |
1.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$151.42 |
$378.54 |
1.8× |
| Meckels Diverticulum (78290) |
$546.80 |
$1,366.99 |
1.4× |
| Mr safety determination physician/other qhp (76016) |
$79.78 |
$199.43 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$22.20 |
$55.48 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$83.16 |
$207.88 |
0.9× |
| MRA head w & w/o contrast (70546) |
$1,863.54 |
$4,658.83 |
5.6× |
| MRA head w/o contrast (70544) |
$1,102 |
$2,755 |
4.9× |
| MRA head with contrast (70545) |
$1,706.50 |
$4,266.25 |
5.1× |
| MRA neck w contrast (70548) |
$1,001.72 |
$2,504.28 |
3.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,166.49 |
$2,916.21 |
3.5× |
| MRA neck w/o contrast (70547) |
$836.95 |
$2,092.36 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,788.76 |
$4,471.88 |
5.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,978.42 |
$4,946.03 |
6.0× |
| MRI abdomen w/o contrast (74181) |
$1,730.45 |
$4,326.11 |
7.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,849.42 |
$4,623.54 |
2.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,573.38 |
$3,933.45 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$2,392.54 |
$5,981.35 |
10.5× |
| MRI breast w/o contrast unilat (77046) |
$1,469.62 |
$3,674.05 |
6.5× |
| MRI c-spine with contrast (72142) |
$2,087.62 |
$5,219.03 |
6.3× |
| MRI cardiac w/o cont stress (75559) |
$3,847.60 |
$9,618.99 |
7.4× |
| MRI cardiac w/o contrast (75557) |
$2,972.30 |
$7,430.74 |
13.1× |
| MRI cervical spine w/o contrast (72141) |
$2,049.17 |
$5,122.91 |
9.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,882.49 |
$4,706.22 |
5.7× |
| MRI chest w/o contrast (71550) |
$1,246.87 |
$3,117.17 |
5.5× |
| MRI chest with contrast (71551) |
$1,549.72 |
$3,874.30 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,865.14 |
$4,662.84 |
5.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,824.45 |
$4,561.11 |
5.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,408.12 |
$3,520.30 |
6.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,900.02 |
$4,750.03 |
8.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,090.67 |
$5,226.67 |
6.3× |
| MRI orbit/face/neck w/contrast (70542) |
$2,072.93 |
$5,182.31 |
6.2× |
| MRI pelvis w contrast (72196) |
$1,315.90 |
$3,289.75 |
4.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,644.87 |
$4,112.16 |
5.0× |
| MRI pelvis w/o contrast (72195) |
$1,196.27 |
$2,990.67 |
5.3× |
| MRI scan of arm joint before and after contrast (73223) |
$1,956.87 |
$4,892.17 |
5.9× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$4,595.30 |
$11,488.25 |
6.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,094.13 |
$5,235.31 |
6.3× |
| MRI spectroscopy (76390) |
$1,549.72 |
$3,874.30 |
18.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,665.31 |
$6,663.27 |
8.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,710.51 |
$4,276.26 |
5.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,183.84 |
$5,459.60 |
6.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,710.51 |
$4,276.26 |
5.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,183.84 |
$5,459.60 |
6.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,679 |
$4,197.50 |
7.4× |
| MRI tmj (70336) |
$1,167.92 |
$2,919.79 |
5.1× |
| MRI upper ext joint w/o contrast (73221) |
$1,523 |
$3,807.48 |
6.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$2,094.13 |
$5,235.31 |
6.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,273.46 |
$3,183.64 |
5.6× |
| Myelogram Cervical (72240) |
$2,055.42 |
$5,138.54 |
2.8× |
| Myelogram Lumbar (72265) |
$1,881.36 |
$4,703.39 |
2.5× |
| Myelogram thoracic (72255) |
$2,033.91 |
$5,084.77 |
2.7× |
| Myelography 2 or more regions (72270) |
$2,657.95 |
$6,644.86 |
3.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,411.76 |
$8,529.39 |
2.8× |
| Myocardial Spect Multiple Studies (78452) |
$3,516.04 |
$8,790.08 |
2.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$762.60 |
$1,906.48 |
0.9× |
| Neck soft tissue (70360) |
$306.91 |
$767.27 |
3.7× |
