| 3-D radiotherapy plan dose-volume histograms (77295) |
$5,754.60 |
$9,591 |
4.3× |
| Abdomen 2 views (74019) |
$295.80 |
$493 |
3.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,036.20 |
$1,727 |
2.7× |
| Angiography extremity bilateral rs&i (75716) |
$4,462.80 |
$7,438 |
1.5× |
| Angiography extremity unilateral rs&i (75710) |
$2,187.60 |
$3,646 |
0.7× |
| Angiography internal mammary rs&i (75756) |
$629.40 |
$1,049 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,420.40 |
$4,034 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$712.80 |
$1,188 |
0.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,546.80 |
$2,578 |
0.5× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,652.40 |
$2,754 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,364 |
$3,940 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$4,006.80 |
$6,678 |
1.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,276.20 |
$2,127 |
0.4× |
| Ankle 2 views (73600) |
$262.20 |
$437 |
3.2× |
| Antegrade urography radiological supvj & interpj (74425) |
$242.40 |
$404 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,355.60 |
$3,926 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,982 |
$4,970 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$2,188.80 |
$3,648 |
0.7× |
| Arthrogram elbow (73085) |
$730.20 |
$1,217 |
2.2× |
| Arthrogram hip (73525) |
$549.60 |
$916 |
1.6× |
| Arthrogram shoulder (73040) |
$670.20 |
$1,117 |
2.0× |
| Arthrogram wrist (73115) |
$1,873.80 |
$3,123 |
5.6× |
| Arthrography knee lt (73580) |
$583.20 |
$972 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$554.40 |
$924 |
4.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,365.60 |
$2,276 |
3.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$631.80 |
$1,053 |
1.7× |
| Bone &/joint imaging whole body (78306) |
$1,707 |
$2,845 |
4.5× |
| Bone age studies (77072) |
$98.40 |
$164 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$1,707 |
$2,845 |
4.5× |
| Bone Marrow Imaging Limited Area (78102) |
$697.20 |
$1,162 |
1.8× |
| Bone survey complete (77075) |
$596.40 |
$994 |
6.0× |
| Brachytx isodose complex (77318) |
$1,831.20 |
$3,052 |
5.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$527.40 |
$879 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,044.80 |
$3,408 |
1.5× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$26.40 |
$44 |
2.4× |
| Cervical spine 2 or 3 views (72040) |
$462 |
$770 |
5.6× |
| Chest 1 view (71045) |
$267.60 |
$446 |
3.2× |
| Chest 3 views (71047) |
$369.60 |
$616 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$397.20 |
$662 |
2.4× |
| Clavicle complete (73000) |
$297.60 |
$496 |
3.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$176.40 |
$294 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$780.60 |
$1,301 |
6.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,702.40 |
$9,504 |
17.1× |
| CT abdomen and pelvis without contrast (74176) |
$4,300.80 |
$7,168 |
18.9× |
| CT abdomen w contrast (74160) |
$2,109 |
$3,515 |
12.6× |
| CT abdomen w wo contrast (74170) |
$2,812.20 |
$4,687 |
16.8× |
| CT abdomen w/o contrast (74150) |
$1,800 |
$3,000 |
18.0× |
| CT angio hrt w/3d image (75574) |
$1,836.60 |
$3,061 |
5.5× |
| CT angiography upper extremity lt (73206) |
$1,784.40 |
$2,974 |
10.6× |
| CT c-spine w/o contrast (72125) |
$1,936.20 |
$3,227 |
19.4× |
| CT cervical spine w&w/o contrast (72127) |
$1,839.60 |
$3,066 |
11.0× |
| CT cervical spine with contrast (72126) |
$2,110.80 |
$3,518 |
6.3× |
| CT chest w/wo contrast (71270) |
$3,007.20 |
$5,012 |
17.9× |
| CT chest with contrast (71260) |
$2,293.80 |
$3,823 |
13.7× |
| CT head/brain with contrast (70460) |
$1,930.80 |
$3,218 |
11.5× |
| CT head/brain without and with contrast (70470) |
$2,925 |
$4,875 |
17.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$257.40 |
$429 |
0.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$110.40 |
$184 |
