| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,172.20 |
$5,287 |
2.3× |
| 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× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$867.60 |
$1,446 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,821.60 |
$3,036 |
0.3× |
| Ankle 2 views (73600) |
$370.20 |
$617 |
4.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$846.60 |
$1,411 |
2.4× |
| Aortogram thoracic (75605) |
$2,918.40 |
$4,864 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,497.40 |
$5,829 |
1.1× |
| Aortography abdominal serialography rs&i (75625) |
$3,182.40 |
$5,304 |
1.0× |
| Arthrogram hip (73525) |
$751.80 |
$1,253 |
2.2× |
| Arthrogram shoulder (73040) |
$1,414.80 |
$2,358 |
4.1× |
| Arthrogram wrist (73115) |
$477.60 |
$796 |
1.4× |
| Arthrography knee lt (73580) |
$640.80 |
$1,068 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$313.20 |
$522 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,180.20 |
$1,967 |
3.0× |
| Bone &/joint imaging whole body (78306) |
$1,788.60 |
$2,981 |
4.5× |
| Bone age studies (77072) |
$112.80 |
$188 |
1.1× |
| Bone Imaging 3 Phase (78315) |
$2,289 |
$3,815 |
5.8× |
| Bone survey complete (77075) |
$673.80 |
$1,123 |
6.5× |
| Brain imaging < 4 static views w vascular flow (78601) |
$736.20 |
$1,227 |
1.8× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,122 |
$1,870 |
2.1× |
| Cervical spine 2 or 3 views (72040) |
$439.80 |
$733 |
5.1× |
| Chest 1 view (71045) |
$204.60 |
$341 |
2.4× |
| Chest 3 views (71047) |
$135 |
$225 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$309 |
$515 |
1.8× |
| Cineradiography/videoradiography (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× |
| 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 hrt w/3d image (75574) |
$1,613.40 |
$2,689 |
4.6× |
| CT angiography upper extremity lt (73206) |
$2,277.60 |
$3,796 |
13.0× |
| CT c-spine w/o contrast (72125) |
$1,434 |
$2,390 |
13.8× |
| CT cervical spine w&w/o contrast (72127) |
$2,552.40 |
$4,254 |
14.6× |
| CT cervical spine with contrast (72126) |
$1,806.60 |
$3,011 |
5.2× |
| CT chest w/wo contrast (71270) |
$1,998 |
$3,330 |
11.4× |
| CT chest with contrast (71260) |
$857.40 |
$1,429 |
4.9× |
| 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 limited/localized follow up study (76380) |
$628.80 |
$1,048 |
7.3× |
| CT lower ext w/o (73700) |
$1,053.60 |
$1,756 |
10.1× |
| CT lower extremity w wo contrast (73702) |
$1,275 |
$2,125 |
7.3× |
| CT lower extremity with contrast (73701) |
$1,559.40 |
$2,599 |
8.9× |
| CT lumbar spine w & w/o contrast (72133) |
$3,082.80 |
$5,138 |
17.7× |
| CT lumbar spine w/o contrast (72131) |
$1,447.20 |
$2,412 |
13.9× |
| CT lumbar spine with contrast (72132) |
$1,809 |
$3,015 |
5.2× |
| CT maxillofacial w contrast (70487) |
$1,644 |
$2,740 |
9.4× |
| CT maxillofacial w/o contrast (70486) |
$1,627.80 |
$2,713 |
15.6× |
| CT maxillofacial w/wo contrast (70488) |
$2,002.20 |
$3,337 |
11.5× |
| CT neck soft tissue w contrast (70491) |
$2,225.40 |
$3,709 |
12.7× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (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 soft tissue neck w/o & w/contrast material (70492) |
$2,692.80 |
$4,488 |
15.4× |
| 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 contrast (72130) |
$1,506 |
$2,510 |
8.6× |
| CT thorax w/o contrast (71250) |
$1,209 |
$2,015 |
11.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,599.80 |
$4,333 |
14.9× |
| CT upper extremity w/o contrast rt (73200) |
$1,320 |
$2,200 |
12.7× |
| 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× |
| CTA abdomen pelvis (74174) |
$4,131.60 |
$6,886 |
11.9× |
| CTA chest (71275) |
$2,097.60 |
$3,496 |
12.0× |
| Cta Head (70496) |
$1,605 |
$2,675 |
9.2× |
| CTA lwr ext w&w/o contrast (73706) |
$1,516.80 |
$2,528 |
8.7× |
| Cta Neck (70498) |
$2,268 |
$3,780 |
13.0× |
| Cystography minimum 3 views rs&i (74430) |
$527.40 |
$879 |
1.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$198.60 |
$331 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$222.60 |
$371 |
2.6× |
| Echoencephalography real time imaging (76506) |