| Nm cisternogram (78630) |
$538.24 |
$1,345.59 |
1.0× |
| Nm csf leak detection (78650) |
$538.24 |
$1,345.59 |
0.4× |
| Nm gastric emptying study (78264) |
$1,315.61 |
$3,289.02 |
3.5× |
| Nm gastroesophageal reflux study (78262) |
$632.50 |
$1,581.24 |
1.7× |
| Nm peritoneal-venous shunt patency (78291) |
$546.80 |
$1,366.99 |
1.4× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$3,637.94 |
$9,094.85 |
2.7× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$1,790.26 |
$4,475.63 |
1.5× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$2,857.87 |
$7,144.67 |
2.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$1,429.92 |
$3,574.78 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$1,776.81 |
$4,442.01 |
8.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$424.47 |
$1,061.16 |
4.3× |
| Parathyroid imaging (78070) |
$1,238.37 |
$3,095.92 |
3.3× |
| Pelvis 1 or 2 views (72170) |
$153.83 |
$384.56 |
1.5× |
| Peritoneogram rs&i (74190) |
$1,168.18 |
$2,920.43 |
2.2× |
| PET image w/CT, skull-thigh (78815) |
$4,522.36 |
$11,305.88 |
3.3× |
| PET imaging CT for attenuation limited area (78814) |
$4,122.59 |
$10,306.46 |
3.0× |
| PET imaging for CT attenuation whole body (78816) |
$4,806.58 |
$12,016.45 |
3.5× |
| Pr MRI brain w/ dye (70558) |
$1,496.83 |
$3,742.07 |
9.0× |
| Pr MRI brain w/o & w/ dye (70559) |
$2,179.23 |
$5,448.06 |
13.1× |
| Pr MRI brain w/o dye (70557) |
$1,232.47 |
$3,081.17 |
2.4× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,001.33 |
$5,003.32 |
6.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,886.64 |
$9,716.60 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$3,565.76 |
$8,914.39 |
1.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$506.91 |
$1,267.27 |
1.3× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,512.78 |
$3,781.94 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$333.29 |
$833.22 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$273.46 |
$683.65 |
3.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$455.77 |
$1,139.41 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$260.44 |
$651.09 |
2.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$227.46 |
$568.65 |
2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$152.59 |
$381.47 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$312.64 |
$781.60 |
3.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$147.07 |
$367.66 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$160.19 |
$400.47 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$489.93 |
$1,224.81 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$544.64 |
$1,361.59 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$210.82 |
$527.05 |
1.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$428.27 |
$1,070.66 |
2.6× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$175.20 |
$437.98 |
2.1× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$187.38 |
$468.44 |
2.3× |
| Radiological examination surgical specimen (76098) |
$113.73 |
$284.32 |
0.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$2,239.98 |
$5,599.94 |
0.7× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,718.46 |
$6,796.15 |
0.9× |
| Ribs bilateral 3 views (71110) |
$279.83 |
$699.56 |
2.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,057.86 |
$2,644.63 |
2.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,481.74 |
$3,704.34 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,405.89 |
$3,514.71 |
2.7× |
| Rp therapy intra-arterial particulate admn (79445) |
$215.38 |
$538.43 |
1.0× |
| Rp Therapy Intravenous Administration (79101) |
$314.26 |
$785.64 |
1.4× |
| Salivary gland function study (78232) |
$672.15 |
$1,680.37 |
1.8× |
| Scanogram (77073) |
$88.30 |
$220.75 |
0.9× |
| Scapula complete (73010) |
$167.73 |
$419.32 |
1.7× |
| Screening digital breast tomosynthesis (77063) |
$18.62 |
$46.55 |
0.8× |
| Sella turcica (70240) |
$84.21 |
$210.51 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$456.40 |
$1,140.98 |
4.6× |
| Small bowel series (74250) |
$637.45 |
$1,593.62 |
3.8× |