1.3× |
| CT iac w contrast (70481) |
$1,764.60 |
$2,941 |
10.5× |
| CT limited/localized follow up study (76380) |
$720 |
$1,200 |
8.7× |
| CT lower ext w/o (73700) |
$1,791.60 |
$2,986 |
17.9× |
| CT lower extremity w wo contrast (73702) |
$2,077.80 |
$3,463 |
12.4× |
| CT lower extremity with contrast (73701) |
$2,310.60 |
$3,851 |
13.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,082 |
$3,470 |
12.4× |
| CT lumbar spine w/o contrast (72131) |
$1,927.80 |
$3,213 |
19.3× |
| CT lumbar spine with contrast (72132) |
$2,120.40 |
$3,534 |
6.4× |
| CT maxillofacial w contrast (70487) |
$1,842.60 |
$3,071 |
11.0× |
| CT maxillofacial w/o contrast (70486) |
$1,486.20 |
$2,477 |
14.9× |
| CT maxillofacial w/wo contrast (70488) |
$2,674.80 |
$4,458 |
16.0× |
| CT neck soft tissue w contrast (70491) |
$2,285.40 |
$3,809 |
13.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,233.20 |
$3,722 |
13.3× |
| CT orbits w/o contrast (70480) |
$1,561.80 |
$2,603 |
15.6× |
| CT pelvis w & w/o contrast (72194) |
$2,268.60 |
$3,781 |
13.5× |
| CT pelvis w/o contrast (72192) |
$1,502.40 |
$2,504 |
15.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$3,222 |
$5,370 |
19.2× |
| CT soft tissue neck w/o contrast (70490) |
$2,170.80 |
$3,618 |
21.7× |
| CT thoracic spine w/contrast (72129) |
$1,978.80 |
$3,298 |
11.8× |
| CT thoracic spine w/o contrast (72128) |
$1,866.60 |
$3,111 |
18.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,034.60 |
$3,391 |
12.1× |
| CT thorax w/o contrast (71250) |
$1,927.80 |
$3,213 |
19.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,383 |
$2,305 |
8.2× |
| CT upper extremity w/o contrast rt (73200) |
$1,796.40 |
$2,994 |
18.0× |
| CT upper extremity with contrast (73201) |
$1,850.40 |
$3,084 |
5.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,513.40 |
$4,189 |
15.0× |
| Cta Abdomen (74175) |
$3,332.40 |
$5,554 |
19.9× |
| CTA abdomen pelvis (74174) |
$4,503 |
$7,505 |
13.5× |
| CTA chest (71275) |
$3,037.20 |
$5,062 |
18.1× |
| Cta Head (70496) |
$2,978.70 |
$4,964.50 |
17.8× |
| CTA lwr ext w&w/o contrast (73706) |
$2,266.20 |
$3,777 |
13.5× |
| Cta Neck (70498) |
$3,012.60 |
$5,021 |
18.0× |
| Cta Pelvis (72191) |
$2,233.20 |
$3,722 |
13.3× |
| Cystography minimum 3 views rs&i (74430) |
$609.60 |
$1,016 |
1.8× |
| Diskogram cervical (72285) |
$1,726.80 |
$2,878 |
0.9× |
| Diskography lumbar (72295) |
$1,726.80 |
$2,878 |
0.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$493.80 |
$823 |
4.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$172.80 |
$288 |
2.1× |
| Echoencephalography real time imaging (76506) |
$504.60 |
$841 |
5.0× |
| Esophagus (74220) |
$448.80 |
$748 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$545.40 |
$909 |
5.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$510 |
$850 |
5.1× |
| Fluoroscopy up to 1 hr (76000) |
$756 |
$1,260 |
3.3× |
| Foot 2 views (73620) |
$225.60 |
$376 |
2.7× |
| Forearm 2 views (73090) |
$240.60 |
$401 |
2.9× |
| Gated Heart Planar Single (78472) |
$1,536 |
$2,560 |
4.0× |
| Hand 2 views (73120) |
$246.60 |
$411 |
2.5× |
| Hand 3 views (73130) |
$403.80 |
$673 |
4.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$4,006.80 |
$6,678 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,813.80 |
$3,023 |
3.5× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,813.80 |
$3,023 |
4.7× |
| Ht muscle image spect sing (78451) |
$3,245.40 |
$5,409 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$285 |
$475 |
3.4× |
| Hysterosalpingogram (74740) |
$374.40 |
$624 |
1.6× |
| Image fusion (77399) |
$455.40 |
$759 |
3.5× |
| Interstitial radiation source applic complex (77778) |
$4,995.60 |
$8,326 |
7.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,999.80 |
$3,333 |
3.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,960.80 |
$3,268 |
3.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,255.20 |
$2,092 |
2.4× |
