| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,115.40 |
$6,859 |
3.0× |
| Abdomen 2 views (74019) |
$330 |
$550 |
3.2× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,079.40 |
$1,799 |
2.7× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$1,504.20 |
$2,507 |
0.5× |
| Angiography extremity bilateral rs&i (75716) |
$3,507 |
$5,845 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,438 |
$5,730 |
1.1× |
| Angiography internal mammary rs&i (75756) |
$734.40 |
$1,224 |
0.2× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$2,368.80 |
$3,948 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,261.40 |
$8,769 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,165.40 |
$3,609 |
0.7× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,111.80 |
$1,853 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,683.80 |
$4,473 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$478.80 |
$798 |
0.2× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,273.40 |
$3,789 |
0.7× |
| Ankle 2 views (73600) |
$267 |
$445 |
3.1× |
| Antegrade urography radiological supvj & interpj (74425) |
$538.80 |
$898 |
1.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,915.80 |
$3,193 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,912.60 |
$6,521 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$4,771.20 |
$7,952 |
1.5× |
| Artery X-Rays Adrenal Gland (75731) |
$1,023.60 |
$1,706 |
0.3× |
| Arthrogram elbow (73085) |
$378 |
$630 |
1.1× |
| Arthrogram hip (73525) |
$359.40 |
$599 |
1.0× |
| Arthrogram shoulder (73040) |
$828.60 |
$1,381 |
2.4× |
| Arthrogram wrist (73115) |
$456 |
$760 |
1.3× |
| Arthrography knee lt (73580) |
$318 |
$530 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$520.20 |
$867 |
3.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,075.20 |
$1,792 |
2.7× |
| Bone &/joint imaging whole body (78306) |
$1,581.60 |
$2,636 |
4.0× |
| Bone age studies (77072) |
$207.60 |
$346 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,502.40 |
$2,504 |
3.8× |
| Bone Marrow Imaging Limited Area (78102) |
$1,083.60 |
$1,806 |
2.7× |
| Bone survey complete (77075) |
$556.20 |
$927 |
5.4× |
| Brachytx isodose complex (77318) |
$1,497 |
$2,495 |
4.0× |
| Brachytx isodose intermed (77317) |
$1,272.60 |
$2,121 |
3.4× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,048.20 |
$1,747 |
2.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$390.60 |
$651 |
1.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,861.60 |
$6,436 |
2.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$957.60 |
$1,596 |
2.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,432.40 |
$4,054 |
7.0× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$988.20 |
$1,647 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$297 |
$495 |
3.4× |
| Chest 1 view (71045) |
$160.80 |
$268 |
1.9× |
| Chest 3 views (71047) |
$252 |
$420 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$246.60 |
$411 |
1.4× |
| Clavicle complete (73000) |
$255 |
$425 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,978.80 |
$3,298 |
19.1× |
| Continuing medical physics consltj pr wk (77336) |
$736.20 |
$1,227 |
5.5× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$259.20 |
$432 |
1.5× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,439.40 |
$7,399 |
12.8× |
| CT abdomen and pelvis without contrast (74176) |
$3,214.80 |
$5,358 |
13.6× |
| CT abdomen w contrast (74160) |
$1,904.40 |
$3,174 |
10.9× |
| CT abdomen w wo contrast (74170) |
$2,298 |
$3,830 |
13.2× |
| CT abdomen w/o contrast (74150) |
$1,516.20 |
$2,527 |
14.6× |
| CT angio hrt w/3d image (75574) |
$2,485.20 |
$4,142 |
7.2× |
| CT angiography upper extremity lt (73206) |
$2,835 |
$4,725 |
16.3× |
| CT c-spine w/o contrast (72125) |
$1,723.20 |
$2,872 |
16.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,239.80 |
$3,733 |
12.9× |
| CT cervical spine with contrast (72126) |
$2,188.20 |
$3,647 |
6.3× |
| CT chest w/wo contrast (71270) |
$2,071.20 |
$3,452 |
11.9× |
| CT chest with contrast (71260) |
$1,755 |
$2,925 |
10.1× |
| CT colonography screening (74263) |
$969.60 |
$1,616 |
4.1× |
| CT colonography w/dye (74262) |
$1,642.80 |
$2,738 |
9.4× |
| CT colonography w/o cntrst (74261) |
$1,217.40 |
$2,029 |
11.7× |
| CT head/brain with contrast (70460) |
