| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,172.20 |
$5,287 |
2.3× |
| Abdomen 1 View (74018) |
$141 |
$235 |
1.6× |
| Abdomen 2 views (74019) |
$145.20 |
$242 |
1.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$456.60 |
$761 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$1,828.20 |
$3,047 |
0.6× |
| Angiography extremity unilateral rs&i (75710) |
$1,828.20 |
$3,047 |
0.6× |
| Ankle 2 views (73600) |
$370.20 |
$617 |
4.3× |
| Aortography thoracic serialography rs&i (75605) |
$2,918.40 |
$4,864 |
0.5× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$1,821.60 |
$3,036 |
0.3× |
Artery X-Rays Spine (75705)
likely a partial charge, not the full procedure |
$867.60 |
$1,446 |
0.2× |
| Arthrogram hip (73525) |
$751.80 |
$1,253 |
2.2× |
| Arthrogram Wrist (73115) |
$477.60 |
$796 |
1.4× |
| Basic radiation dosimetry calculation (77300) |
$313.20 |
$522 |
2.3× |
| Bone age studies (77072) |
$112.80 |
$188 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$2,289 |
$3,815 |
5.8× |
| Bone Imaging Limited Area (78300) |
$1,180.20 |
$1,967 |
3.0× |
| Bone Imaging Whole Body (78306) |
$1,788.60 |
$2,981 |
4.5× |
| Bone survey infant (77076) |
$552.60 |
$921 |
5.3× |
| Brain Image W/Flow < 4 Views (78601) |
$736.20 |
$1,227 |
1.8× |
| Cat Scan Follow-Up Study (76380) |
$628.80 |
$1,048 |
7.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,122 |
$1,870 |
2.1× |
| Cerebrospinal Fluid Scan (78630) |
$592.80 |
$988 |
1.1× |
| Chest 1 view (71045) |
$204.60 |
$341 |
2.4× |
| Chest 2 views (71046) |
$304.80 |
$508 |
3.5× |
| Chest 3 views (71047) |
$135 |
$225 |
1.6× |
| Chest 4 or more views (71048) |
$462 |
$770 |
4.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$439.20 |
$732 |
4.2× |
| Clavicle complete (73000) |
$270 |
$450 |
3.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$154.80 |
$258 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$417 |
$695 |
3.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,182.40 |
$5,304 |
1.0× |
| Contrast X-Ray Bladder (74430) |
$527.40 |
$879 |
1.5× |
| Contrast X-Ray Of Knee Joint (73580) |
$640.80 |
$1,068 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,028.40 |
$6,714 |
11.6× |
| CT abdomen and pelvis without contrast (74176) |
$2,503.80 |
$4,173 |
10.5× |
| CT abdomen w contrast (74160) |
$2,098.80 |
$3,498 |
12.0× |
| CT abdomen w wo contrast (74170) |
$2,469 |
$4,115 |
14.1× |
| CT abdomen w/o contrast (74150) |
$1,678.80 |
$2,798 |
16.1× |
| CT Angio Abdomen and Pelvis (74174) |
$4,131.60 |
$6,886 |
11.9× |
| CT Angio Chest (71275) |
$2,097.60 |
$3,496 |
12.0× |
| CT Angio Head (70496) |
$1,605 |
$2,675 |
9.2× |
| CT angio hrt w/3d image (75574) |
$1,613.40 |
$2,689 |
4.6× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,516.80 |
$2,528 |
8.7× |
| CT Angio Neck (70498) |
$2,268 |
$3,780 |
13.0× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,277.60 |
$3,796 |
13.0× |
| CT cervical spine w/ contrast (72126) |
$1,806.60 |
$3,011 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,434 |
$2,390 |
13.8× |
| CT cervical spine w/wo cont (72127) |
$2,552.40 |
$4,254 |
14.6× |
| CT chest w contrast (71260) |
$857.40 |
$1,429 |
4.9× |
| CT chest w/wo contrast (71270) |
$1,998 |
$3,330 |
11.4× |
| CT head/brain with contrast (70460) |
$1,461.60 |
$2,436 |
8.4× |
| CT head/brain without and with contrast (70470) |
$1,804.80 |
$3,008 |
10.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$355.80 |
$593 |
4.1× |
| CT iac w contrast (70481) |
$1,696.80 |
$2,828 |
9.7× |
| CT l-spine w&w/o contrast (72133) |
$3,082.80 |
$5,138 |
17.7× |
| CT lower ext w/o (73700) |
$1,053.60 |
$1,756 |
10.1× |
| CT lower extremity w/contrast material (73701) |
$1,559.40 |
$2,599 |
8.9× |
| CT lumbar spine w contrast (72132) |
$1,809 |
$3,015 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$1,447.20 |
$2,412 |
13.9× |
| CT maxillofacial w contrast (70487) |
$1,644 |
$2,740 |
9.4× |
| CT maxillofacial wo contrast (70486) |
$1,627.80 |
$2,713 |
15.6× |
| CT neck tissue combo (70492) |
$2,692.80 |
$4,488 |
15.4× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,002.20 |