$235.80 |
$393 |
2.3× |
| Esophagus (74220) |
$533.40 |
$889 |
3.1× |
| Fetal biophysical profile non-stress testing (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× |
| Gated Heart Planar Single (78472) |
$1,303.80 |
$2,173 |
3.3× |
| Hand 2 views (73120) |
$271.80 |
$453 |
2.6× |
| Hand 3 views (73130) |
$316.20 |
$527 |
3.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,765.80 |
$2,943 |
3.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,783.80 |
$2,973 |
4.5× |
| Ht muscle image spect sing (78451) |
$2,730 |
$4,550 |
2.1× |
| Humerus Min 2 Views Left (73060) |
$237.60 |
$396 |
2.7× |
| Hysterosalpingogram (74740) |
$435.60 |
$726 |
1.8× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,230 |
$2,050 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,366.80 |
$2,278 |
2.5× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,571.40 |
$2,619 |
2.9× |
| 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 Ventilation Imaging (78579) |
$615.60 |
$1,026 |
1.5× |
| Lymphoscintigraphy (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 Diverticulum (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 & w/contrast material (74183) |
$2,424.60 |
$4,041 |
7.0× |
| MRI abdomen w/o contrast (74181) |
$1,827 |
$3,045 |
7.7× |
| MRI any jnt lwr ext with con lt (73722) |
$2,556.60 |
$4,261 |
3.3× |
| 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 w/o contrast unilat (77046) |
$1,342.20 |
$2,237 |
5.7× |
| MRI c-spine with contrast (72142) |
$3,148.80 |
$5,248 |
9.1× |
| MRI cervical spine w/o contrast (72141) |
$2,944.20 |
$4,907 |
12.4× |
| MRI chest w/o & w/contrast material (71552) |
$2,526.60 |
$4,211 |
7.3× |
| MRI chest w/o contrast (71550) |
$2,299.80 |
$3,833 |
9.7× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,485.80 |
$4,143 |
7.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,980 |
$3,300 |
5.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,863.60 |
$3,106 |
7.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,024.40 |
$3,374 |
8.5× |
| MRI orbit/face/neck w&w/o cont (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 material (72197) |
$3,476.40 |
$5,794 |
10.0× |
| MRI pelvis w/o contrast (72195) |
$2,232 |
$3,720 |
9.4× |
| MRI scan of arm joint before and after contrast (73223) |
$1,371.60 |
$2,286 |
3.9× |
| MRI scan of leg joint before and after contrast (73723) |
$3,631.80 |
$6,053 |
10.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,850.80 |
$6,418 |
11.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,823 |
$4,705 |
8.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$4,149.60 |
$6,916 |
11.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,255 |
$5,425 |
9.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,741 |
$6,235 |
10.8× |
| MRI thoracic spine w/o contrast (72146) |
$2,693.40 |
$4,489 |
11.3× |
| MRI upper ext joint w/o contrast (73221) |
$1,097.40 |
$1,829 |
4.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,620.60 |
$2,701 |
4.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$994.20 |
$1,657 |
4.2× |
| 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× |
| Nm cisternogram (78630) |
$592.80 |
$988 |
1.1× |
| Nm gastric emptying study (78264) |
$1,316.40 |
$2,194 |
3.3× |
| 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× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$375.60 |
$626 |
3.6× |
| Osseous survey infant (77076) |
$552.60 |
$921 |
5.3× |
| Osseous survey limited (77074) |
$714.60 |
$1,191 |
6.9× |
| Parathyrd planar w/wo subtrj (78071) |
$1,128 |
$1,880 |
2.8× |
| Parathyroid imaging (78070) |
$778.80 |
$1,298 |
2.0× |
| Pelvis 1 or 2 views (72170) |
$190.80 |
$318 |
1.8× |
| PET image w/CT, skull-thigh (78815) |
$2,266.20 |
$3,777 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$3,625.80 |
$6,043 |
2.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,329.20 |
$3,882 |
6.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$843.60 |
$1,406 |
2.1× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,338.60 |
$2,231 |
2.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$277.20 |