$1,614 |
$2,690 |
9.3× |
| CT head/brain without and with contrast (70470) |
$1,953 |
$3,255 |
11.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,417.40 |
$4,029 |
7.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,883 |
$4,805 |
33.4× |
| CT hrt w/3d image congen (75573) |
$2,495.40 |
$4,159 |
7.2× |
| CT iac w contrast (70481) |
$1,764 |
$2,940 |
10.1× |
| CT limited/localized follow up study (76380) |
$1,020 |
$1,700 |
11.8× |
| CT lower ext w/o (73700) |
$1,506.60 |
$2,511 |
14.5× |
| CT lower extremity w wo contrast (73702) |
$2,541 |
$4,235 |
14.6× |
| CT lower extremity with contrast (73701) |
$1,943.40 |
$3,239 |
11.2× |
| CT lumbar spine w & w/o contrast (72133) |
$2,249.40 |
$3,749 |
12.9× |
| CT lumbar spine w/o contrast (72131) |
$1,573.20 |
$2,622 |
15.2× |
| CT lumbar spine with contrast (72132) |
$1,919.40 |
$3,199 |
5.5× |
| CT maxillofacial w contrast (70487) |
$1,856.40 |
$3,094 |
10.7× |
| CT maxillofacial w/o contrast (70486) |
$1,521.60 |
$2,536 |
14.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,099.40 |
$3,499 |
12.1× |
| CT neck soft tissue w contrast (70491) |
$1,849.20 |
$3,082 |
10.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,984.20 |
$3,307 |
11.4× |
| CT orbits w/o contrast (70480) |
$1,470 |
$2,450 |
14.2× |
| CT pelvis w & w/o contrast (72194) |
$1,856.40 |
$3,094 |
10.7× |
| CT pelvis w/o contrast (72192) |
$1,375.20 |
$2,292 |
13.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,126.40 |
$3,544 |
12.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,553.40 |
$2,589 |
15.0× |
| CT thoracic spine w/contrast (72129) |
$1,641 |
$2,735 |
9.4× |
| CT thoracic spine w/o contrast (72128) |
$1,345.20 |
$2,242 |
13.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,923.60 |
$3,206 |
11.1× |
| CT thorax w/o contrast (71250) |
$1,404 |
$2,340 |
13.5× |
| CT unlisted procedure (76497) |
$990 |
$1,650 |
11.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,623.20 |
$4,372 |
15.1× |
| CT upper extremity w/o contrast rt (73200) |
$1,760.40 |
$2,934 |
17.0× |
| CT upper extremity with contrast (73201) |
$2,413.20 |
$4,022 |
7.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,437.20 |
$4,062 |
14.0× |
| Cta Abdomen (74175) |
$2,435.40 |
$4,059 |
14.0× |
| CTA abdomen pelvis (74174) |
$4,416.60 |
$7,361 |
12.8× |
| CTA chest (71275) |
$2,324.40 |
$3,874 |
13.4× |
| Cta Head (70496) |
$2,512.80 |
$4,188 |
14.4× |
| CTA lwr ext w&w/o contrast (73706) |
$2,956.20 |
$4,927 |
17.0× |
| Cta Neck (70498) |
$2,382.60 |
$3,971 |
13.7× |
| Cta Pelvis (72191) |
$2,565 |
$4,275 |
14.7× |
| Cystography minimum 3 views rs&i (74430) |
$484.80 |
$808 |
1.4× |
| Dacryocystography (70170) |
$306.60 |
$511 |
1.3× |
| Diskography lumbar (72295) |
$1,825.20 |
$3,042 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$321 |
$535 |
3.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$321 |
$535 |
3.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$208.20 |
$347 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$546.60 |
$911 |
5.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$175.20 |
$292 |
2.0× |
| Echo exam of fetal heart (76825) |
$808.20 |
$1,347 |
1.5× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$541.20 |
$902 |
2.3× |
| Echoencephalography real time imaging (76506) |
$478.20 |
$797 |
4.6× |
| Esophagus (74220) |
$469.20 |
$782 |
2.7× |
| Fetal biophysical profile non-stress testing (76818) |
$465 |
$775 |
4.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$378 |
$630 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$573.60 |
$956 |
2.4× |
| Foot 2 views (73620) |
$319.80 |
$533 |
3.7× |
| Forearm 2 views (73090) |
$227.40 |
$379 |
2.6× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$306 |
$510 |
1.3× |
| Functional MRI brain by phys/psych (70555) |
$1,876.80 |
$3,128 |
7.9× |
| Functional MRI brain by tech (70554) |
$1,507.20 |
$2,512 |
6.4× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,745.40 |
$2,909 |
3.2× |
| Gated Heart Planar Single (78472) |
$1,514.40 |
$2,524 |
3.8× |
| Hand 2 views (73120) |
$258.60 |
$431 |
2.5× |
| Hand 3 views (73130) |
$236.40 |
$394 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,294.40 |
$3,824 |
3.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,637.60 |
$4,396 |