| Special treatment procedure (77470) |
$509.58 |
$1,273.95 |
1.0× |
| Spine thoracic 3 views (72072) |
$256.86 |
$642.14 |
2.6× |
| Splenoportograpy rs&i (75810) |
$2,718.58 |
$6,796.45 |
0.9× |
| Testicular Imaging With Vascular Flow (78761) |
$529.12 |
$1,322.78 |
1.4× |
| Therapeutic Enema (74283) |
$563.73 |
$1,409.31 |
3.4× |
| Thoracolumbar 2 views (72080) |
$43.60 |
$108.98 |
0.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,475.54 |
$3,688.84 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$262.90 |
$657.23 |
0.7× |
| Thyroid uptake measurement (78012) |
$769.26 |
$1,923.15 |
2.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,571.42 |
$3,928.53 |
4.1× |
| Tomogram (76100) |
$248.91 |
$622.27 |
2.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,799.64 |
$4,499.08 |
3.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$816.49 |
$2,041.22 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$533.38 |
$1,333.43 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$1,552.60 |
$3,881.48 |
15.6× |
| Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) |
$589.97 |
$1,474.91 |
1.6× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$523.67 |
$1,309.16 |
6.3× |
| Unlisted magnetic resonance procedure (76498) |
$88.28 |
$220.68 |
1.1× |
| Upper Extremity Infant (73092) |
$60.40 |
$150.99 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$457.81 |
$1,144.51 |
2.0× |
| Urethrocystography voiding (74455) |
$681.57 |
$1,703.92 |
3.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$953.42 |
$2,383.53 |
5.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$421.79 |
$1,054.46 |
2.5× |
| Us abdl aorta screen aaa (76706) |
$102.71 |
$256.76 |
1.0× |
| Us breast unilateral complete (76641) |
$324.02 |
$810.04 |
3.3× |
| Us breast unilateral limited (76642) |
$269.72 |
$674.29 |
3.3× |
| Us chest (76604) |
$533.38 |
$1,333.43 |
5.4× |
| Us compl joint r-t w/image documentation (76881) |
$361.70 |
$904.25 |
3.6× |
| Us elastography parenchyma (76981) |
$138.61 |
$346.51 |
1.4× |
| Us fetal nuchal translucency 1st gestation (76813) |
$342.17 |
$855.42 |
3.4× |
| Us guided compression repair (76936) |
$4,346.46 |
$10,866.13 |
21.2× |
| Us infant hips dynamic (76885) |
$341.42 |
$853.53 |
4.1× |
| Us ob detailed single fetus (76811) |
$424.47 |
$1,061.16 |
1.9× |
| Us ob transvaginal (76817) |
$289.55 |
$723.87 |
2.9× |
| Us pelvic non ob complete (76856) |
$877.23 |
$2,193.06 |
8.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$182.16 |
$455.39 |
1.8× |
| Us pregnancy ltd (76815) |
$254.69 |
$636.71 |
2.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$590.95 |
$1,477.36 |
5.9× |
| Us retroperitoneal complete (76770) |
$552.01 |
$1,380.02 |
5.5× |
| Us retroperitoneal limited (76775) |
$533.38 |
$1,333.43 |
5.4× |
| Us scrotum and contents (76870) |
$443.98 |
$1,109.94 |
4.5× |
| Us soft tissue head/neck (76536) |
$635.94 |
$1,589.84 |
6.4× |
| Us spinal canal and contents (76800) |
$357.53 |
$893.82 |
3.6× |
| Us transrectal (76872) |
$260.27 |
$650.67 |
2.6× |
| Us transrectal prostate volume (76873) |
$527.86 |
$1,319.63 |
5.3× |
| Us xtr non-vasc lmtd (76882) |
$256.84 |
$642.10 |
2.6× |
| Vascular flow imaging (78445) |
$596.45 |
$1,491.12 |
1.6× |
| Venogram extremity bilateral (75822) |
$1,675.78 |
$4,189.43 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$2,718.58 |
$6,796.45 |
0.9× |
| Venography caval superior serialography rs&i (75827) |
$1,572.27 |
$3,930.67 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$897.91 |
$2,244.77 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,718.58 |
$6,796.45 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,718.58 |
$6,796.45 |
0.9× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,662.26 |
$6,655.65 |
0.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$2,718.58 |
$6,796.45 |
0.5× |
| Wrist 2 views (73100) |
$140.58 |
$351.44 |
1.7× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$496.52 |
$1,241.29 |
5.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$294.96 |
$737.39 |