| Knee 3 views (73562) |
$371.40 |
$619 |
4.5× |
| Liver & spleen imaging static only (78215) |
$1,012.80 |
$1,688 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$1,533.60 |
$2,556 |
3.0× |
| Lung perfusion differential (78597) |
$1,090.80 |
$1,818 |
2.9× |
| Lung Ventilation Imaging (78579) |
$817.20 |
$1,362 |
2.1× |
| Lymphoscintigraphy (78195) |
$1,204.80 |
$2,008 |
2.3× |
| Mammary ductogram or galactogram single (77053) |
$390.60 |
$651 |
1.7× |
| Meckels Diverticulum (78290) |
$1,407.60 |
$2,346 |
3.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,723.40 |
$4,539 |
7.6× |
| Mr safety determination physician/other qhp (76016) |
$123.60 |
$206 |
1.5× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$83.40 |
$139 |
1.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$34.80 |
$58 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$129 |
$215 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$339 |
$565 |
1.5× |
| MRA head w & w/o contrast (70546) |
$3,705 |
$6,175 |
11.1× |
| MRA head w/o contrast (70544) |
$2,503.20 |
$4,172 |
11.0× |
| MRA head with contrast (70545) |
$3,404.40 |
$5,674 |
10.2× |
| MRA neck w contrast (70548) |
$2,303.40 |
$3,839 |
6.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,916 |
$4,860 |
8.7× |
| MRA neck w/o contrast (70547) |
$2,041.20 |
$3,402 |
9.0× |
| MRI abdomen w contrast (74182) |
$3,393.60 |
$5,656 |
10.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,992.40 |
$6,654 |
12.0× |
| MRI abdomen w/o contrast (74181) |
$2,794.80 |
$4,658 |
12.3× |
| MRI any jnt lwr ext with con lt (73722) |
$3,528.60 |
$5,881 |
4.7× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,297.60 |
$5,496 |
4.4× |
| MRI breast w/o contrast bilateral (77047) |
$2,558.40 |
$4,264 |
11.2× |
| MRI breast w/o contrast unilat (77046) |
$1,704 |
$2,840 |
7.5× |
| MRI c-spine with contrast (72142) |
$3,300 |
$5,500 |
9.9× |
| MRI cervical spine w/o contrast (72141) |
$2,973 |
$4,955 |
13.0× |
| MRI chest w/o & w/contrast material (71552) |
$2,953.80 |
$4,923 |
8.9× |
| MRI chest w/o contrast (71550) |
$1,983.60 |
$3,306 |
8.7× |
| MRI chest with contrast (71551) |
$1,001.40 |
$1,669 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$594 |
$990 |
1.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$645.60 |
$1,076 |
1.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,276.40 |
$3,794 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,408.40 |
$4,014 |
10.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,010.20 |
$5,017 |
9.0× |
| MRI orbit/face/neck w/contrast (70542) |
$541.80 |
$903 |
1.6× |
| MRI pelvis w contrast (72196) |
$618.60 |
$1,031 |
1.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,435.60 |
$5,726 |
10.3× |
| MRI pelvis w/o contrast (72195) |
$2,199 |
$3,665 |
9.6× |
| MRI scan of arm joint before and after contrast (73223) |
$3,796.80 |
$6,328 |
11.4× |
| MRI scan of leg joint before and after contrast (73723) |
$3,822.60 |
$6,371 |
11.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,864.60 |
$6,441 |
11.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,508.20 |
$5,847 |
10.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,924 |
$6,540 |
11.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,567.60 |
$5,946 |
10.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,924 |
$6,540 |
11.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,973 |
$4,955 |
13.0× |
| MRI tmj (70336) |
$1,931.40 |
$3,219 |
8.5× |
| MRI upper ext joint w/o contrast (73221) |
$2,771.40 |
$4,619 |
12.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,298.80 |
$5,498 |
9.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,210.40 |
$3,684 |
9.7× |
| Myelogram Cervical (72240) |
$1,001.40 |
$1,669 |
1.3× |
| Myelogram Lumbar (72265) |
$1,001.40 |
$1,669 |
1.3× |
| Myelogram thoracic (72255) |
$1,001.40 |
$1,669 |
1.3× |
| Myelography 2 or more regions (72270) |
$1,001.40 |
$1,669 |