3.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,637.60 |
$4,396 |
3.8× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,338.60 |
$2,231 |
0.4× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,639.80 |
$2,733 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,454.40 |
$2,424 |
3.7× |
| Ht muscle image spect sing (78451) |
$2,353.80 |
$3,923 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$264 |
$440 |
3.1× |
| Hysterosalpingogram (74740) |
$663 |
$1,105 |
2.8× |
| Interstitial radiation source applic complex (77778) |
$1,799.40 |
$2,999 |
2.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,598.40 |
$2,664 |
2.3× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,539 |
$2,565 |
2.8× |
| Intracavitary radiation source applic simple (77761) |
$1,474.80 |
$2,458 |
2.7× |
Io rad tx deliver by elctrns (77425)
likely a partial charge, not the full procedure |
$1,081.80 |
$1,803 |
0.1× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$132.60 |
$221 |
1.3× |
| Kidney funcj study non-img radioisotopic study (78725) |
$757.80 |
$1,263 |
1.9× |
| Kidney imaging morphology (78700) |
$1,138.80 |
$1,898 |
2.9× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,237.20 |
$2,062 |
2.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,963.80 |
$3,273 |
3.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$1,963.80 |
$3,273 |
3.6× |
| Knee 3 views (73562) |
$222.60 |
$371 |
2.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,333.20 |
$2,222 |
3.4× |
| Lung perf&ventilat diferentl (78598) |
$1,275 |
$2,125 |
2.4× |
| Lung perfusion differential (78597) |
$973.20 |
$1,622 |
2.5× |
| Lung Ventilation Imaging (78579) |
$790.80 |
$1,318 |
2.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$294.60 |
$491 |
0.1× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$256.20 |
$427 |
0.4× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$280.20 |
$467 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$368.40 |
$614 |
0.1× |
| Lymphoscintigraphy (78195) |
$1,569.60 |
$2,616 |
2.9× |
| Mammary ductogram or galactogram multiple (77054) |
$276 |
$460 |
1.2× |
| Mammary ductogram or galactogram single (77053) |
$276 |
$460 |
1.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$60 |
$100 |
0.7× |
| Meckels Diverticulum (78290) |
$966 |
$1,610 |
2.4× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,557.60 |
$7,596 |
12.3× |
| Mr elastography (76391) |
$634.80 |
$1,058 |
2.7× |
| Mr safety determination physician/other qhp (76016) |
$158.40 |
$264 |
1.8× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$71.40 |
$119 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$44.40 |
$74 |
1.5× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$165 |
$275 |
1.8× |
| Mr safety med physics xm customization plng&mntr (76017) |
$435 |
$725 |
1.8× |
| MRA head w & w/o contrast (70546) |
$3,246 |
$5,410 |
9.4× |
| MRA head w/o contrast (70544) |
$2,080.80 |
$3,468 |
8.8× |
| MRA head with contrast (70545) |
$2,205.60 |
$3,676 |
6.4× |
| MRA neck w contrast (70548) |
$2,189.40 |
$3,649 |
6.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,999.40 |
$4,999 |
8.7× |
| MRA neck w/o contrast (70547) |
$1,949.40 |
$3,249 |
8.2× |
| MRI abdomen w contrast (74182) |
$2,732.40 |
$4,554 |
7.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,140.40 |
$5,234 |
9.1× |
| MRI abdomen w/o contrast (74181) |
$2,544 |
$4,240 |
10.8× |
| MRI any jnt lwr ext with con lt (73722) |
$2,249.40 |
$3,749 |
2.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,437.80 |
$4,063 |
3.1× |
| MRI bone marrow blood supply (77084) |
$938.40 |
$1,564 |
4.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,192.20 |
$1,987 |
5.0× |
| MRI breast w/o contrast unilat (77046) |
$1,440 |
$2,400 |
6.1× |
| MRI c-spine with contrast (72142) |
$2,511 |
$4,185 |
7.3× |
| MRI cardiac w/o cont stress (75559) |
$2,262 |
$3,770 |
4.2× |
| MRI cardiac w/o contrast (75557) |
$1,945.80 |
$3,243 |
8.2× |
| MRI cervical spine w/o contrast (72141) |
$2,414.40 |
$4,024 |
10.2× |
| MRI chest w/o & w/contrast material (71552) |
$3,676.20 |
$6,127 |
10.6× |
| MRI chest w/o contrast (71550) |
$1,645.80 |
$2,743 |
7.0× |
| MRI chest with contrast (71551) |
$3,041.40 |
$5,069 |
3.9× |
| MRI fetal sngl/1st gestation (74712) |
$1,557.60 |
$2,596 |