3.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$193.79 |
$484.47 |
2.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$961.96 |
$2,404.88 |
5.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$159.38 |
$398.44 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$193.31 |
$483.26 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$103.26 |
$258.14 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$108.42 |
$271.05 |
1.3× |
| X-ray exam of femur 1 (73551) |
$87.60 |
$218.99 |
1.1× |
| X-ray eye for foreign body (70030) |
$249.16 |
$622.88 |
3.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$234.35 |
$585.87 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$102.51 |
$256.27 |
1.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$190.46 |
$476.15 |
2.3× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$1,016.10 |
$2,540.25 |
0.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$145.42 |
$363.55 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$88.21 |
$220.52 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$237.87 |
$594.66 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$120.30 |
$300.73 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$69.67 |
$174.16 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$347.80 |
$869.50 |
3.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$417.36 |
$1,043.39 |
4.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$209.49 |
$523.71 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$168.36 |
$420.88 |
2.0× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$92.97 |
$232.42 |
1.1× |
| X-ray of voice box or throat (70370) |
$306.91 |
$767.27 |
3.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$188.10 |
$470.25 |
1.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$196.80 |
$491.99 |
2.0× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$357.82 |
$894.54 |
0.7× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$328.37 |
$820.92 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$188.44 |
$471.10 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$254.39 |
$635.97 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$305.81 |
$764.51 |
3.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$151.58 |
$378.93 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$188.30 |
$470.73 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$207.41 |
$518.51 |
2.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$270.94 |
$677.35 |
3.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$162.97 |
$407.42 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$280.59 |
$701.47 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$210.25 |
$525.61 |
2.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$63.60 |
$159 |
0.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$122.13 |
$305.31 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$198.10 |
$495.25 |
2.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$244.63 |
$611.56 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$269.09 |
$672.72 |
2.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$136.92 |
$342.29 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$191.06 |
$477.65 |
2.3× |
| Xr arthrogram ankle (73615) |
$600.74 |
$1,501.85 |
1.8× |
| Xr c-spine 6 or more views (72052) |
$299.58 |
$748.93 |
3.0× |
| Xr chest 4+ views (71048) |
$295.78 |
$739.46 |
3.0× |
| Xr Cholecystography Oral Contrast (74290) |
$278.17 |
$695.42 |
1.7× |
| Xr finger(s) 2+ views (73140) |
$142.22 |
$355.54 |
1.7× |
| Xr internal auditory meati complete (70134) |
$233.91 |
$584.77 |
0.4× |
| XR Mastoids < 3 Views Bilateral (70120) |
$173.76 |
$434.39 |
1.7× |
| Xr optic foramina (70190) |
$150.46 |
$376.15 |
1.8× |
| Xr shoulder 1 view (73020) |
$165.92 |
$414.80 |
2.0× |
| Xr spine cervical 4 or 5 views (72050) |
$272.34 |
$680.85 |
2.7× |
| Xr tibia/fibula 2 views (73590) |
$182.37 |
$455.91 |
2.2× |
| Xr tmj bilateral (70330) |
$119.11 |
$297.76 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$172.41 |
$431.02 |
2.1× |