1.3× |
| Myocardial Spect Multiple Studies (78452) |
$4,327.20 |
$7,212 |
3.5× |
| Neck soft tissue (70360) |
$237.60 |
$396 |
2.9× |
| Nm bone marrow multiple (78103) |
$527.40 |
$879 |
1.4× |
| Nm bone marrow wb (78104) |
$956.40 |
$1,594 |
2.5× |
| Nm cisternogram (78630) |
$629.40 |
$1,049 |
1.2× |
| Nm csf leak detection (78650) |
$1,190.40 |
$1,984 |
1.0× |
| Nm gastric emptying study (78264) |
$1,483.80 |
$2,473 |
3.9× |
| Nm gastroesophageal reflux study (78262) |
$527.40 |
$879 |
1.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,680.40 |
$11,134 |
5.0× |
| Nuclear Rx Oral Admin (79005) |
$808.20 |
$1,347 |
3.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$373.80 |
$623 |
3.7× |
| Osseous survey infant (77076) |
$148.80 |
$248 |
1.5× |
| Parathyroid imaging (78070) |
$796.80 |
$1,328 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$178.80 |
$298 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$4,951.80 |
$8,253 |
3.6× |
| PET imaging for CT attenuation whole body (78816) |
$4,951.80 |
$8,253 |
3.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,397.20 |
$5,662 |
10.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,006.80 |
$6,678 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$4,006.80 |
$6,678 |
1.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,066.20 |
$1,777 |
2.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,384.80 |
$2,308 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$457.20 |
$762 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$213 |
$355 |
2.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$266.40 |
$444 |
2.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$273.60 |
$456 |
2.7× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$240.60 |
$401 |
2.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$423.60 |
$706 |
4.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,179.20 |
$18,632 |
1.6× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$582 |
$970 |
1.1× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$548.40 |
$914 |
5.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$383.40 |
$639 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$353.40 |
$589 |
3.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$249 |
$415 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$330.60 |
$551 |
3.3× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$334.80 |
$558 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$514.80 |
$858 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$366.60 |
$611 |
2.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$780 |
$1,300 |
4.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$623.40 |
$1,039 |
3.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$236.40 |
$394 |
2.8× |
| Radiological examination surgical specimen (76098) |
$199.20 |
$332 |
0.4× |
| Radiopharm Dacryocystography (78660) |
$583.80 |
$973 |
1.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,199.60 |
$3,666 |
0.7× |
| Ribs bilateral 3 views (71110) |
$450 |
$750 |
4.5× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$831.60 |
$1,386 |
2.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,261.20 |
$2,102 |
2.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,385.40 |
$2,309 |
2.7× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,385.40 |
$2,309 |
1.1× |
| Rp Therapy Intravenous Administration (79101) |
$896.40 |
$1,494 |
4.0× |
| Sacroiliac Joints < 3 Views (72200) |
$220.20 |
$367 |
2.2× |
| Scanogram (77073) |
$286.20 |
$477 |
2.9× |
| Scapula complete (73010) |
$236.40 |
$394 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$64.20 |
$107 |
2.7× |
| Sialogram (70390) |
$372.60 |
$621 |
1.6× |
| Simulation intermediate (77285) |
$1,549.20 |
$2,582 |
4.3× |
| Small bowel series (74250) |
$478.80 |
$798 |
2.9× |
| Spec medical radj physics consltj (77370) |
$928.80 |
$1,548 |