6.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,290.20 |
$3,817 |
6.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,367.60 |
$3,946 |
6.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,224.80 |
$3,708 |
9.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,547 |
$4,245 |
10.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,351.60 |
$5,586 |
9.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,815.20 |
$4,692 |
8.1× |
| MRI pelvis w contrast (72196) |
$3,136.20 |
$5,227 |
9.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,232.80 |
$5,388 |
9.3× |
| MRI pelvis w/o contrast (72195) |
$2,075.40 |
$3,459 |
8.8× |
| MRI scan of arm joint before and after contrast (73223) |
$2,812.80 |
$4,688 |
8.1× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$2,529.60 |
$4,216 |
3.3× |
| MRI scan of leg joint before and after contrast (73723) |
$3,087 |
$5,145 |
8.9× |
| MRI spectroscopy (76390) |
$1,534.80 |
$2,558 |
17.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,062.40 |
$5,104 |
8.9× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,451.60 |
$4,086 |
7.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,276 |
$5,460 |
9.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,593.20 |
$4,322 |
7.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,947.20 |
$4,912 |
8.5× |
| MRI thoracic spine w/o contrast (72146) |
$2,109.60 |
$3,516 |
8.9× |
| MRI tmj (70336) |
$1,687.80 |
$2,813 |
7.1× |
| MRI upper ext joint w/o contrast (73221) |
$2,083.20 |
$3,472 |
8.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,094.80 |
$5,158 |
8.9× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,166 |
$3,610 |
9.2× |
| Myelogram Cervical (72240) |
$564.60 |
$941 |
0.7× |
| Myelogram Lumbar (72265) |
$400.80 |
$668 |
0.5× |
| Myelogram thoracic (72255) |
$487.80 |
$813 |
0.6× |
| Myelography 2 or more regions (72270) |
$523.80 |
$873 |
0.7× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,592.60 |
$4,321 |
2.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,906.40 |
$4,844 |
2.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$3,321 |
$5,535 |
2.3× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,976 |
$4,960 |
2.1× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$4,312.80 |
$7,188 |
2.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$6,383.40 |
$10,639 |
2.9× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,605.20 |
$4,342 |
3.1× |
| Neck soft tissue (70360) |
$217.20 |
$362 |
2.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$76.20 |
$127 |
0.2× |
| Nm bone marrow multiple (78103) |
$1,114.20 |
$1,857 |
2.8× |
| Nm bone marrow wb (78104) |
$1,131 |
$1,885 |
2.9× |
| Nm cisternogram (78630) |
$973.80 |
$1,623 |
1.8× |
| Nm csf leak detection (78650) |
$778.80 |
$1,298 |
0.6× |
| Nm gastric emptying study (78264) |
$1,347 |
$2,245 |
3.4× |
| Nm gastroesophageal reflux study (78262) |
$836.40 |
$1,394 |
2.1× |
| Nm peritoneal-venous shunt patency (78291) |
$391.80 |
$653 |
1.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,362.60 |
$7,271 |
3.2× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$2,739.60 |
$4,566 |
1.9× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,922.60 |
$4,871 |
2.1× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,890 |
$3,150 |
1.3× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,315.80 |
$2,193 |
3.3× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$917.40 |
$1,529 |
2.3× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,745.40 |
$2,909 |
4.4× |
| Nuclear Rx Oral Admin (79005) |
$1,148.40 |
$1,914 |
5.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$256.20 |
$427 |
2.5× |
| Orthopantogram (70355) |
$163.20 |
$272 |
1.9× |
| Osseous survey infant (77076) |
$183.60 |
$306 |
1.8× |
| Osseous survey limited (77074) |
$160.80 |
$268 |
1.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,534.20 |
$2,557 |
2.8× |
| Parathyrd planar w/wo subtrj (78071) |
$1,365.60 |
$2,276 |
3.4× |
| Parathyroid imaging (78070) |
$896.40 |
$1,494 |
2.3× |
| Pelvis 1 or 2 views (72170) |
$204.60 |
$341 |
2.0× |
| Peritoneogram rs&i (74190) |
$345 |
$575 |
0.6× |
| PET image w/CT, skull-thigh (78815) |
$3,894.60 |
$6,491 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$1,986.60 |
$3,311 |
1.4× |
| PET imaging for CT attenuation whole body (78816) |