$3,337 |
11.5× |
| CT orbits w/o contrast (70480) |
$1,527 |
$2,545 |
14.7× |
| CT pelvis w&w/o contrast (72194) |
$2,037.60 |
$3,396 |
11.7× |
| CT pelvis w/o contrast (72192) |
$1,386 |
$2,310 |
13.3× |
| CT scan of leg combo (73702) |
$1,275 |
$2,125 |
7.3× |
| CT scans face/jaw combo (70488) |
$2,002.20 |
$3,337 |
11.5× |
| CT soft tissue neck w contrast (70491) |
$2,225.40 |
$3,709 |
12.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,891.80 |
$3,153 |
18.2× |
| CT thoracic spine w contrast (72129) |
$1,806.60 |
$3,011 |
10.3× |
| CT thoracic spine w/o contrast (72128) |
$1,434 |
$2,390 |
13.8× |
| CT thoracic spine w/wo cont (72130) |
$1,506 |
$2,510 |
8.6× |
| CT thorax w/o contrast (71250) |
$1,209 |
$2,015 |
11.6× |
| CT upper ext wo (73200) |
$1,320 |
$2,200 |
12.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,599.80 |
$4,333 |
14.9× |
| CT upper extremity with contrast (73201) |
$1,887 |
$3,145 |
5.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,516.80 |
$2,528 |
8.7× |
| Cta Abdomen (74175) |
$2,313.60 |
$3,856 |
13.2× |
| Dilation ureters/urethra rs&i (74485) |
$300 |
$500 |
0.1× |
| Dxa Bone Density Axial (77080) |
$198.60 |
$331 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$222.60 |
$371 |
2.6× |
| Echo exam uterus (76831) |
$293.40 |
$489 |
1.2× |
| Echo Guide For Artery Repair (76936) |
$1,460.40 |
$2,434 |
6.8× |
| Esophagram (74220) |
$533.40 |
$889 |
3.1× |
| Fetal Biophys Profile W/Nst (76818) |
$321 |
$535 |
3.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$241.20 |
$402 |
2.3× |
| Fluoroscopy up to 1 hr (76000) |
$756 |
$1,260 |
3.2× |
| Foot 2 views (73620) |
$268.20 |
$447 |
3.1× |
| Forearm 2 views (73090) |
$280.20 |
$467 |
3.2× |
| Gastric emptying imaging study (78264) |
$1,316.40 |
$2,194 |
3.3× |
| Gated Heart Planar Single (78472) |
$1,303.80 |
$2,173 |
3.3× |
| Hand 2 views (73120) |
$271.80 |
$453 |
2.6× |
| Hepatobil Syst Image W/Drug (78227) |
$1,765.80 |
$2,943 |
3.3× |
| Hepatobiliary System Imaging (78226) |
$1,783.80 |
$2,973 |
4.5× |
| Ht Muscle Image Spect Sing (78451) |
$2,730 |
$4,550 |
2.1× |
| Hysterosalpingogram (74740) |
$435.60 |
$726 |
1.8× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$221.40 |
$369 |
2.6× |
| Infant hip ultrasound, limited static exam (76886) |
$264.60 |
$441 |
3.1× |
| K Flow/Funct Image Multiple (78709) |
$1,571.40 |
$2,619 |
2.9× |
| K Flow/Funct Image W/Drug (78708) |
$1,366.80 |
$2,278 |
2.5× |
| K Flow/Funct Image W/O Drug (78707) |
$1,230 |
$2,050 |
2.3× |
| Knee 3 Views (73562) |
$359.40 |
$599 |
4.1× |
| Liver imaging static only (78201) |
$798 |
$1,330 |
1.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$627 |
$1,045 |
1.2× |
| Lung perfusion differential (78597) |
$401.40 |
$669 |
1.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,338.60 |
$2,231 |
2.5× |
| Lung Ventilation Imaging (78579) |
$615.60 |
$1,026 |
1.5× |
| Lymph System Imaging (78195) |
$1,275 |
$2,125 |
2.4× |
| Mammary ductogram or galactogram multiple (77054) |
$679.80 |
$1,133 |
2.9× |
| Mammary ductogram or galactogram single (77053) |
$544.20 |
$907 |
2.3× |
| Meckels Divert Exam (78290) |
$895.80 |
$1,493 |
2.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$969 |
$1,615 |
2.6× |
| MRA head w/o contrast (70544) |
$2,031 |
$3,385 |
8.5× |
| MRA neck w contrast (70548) |
$1,777.20 |
$2,962 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,484.80 |
$5,808 |
10.0× |
| MRA neck w/o contrast (70547) |
$2,369.40 |
$3,949 |
10.0× |
| MRI abdomen w/o contrast (74181) |
$1,827 |
$3,045 |
7.7× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,556.60 |
$4,261 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,631.80 |
$6,053 |
10.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,272.60 |
$2,121 |
1.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$1,904.40 |
$3,174 |
8.0× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,342.20 |
$2,237 |
5.7× |
| MRI cervical spine w contrast (72142) |
$3,148.80 |
$5,248 |
9.1× |
| MRI cervical spine w/o cont (72141) |
$2,944.20 |
$4,907 |
12.4× |
| MRI chest w/o contrast (71550) |
$2,299.80 |