$462 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$297 |
$495 |
3.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$362.40 |
$604 |
3.5× |
| Radex hips bilateral with pelvis 2 views (73521) |
$216.60 |
$361 |
2.1× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$364.20 |
$607 |
3.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$17,626.80 |
$29,378 |
2.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$543.60 |
$906 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$251.40 |
$419 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$141 |
$235 |
1.6× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$173.40 |
$289 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$304.80 |
$508 |
3.5× |
| 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 upr gi trc double contrast study (74246) |
$462 |
$770 |
2.6× |
| Radiologic exam upr gi trc single contrast study (74240) |
$616.80 |
$1,028 |
3.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$186.60 |
$311 |
2.2× |
| Radiological examination surgical specimen (76098) |
$501.60 |
$836 |
0.9× |
| Ribs bilateral 3 views (71110) |
$328.80 |
$548 |
3.2× |
| 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 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× |
| Sacroiliac Joints < 3 Views (72200) |
$209.40 |
$349 |
2.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$293.40 |
$489 |
1.2× |
| Scanogram (77073) |
$159 |
$265 |
1.5× |
| Scapula complete (73010) |
$253.20 |
$422 |
2.4× |
| Screening digital breast tomosynthesis (77063) |
$88.80 |
$148 |
3.8× |
| Sialogram (70390) |
$451.80 |
$753 |
1.9× |
| Small bowel series (74250) |
$617.40 |
$1,029 |
3.5× |
| Spec medical radj physics consltj (77370) |
$588 |
$980 |
4.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$850.80 |
$1,418 |
2.3× |
| Special dosimetry (77331) |
$331.20 |
$552 |
2.5× |
| Special treatment procedure (77470) |
$1,487.40 |
$2,479 |
2.7× |
| Spine thoracic 3 views (72072) |
$348 |
$580 |
3.3× |
| Stereotactic body radiation delivery (77373) |
$4,888.80 |
$8,148 |
2.7× |
| 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× |
| Thoracolumbar 2 views (72080) |
$328.80 |
$548 |
3.8× |
| Thyroid carcinoma metastases img whole 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× |
| Tmj unilateral (70328) |
$214.20 |
$357 |
2.5× |
| Treatment device intermediate (77333) |
$684.60 |
$1,141 |
5.1× |
| Treatment devices simple (77332) |
$450.60 |
$751 |
3.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,168.40 |
$3,614 |
4.0× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$565.20 |
$942 |
1.4× |
| Tx devices design & construction complex (77334) |
$834.60 |
$1,391 |
2.2× |
| Ultrasound elastography first target lesion (76982) |
$243 |
$405 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$537.90 |
$896.50 |
5.2× |
| Umbilical-artery Doppler (OB) (76820) |
$267 |
$445 |
2.6× |
| Upper Extremity Infant (73092) |
$250.80 |
$418 |
2.4× |
| Urethrocystography retrograde rs&i (74450) |
$527.40 |
$879 |
2.2× |
| Urethrocystography voiding (74455) |
$527.40 |
$879 |
2.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$742.20 |
$1,237 |
4.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$846.60 |
$1,411 |
4.8× |
| Us abdl aorta screen aaa (76706) |
$342.60 |
$571 |
3.3× |
| Us breast unilateral complete (76641) |
$377.40 |
$629 |
3.6× |
| Us breast unilateral limited (76642) |
$343.20 |
$572 |
4.0× |
| Us chest (76604) |
$340.20 |
$567 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$400.80 |
$668 |
3.9× |
| Us elastography parenchyma (76981) |
$292.80 |
$488 |
2.8× |
| Us guided compression repair (76936) |
$1,460.40 |
$2,434 |
6.8× |
| Us infant hips dynamic (76885) |
$221.40 |
$369 |
2.6× |
| Us infant hips limited static (76886) |
$264.60 |
$441 |
3.1× |
| Us ob detailed single fetus (76811) |
$600 |
$1,000 |
2.5× |
| Us ob transvaginal (76817) |
$417.60 |
$696 |
4.0× |
| Us pelvic non ob complete (76856) |
$561.60 |
$936 |
5.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$449.40 |
$749 |
4.3× |
| Us pregnancy ltd (76815) |
$309.60 |
$516 |