$3,690 |
$6,150 |
2.6× |
| PET imaging limited area chest head/neck (78811) |
$1,524.60 |
$2,541 |
1.2× |
| PET whole body (78813) |
$3,127.20 |
$5,212 |
2.2× |
| Pr heart first pass single,planar (78481) |
$798 |
$1,330 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,199.20 |
$5,332 |
9.2× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,434.60 |
$2,391 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,010.40 |
$1,684 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$954.60 |
$1,591 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,491.60 |
$2,486 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$309.60 |
$516 |
0.6× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$375.60 |
$626 |
4.4× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$487.20 |
$812 |
4.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$456 |
$760 |
4.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$104.40 |
$174 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$624 |
$1,040 |
6.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$16,691.40 |
$27,819 |
2.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$859.80 |
$1,433 |
1.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$533.40 |
$889 |
5.3× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$697.80 |
$1,163 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$327 |
$545 |
3.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$257.10 |
$428.50 |
3.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$324.60 |
$541 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$225 |
$375 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$550.80 |
$918 |
3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$475.80 |
$793 |
2.7× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$229.20 |
$382 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$361.20 |
$602 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$378.60 |
$631 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$259.20 |
$432 |
3.0× |
| Radiological examination surgical specimen (76098) |
$723.60 |
$1,206 |
1.3× |
| Radiopharm Dacryocystography (78660) |
$279 |
$465 |
0.7× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$348 |
$580 |
1.5× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,403.40 |
$2,339 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,848.80 |
$4,748 |
0.9× |
| Ribs bilateral 3 views (71110) |
$655.20 |
$1,092 |
6.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,802.60 |
$4,671 |
5.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,371.80 |
$3,953 |
4.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,155.80 |
$3,593 |
1.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,155.80 |
$3,593 |
1.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,155.80 |
$3,593 |
1.7× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,537.20 |
$2,562 |
6.6× |
| Rp therapy intra-arterial particulate admn (79445) |
$793.80 |
$1,323 |
3.4× |
| Rp Therapy Intravenous Administration (79101) |
$1,449.60 |
$2,416 |
6.3× |
| Sacroiliac Joints < 3 Views (72200) |
$179.40 |
$299 |
1.7× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$453.60 |
$756 |
1.9× |
| Salivary gland imaging (78230) |
$208.20 |
$347 |
0.5× |
| Scanogram (77073) |
$411 |
$685 |
4.0× |
| Scapula complete (73010) |
$229.20 |
$382 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$83.40 |
$139 |
3.6× |
| Sella turcica (70240) |
$87.60 |
$146 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$179.40 |
$299 |
1.7× |
| Simulation intermediate (77285) |
$1,054.20 |
$1,757 |
2.8× |
| Small bowel series (74250) |
$613.20 |
$1,022 |
3.5× |
| Spec medical radj physics consltj (77370) |
$1,068 |
$1,780 |
8.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,693.20 |
$2,822 |
4.6× |
| Special dosimetry (77331) |
$626.40 |
$1,044 |
4.7× |
| Special treatment procedure (77470) |
$2,833.80 |
$4,723 |
5.2× |
| Speech evaluation complex (70371) |
$354.60 |
$591 |
1.5× |
| Spine thoracic 3 views (72072) |
$196.80 |
$328 |
1.9× |
| Spleen imaging only (78185) |
$368.40 |
$614 |
0.9× |
| Splenoportograpy rs&i (75810) |
$676.80 |
$1,128 |
0.2× |
| Stereotactic body radiation delivery (77373) |
$5,150.40 |
$8,584 |
2.9× |
| Superior sagittal sinus venogram (75870) |
$684 |