$3,833 |
9.7× |
| MRI chest wo w contrast (71552) |
$2,526.60 |
$4,211 |
7.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,980 |
$3,300 |
5.7× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,329.20 |
$3,882 |
6.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,863.60 |
$3,106 |
7.8× |
| MRI lumbar spine w contrast (72149) |
$2,823 |
$4,705 |
8.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,850.80 |
$6,418 |
11.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,024.40 |
$3,374 |
8.5× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,106.80 |
$5,178 |
8.9× |
| MRI pelvis w contrast (72196) |
$2,847 |
$4,745 |
8.2× |
| MRI pelvis w/o & w contrast (72197) |
$3,476.40 |
$5,794 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,232 |
$3,720 |
9.4× |
| MRI thoracic spine w/o contrast (72146) |
$2,693.40 |
$4,489 |
11.3× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,485.80 |
$4,143 |
7.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$994.20 |
$1,657 |
4.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,620.60 |
$2,701 |
4.7× |
| MRI, abdomen, combo (74183) |
$2,424.60 |
$4,041 |
7.0× |
| MRI, dorsal spine combo (72157) |
$3,741 |
$6,235 |
10.8× |
| MRI, dorsal spine contrast (72147) |
$3,255 |
$5,425 |
9.4× |
| MRI, joint upper extrem (73221) |
$1,097.40 |
$1,829 |
4.6× |
| MRI, joint upper extrem combo (73223) |
$1,371.60 |
$2,286 |
3.9× |
| MRI, lumbar spine combo (72158) |
$4,149.60 |
$6,916 |
11.9× |
| Myelogram Lumbar (72265) |
$697.80 |
$1,163 |
0.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,277.20 |
$5,462 |
2.5× |
| Myocardial Spect Multiple Studies (78452) |
$3,689.40 |
$6,149 |
2.9× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$3,119.40 |
$5,199 |
2.2× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,079.20 |
$5,132 |
2.2× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,051.20 |
$6,752 |
1.8× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$4,294.20 |
$7,157 |
2.0× |
| Neck soft tissue (70360) |
$314.40 |
$524 |
3.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,649.80 |
$6,083 |
2.6× |
| Nuclear Rx Oral Admin (79005) |
$551.40 |
$919 |
2.4× |
| Parathyroid Planar Imaging (78070) |
$778.80 |
$1,298 |
2.0× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,128 |
$1,880 |
2.8× |
| Pelvis 1 or 2 views (72170) |
$190.80 |
$318 |
1.8× |
| PET image w/CT, full body (78816) |
$3,625.80 |
$6,043 |
2.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,266.20 |
$3,777 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$843.60 |
$1,406 |
2.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$294.60 |
$491 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$277.20 |
$462 |
0.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$352.80 |
$588 |
4.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$174 |
$290 |
2.0× |
| Radex elbow complete minimum 3 views (73080) |
$337.20 |
$562 |
3.9× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$410.40 |
$684 |
3.9× |
| Radex fingr minimum 2 views (73140) |
$175.20 |
$292 |
2.0× |
| Radex foot complete minimum 3 views (73630) |
$279.60 |
$466 |
3.2× |
| Radex Hand Minimum 3 Views (73130) |
$316.20 |
$527 |
3.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$250.80 |
$418 |
2.9× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$364.20 |
$607 |
3.5× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$292.80 |
$488 |
3.4× |
| Radex Ribs Unilateral 2 Views (71100) |
$355.20 |
$592 |
4.1× |
| Radex shoulder complete minimum 2 views (73030) |
$373.80 |
$623 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$317.40 |
$529 |
3.7× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$950.40 |
$1,584 |
5.4× |
| Radex Spine 1 View Specify Level (72020) |
$261 |
$435 |
3.0× |
| Radex Sternum Minimum 2 Views (71120) |
$258.60 |
$431 |
3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$343.20 |
$572 |
4.0× |
| Radex Toe Minimum 2 Views (73660) |
$217.20 |
$362 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$250.80 |
$418 |
2.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$235.20 |
$392 |