7.2× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,236.60 |
$2,061 |
3.5× |
| Special dosimetry (77331) |
$515.40 |
$859 |
4.0× |
| Special treatment procedure (77470) |
$2,482.20 |
$4,137 |
4.7× |
| Spine thoracic 3 views (72072) |
$428.40 |
$714 |
4.3× |
| Stereotactic body radiation delivery (77373) |
$2,569.20 |
$4,282 |
1.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$3,751.80 |
$6,253 |
10.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,575.60 |
$2,626 |
4.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,011.80 |
$3,353 |
5.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,126.20 |
$1,877 |
8.8× |
| Therapeutic Enema (74283) |
$250.20 |
$417 |
1.5× |
| Thoracolumbar 2 views (72080) |
$384 |
$640 |
4.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,023.60 |
$1,706 |
2.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$741 |
$1,235 |
1.9× |
| Thyroid uptake measurement (78012) |
$527.40 |
$879 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,453.20 |
$2,422 |
3.8× |
| Tomogram (76100) |
$444 |
$740 |
4.4× |
| Treatment devices simple (77332) |
$677.40 |
$1,129 |
5.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,648.80 |
$2,748 |
3.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$831.60 |
$1,386 |
2.2× |
| Tx devices design & construction complex (77334) |
$1,504.80 |
$2,508 |
4.2× |
| Ultrasound, abdomen limited (76705) |
$745.80 |
$1,243 |
7.5× |
| Unlisted fluoroscopic procedure (76496) |
$113.40 |
$189 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$363 |
$605 |
4.4× |
| Upper Extremity Infant (73092) |
$157.80 |
$263 |
1.6× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$527.40 |
$879 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$322.20 |
$537 |
1.4× |
| Urethrocystography voiding (74455) |
$609.60 |
$1,016 |
2.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$446.40 |
$744 |
2.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$250.20 |
$417 |
1.5× |
| Us abdl aorta screen aaa (76706) |
$133.20 |
$222 |
1.3× |
| Us breast unilateral complete (76641) |
$652.20 |
$1,087 |
6.5× |
| Us breast unilateral limited (76642) |
$435 |
$725 |
5.2× |
| Us chest (76604) |
$337.80 |
$563 |
3.4× |
| Us compl joint r-t w/image documentation (76881) |
$492.60 |
$821 |
4.9× |
| Us elastography parenchyma (76981) |
$152.40 |
$254 |
1.5× |
| Us infant hips dynamic (76885) |
$484.20 |
$807 |
5.8× |
| Us infant hips limited static (76886) |
$111.60 |
$186 |
1.3× |
| Us kidney transplant (76776) |
$152.40 |
$254 |
1.5× |
| Us ob detailed single fetus (76811) |
$318.60 |
$531 |
1.4× |
| Us ob transvaginal (76817) |
$461.40 |
$769 |
4.6× |
| Us pelvic non ob complete (76856) |
$817.80 |
$1,363 |
8.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$450 |
$750 |
4.5× |
| Us pregnancy ltd (76815) |
$512.40 |
$854 |
5.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$441.60 |
$736 |
4.4× |
| Us retroperitoneal complete (76770) |
$622.20 |
$1,037 |
6.2× |
| Us retroperitoneal limited (76775) |
$591 |
$985 |
5.9× |
| Us scrotum and contents (76870) |
$638.40 |
$1,064 |
6.4× |
| Us soft tissue head/neck (76536) |
$627 |
$1,045 |
6.3× |
| Us spinal canal and contents (76800) |
$288.60 |
$481 |
2.9× |
| Us transrectal prostate volume (76873) |
$243.60 |
$406 |
2.4× |
| Us xtr non-vasc lmtd (76882) |
$421.20 |
$702 |
4.2× |
| Venogram extremity bilateral (75822) |
$2,064 |
$3,440 |
1.4× |
| Venography caval inferior serialography rs&i (75825) |
$2,130.60 |
$3,551 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$1,968 |
$3,280 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$1,002 |
$1,670 |
0.7× |
| Venography Renal Bilateral (75833) |
$4,006.80 |
$6,678 |
1.3× |
| Venography renal unilateral selective rs&i (75831) |
$1,959 |
$3,265 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,305 |
$2,175 |
0.4× |
| Wrist 2 views (73100) |
$257.40 |
$429 |
3.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$582 |