3.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$468 |
$780 |
4.5× |
| 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 soft tissue head/neck (76536) |
$680.40 |
$1,134 |
6.5× |
| Us spinal canal and contents (76800) |
$273.60 |
$456 |
2.6× |
| Us xtr non-vasc lmtd (76882) |
$268.80 |
$448 |
2.6× |
| Venogram extremity bilateral (75822) |
$1,183.80 |
$1,973 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$1,584.60 |
$2,641 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$793.80 |
$1,323 |
0.5× |
| 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 selective rs&i (75831) |
$1,584.60 |
$2,641 |
0.5× |
| Wrist 2 views (73100) |
$209.40 |
$349 |
2.4× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$294.60 |
$491 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$305.40 |
$509 |
3.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$352.80 |
$588 |
4.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$876 |
$1,460 |
5.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$273 |
$455 |
3.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$337.20 |
$562 |
3.9× |
| 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 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 of femur 1 (73551) |
$156.60 |
$261 |
1.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$950.40 |
$1,584 |
5.4× |
| X-ray eye for foreign body (70030) |
$151.20 |
$252 |
1.7× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$410.40 |
$684 |
3.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$307.80 |
$513 |
3.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$279.60 |
$466 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$300 |
$500 |
0.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$174 |
$290 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$213.60 |
$356 |
2.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$409.80 |
$683 |
3.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$316.20 |
$527 |
3.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$250.80 |
$418 |
2.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$371.40 |
$619 |
3.6× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$865.80 |
$1,443 |
8.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$624 |
$1,040 |
6.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$292.80 |
$488 |
3.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$259.80 |
$433 |
3.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$174.60 |
$291 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$198.60 |
$331 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$355.20 |
$592 |
4.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$382.20 |
$637 |
3.7× |
| 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 Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$279.60 |
$466 |
3.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$373.80 |
$623 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$411.60 |
$686 |
4.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$317.40 |
$529 |
3.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$330 |
$550 |
3.2× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$237.60 |
$396 |
2.3× |
| X-Ray Spine One View - Xr Spine (72020) |
$261 |
$435 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$309 |
$515 |
3.6× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$258.60 |
$431 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$366.60 |
$611 |
3.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$410.40 |
$684 |
3.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$217.20 |
$362 |
2.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$235.20 |
$392 |
2.7× |
| Xr c-spine 6 or more views (72052) |
$708 |
$1,180 |
6.8× |
| Xr chest 4+ views (71048) |
$462 |
$770 |
4.4× |
| Xr finger(s) 2+ views (73140) |
$175.20 |
$292 |
2.0× |
| Xr shoulder 1 view (73020) |
$384.60 |
$641 |
4.4× |
| Xr spine cervical 4 or 5 views (72050) |
$734.40 |
$1,224 |
7.1× |
| Xr tibia/fibula 2 views (73590) |
$299.40 |
$499 |
3.5× |
| Xr tmj bilateral (70330) |
$343.20 |
$572 |
4.0× |
| Xray knee 1 or 2 views rt (73560) |
$319.80 |
$533 |
3.7× |