2.7× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,626.80 |
$29,378 |
2.4× |
| Radiation treatment delivery level 3 (77412) |
$543.60 |
$906 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$251.40 |
$419 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$173.40 |
$289 |
1.7× |
| Radiologic exam colon double contrast study (74280) |
$876 |
$1,460 |
5.0× |
| Radiologic exam colon single contrast study (74270) |
$689.40 |
$1,149 |
3.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$448.20 |
$747 |
2.6× |
| Radiologic exam knee complete 4/more views (73564) |
$409.80 |
$683 |
3.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$198.60 |
$331 |
1.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$617.40 |
$1,029 |
3.5× |
| Radiologic exam swallow function contrast study (74230) |
$309 |
$515 |
1.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$462 |
$770 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$156.60 |
$261 |
1.8× |
| Radiologic examination femur minimum 2 views (73552) |
$186.60 |
$311 |
2.2× |
| Radiologic examination knee 1/2 views (73560) |
$319.80 |
$533 |
3.7× |
| Radiologic Examination Osseous Survey Limited (77074) |
$714.60 |
$1,191 |
6.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$299.40 |
$499 |
3.5× |
| Ribs bilateral 3 views (71110) |
$328.80 |
$548 |
3.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$565.20 |
$942 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,179.60 |
$1,966 |
3.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,168.40 |
$3,614 |
4.0× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,503.60 |
$2,506 |
2.8× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,494.60 |
$2,491 |
2.8× |
| Rp Therapy Intravenous Administration (79101) |
$956.40 |
$1,594 |
4.1× |
| Scapula (73010) |
$253.20 |
$422 |
2.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$88.80 |
$148 |
3.8× |
| Shoulder 1 view (73020) |
$384.60 |
$641 |
4.4× |
| Shoulder Arthrography (73040) |
$1,414.80 |
$2,358 |
4.1× |
| Sialogram (70390) |
$451.80 |
$753 |
1.9× |
| Skull less than 4 views (70250) |
$237.60 |
$396 |
2.3× |
| Special dosimetry (77331) |
$331.20 |
$552 |
2.5× |
| Special Physics Consult (77370) |
$588 |
$980 |
4.4× |
| Special teletherapy port plan (77321) |
$850.80 |
$1,418 |
2.3× |
| Special treatment procedure (77470) |
$1,487.40 |
$2,479 |
2.7× |
| Stereotactic Body Radiation Delivery (77373) |
$4,888.80 |
$8,148 |
2.7× |
| Sternoclavicular joints (71130) |
$309 |
$515 |
3.6× |
| Superior sagittal sinus venogram (75870) |
$879 |
$1,465 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$773.40 |
$1,289 |
2.1× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,134.60 |
$1,891 |
3.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$624 |
$1,040 |
4.7× |
| Thoracic spine 2 views (72070) |
$366.60 |
$611 |
3.5× |
| Thoracic spine 3 views (72072) |
$348 |
$580 |
3.3× |
| Thoracolumbar 2 views (72080) |
$328.80 |
$548 |
3.8× |
| Thyroid Met Imaging Body (78018) |
$1,341 |
$2,235 |
2.5× |
| Thyroid Uptake Measurement (78012) |
$396 |
$660 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$937.80 |
$1,563 |
2.4× |
| Tx Devices Design & Construction Complex (77334) |
$834.60 |
$1,391 |
2.2× |
| Tx devices design & construction intermediate (77333) |
$684.60 |
$1,141 |
5.1× |
| Tx devices design & construction simple (77332) |
$450.60 |
$751 |
3.4× |
| Ultrasound Breast Limited (76642) |
$343.20 |
$572 |
4.0× |
| Ultrasound elastography first target lesion (76982) |
$243 |
$405 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$292.80 |
$488 |
2.8× |
| Ultrasound Exam Aaa Screen (76706) |
$342.60 |
$571 |
3.3× |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
$403.20–$672.60 |
$672–$1,121 |
varies |
| Umbilical-artery Doppler (OB) (76820) |
$267 |
$445 |
2.6× |
| Upper gi w/o kub (74240) |
$616.80 |
$1,028 |
3.5× |
| Urethrocystogram voiding (74455) |
$527.40 |
$879 |
2.2× |
| Urethrocystography retrograde (74450) |
$527.40 |
$879 |
2.2× |
| Us breast unilateral complete (76641) |
$377.40 |
$629 |
3.6× |
| Us chest (76604) |
$340.20 |
$567 |
3.3× |