$970 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$353.40 |
$589 |
4.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$391.80 |
$653 |
4.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$819 |
$1,365 |
4.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$274.80 |
$458 |
3.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$343.20 |
$572 |
4.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$351.60 |
$586 |
3.5× |
| X-ray exam hip uni 1 view (73501) |
$183.60 |
$306 |
2.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$229.80 |
$383 |
2.8× |
| X-ray exam hip uni 4/> views (73503) |
$276 |
$460 |
2.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$328.80 |
$548 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$395.40 |
$659 |
4.0× |
| X-ray exam of femur 1 (73551) |
$189 |
$315 |
2.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$277.80 |
$463 |
1.7× |
| X-ray eye for foreign body (70030) |
$164.40 |
$274 |
2.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$398.40 |
$664 |
4.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$203.40 |
$339 |
2.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$363.60 |
$606 |
4.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$229.80 |
$383 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$134.40 |
$224 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$453.60 |
$756 |
4.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$208.20 |
$347 |
2.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$127.20 |
$212 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$391.20 |
$652 |
3.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$613.80 |
$1,023 |
6.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$430.20 |
$717 |
4.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$241.80 |
$403 |
2.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$156 |
$260 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$292.20 |
$487 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$235.80 |
$393 |
2.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$515.40 |
$859 |
1.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$404.40 |
$674 |
4.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$417 |
$695 |
4.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$533.40 |
$889 |
5.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$346.80 |
$578 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$333.60 |
$556 |
4.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$415.80 |
$693 |
5.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$442.80 |
$738 |
5.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$172.80 |
$288 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$606.60 |
$1,011 |
6.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$256.80 |
$428 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$208.20 |
$347 |
2.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$189 |
$315 |
2.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$210 |
$350 |
2.5× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$354 |
$590 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$460.80 |
$768 |
4.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$295.20 |
$492 |
3.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$402 |
$670 |
4.8× |
| Xr arthrogram ankle (73615) |
$567.60 |
$946 |
1.7× |
| Xr c-spine 6 or more views (72052) |
$799.80 |
$1,333 |
8.0× |
| Xr chest 4+ views (71048) |
$452.40 |
$754 |
4.5× |
| Xr Cholecystography Oral Contrast (74290) |
$271.80 |
$453 |
1.6× |
| Xr finger(s) 2+ views (73140) |
$323.40 |
$539 |
3.9× |
| Xr shoulder 1 view (73020) |
$274.20 |
$457 |
3.3× |
| Xr spine cervical 4 or 5 views (72050) |
$517.80 |
$863 |
5.2× |
| Xr tibia/fibula 2 views (73590) |
$256.20 |
$427 |
3.1× |
| Xr tmj bilateral (70330) |
$292.20 |
$487 |
3.5× |
| Xray knee 1 or 2 views rt (73560) |
$249 |
$415 |
3.0× |