| Us complete joint (76881) |
$400.80 |
$668 |
3.9× |
| Us exam, pelvic, limited (76857) |
$449.40 |
$749 |
4.3× |
| Us head (76506) |
$235.80 |
$393 |
2.3× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$268.80 |
$448 |
2.6× |
| Us ob detailed single fetus (76811) |
$600 |
$1,000 |
2.5× |
Us ob limited 1 or more fetuses (76815)
range across 2 matching MRF lines |
$243.60–$375.60 |
$406–$626 |
varies |
| Us ob transvaginal (76817) |
$417.60 |
$696 |
4.0× |
| Us pelvic non ob complete (76856) |
$561.60 |
$936 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$468 |
$780 |
4.5× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$375.60 |
$626 |
3.6× |
| Us retroperitoneal complete (76770) |
$661.80 |
$1,103 |
6.4× |
| Us retroperitoneal limited (76775) |
$377.40 |
$629 |
3.6× |
| Us scrotum and contents (76870) |
$520.80 |
$868 |
5.0× |
| Us spinal canal and contents (76800) |
$273.60 |
$456 |
2.6× |
| Us thyroid (76536) |
$680.40 |
$1,134 |
6.5× |
| Vein X-Ray Chest (75827) |
$793.80 |
$1,323 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,584.60 |
$2,641 |
0.5× |
| Venography extremity bilateral rs&i (75822) |
$1,183.80 |
$1,973 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$962.40 |
$1,604 |
0.6× |
| Venography Renal Bilateral (75833) |
$1,584.60 |
$2,641 |
0.5× |
| Venography Renal Unilateral (75831) |
$1,584.60 |
$2,641 |
0.5× |
| Wrist 2 views (73100) |
$209.40 |
$349 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$305.40 |
$509 |
3.5× |
| X-ray antegrade pyelogram tube (74425) |
$846.60 |
$1,411 |
2.4× |
| X-Ray Aorta Leg Arteries (75630) |
$3,497.40 |
$5,829 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$624 |
$1,040 |
6.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$273 |
$455 |
3.2× |
| X-Ray Exam Breast Specimen (76098) |
$501.60 |
$836 |
0.9× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$297 |
$495 |
3.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$362.40 |
$604 |
3.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$550.80 |
$918 |
5.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$131.40 |
$219 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$131.40 |
$219 |
1.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$216.60 |
$361 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$216.60 |
$361 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$216.60 |
$361 |
2.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$412.80 |
$688 |
4.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$865.80 |
$1,443 |
8.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$439.80 |
$733 |
5.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$708 |
$1,180 |
6.8× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$382.20 |
$637 |
3.7× |
| X-ray eye for foreign body (70030) |
$151.20 |
$252 |
1.7× |
| X-ray humerus (73060) |
$237.60 |
$396 |
2.7× |
| X-ray IV pyelogram (ivp) (74400) |
$742.20 |
$1,237 |
4.3× |
| X-ray IV pyelogram+tomography (74415) |
$846.60 |
$1,411 |
4.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$213.60 |
$356 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$316.20 |
$527 |
3.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$371.40 |
$619 |
3.6× |
| X-ray nose-rectum child f.b. (76010) |
$259.80 |
$433 |
3.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$432 |
$720 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$271.20 |
$452 |
2.6× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$209.40 |
$349 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$279.60 |
$466 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$411.60 |
$686 |
4.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$330 |
$550 |
3.2× |
| X-ray thoracic spine 4 vw (72074) |
$410.40 |
$684 |
3.9× |
| X-Ray Tmj Unilat (70328) |
$214.20 |
$357 |
2.5× |
| X-Rays Bone Length Studies (77073) |
$159 |
$265 |
1.5× |
| X-Rays Bone Survey Complete (77075) |
$673.80 |
$1,123 |
6.5× |
| Xr c-spine 4 or 5 views (72050) |
$734.40 |
$1,224 |
7.1× |
| Xr facial bones less than 3 views (70140) |
$307.80 |
$513 |
3.6× |
| Xr orbits complete 4 views (70200) |
$174.60 |
$291 |
1.7× |