$1,140 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$189.60 |
$316 |
1.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,607.40 |
$2,679 |
4.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,382.40 |
$2,304 |
3.7× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$303 |
$505 |
1.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,151.60 |
$3,586 |
5.8× |
| Ther rad simulaj-aided field setting simple (77280) |
$860.40 |
$1,434 |
6.5× |
| Therapeutic Enema (74283) |
$415.80 |
$693 |
2.4× |
| Thoracolumbar 2 views (72080) |
$338.40 |
$564 |
3.9× |
| Thyroid carcinoma metastases img addl study (78016) |
$458.40 |
$764 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,834.20 |
$3,057 |
3.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$896.40 |
$1,494 |
2.3× |
| Thyroid uptake measurement (78012) |
$530.40 |
$884 |
1.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,545 |
$2,575 |
3.9× |
| Treatment device intermediate (77333) |
$945 |
$1,575 |
7.1× |
| Treatment devices simple (77332) |
$592.20 |
$987 |
4.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,737.80 |
$4,563 |
5.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,767.60 |
$2,946 |
4.5× |
| Tx devices design & construction complex (77334) |
$1,138.20 |
$1,897 |
3.1× |
| Ultrasound elastography first target lesion (76982) |
$296.40 |
$494 |
2.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$456 |
$760 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$561.60 |
$936 |
5.4× |
| Umbilical-artery Doppler (OB) (76820) |
$399 |
$665 |
3.8× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$529.80 |
$883 |
6.1× |
| Unlisted fluoroscopic procedure (76496) |
$94.20 |
$157 |
1.1× |
| Unlisted magnetic resonance procedure (76498) |
$1,468.20 |
$2,447 |
17.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$1,524.60 |
$2,541 |
3.8× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,249.80 |
$2,083 |
12.4× |
| Upper Extremity Infant (73092) |
$178.80 |
$298 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$777 |
$1,295 |
2.0× |
| Urethrocystography retrograde rs&i (74450) |
$381.60 |
$636 |
1.6× |
| Urethrocystography voiding (74455) |
$625.20 |
$1,042 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$975 |
$1,625 |
5.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$1,050.60 |
$1,751 |
6.0× |
| Us abdl aorta screen aaa (76706) |
$75 |
$125 |
0.7× |
| Us breast unilateral complete (76641) |
$274.80 |
$458 |
2.7× |
| Us breast unilateral limited (76642) |
$295.20 |
$492 |
3.4× |
| Us chest (76604) |
$344.40 |
$574 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$711 |
$1,185 |
6.9× |
| Us elastography parenchyma (76981) |
$296.40 |
$494 |
2.9× |
| Us fetal nuchal translucency 1st gestation (76813) |
$168.60 |
$281 |
1.6× |
| Us infant hips dynamic (76885) |
$315 |
$525 |
3.7× |
| Us infant hips limited static (76886) |
$176.40 |
$294 |
2.0× |
| Us kidney transplant (76776) |
$768 |
$1,280 |
7.4× |
| Us ob detailed single fetus (76811) |
$576.60 |
$961 |
2.4× |
| Us ob transvaginal (76817) |
$501 |
$835 |
4.8× |
| Us pelvic non ob complete (76856) |
$622.20 |
$1,037 |
6.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$493.80 |
$823 |
4.8× |
| Us pregnancy ltd (76815) |
$382.20 |
$637 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$454.80 |
$758 |
4.4× |
| Us retroperitoneal complete (76770) |
$652.20 |
$1,087 |
6.3× |
| Us retroperitoneal limited (76775) |
$469.20 |
$782 |
4.5× |
| Us scrotum and contents (76870) |
$551.40 |
$919 |
5.3× |
| Us soft tissue head/neck (76536) |
$536.40 |
$894 |
5.2× |
| Us spinal canal and contents (76800) |
$202.20 |
$337 |
2.0× |
| Us transrectal (76872) |
$643.80 |
$1,073 |
6.2× |
| Us xtr non-vasc lmtd (76882) |
$458.40 |
$764 |
4.4× |
| Us, eye b-scan (76512) |
$101.40 |
$169 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,160.40 |
$1,934 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$1,210.80 |
$2,018 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$1,261.20 |
$2,102 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$975 |
$1,625 |
0.6× |
| Venography Renal Bilateral (75833) |
$2,838 |
$4,730 |
0.9× |
| Venography renal unilateral selective rs&i (75831) |
$2,580 |
$4,300 |
0.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$684 |
$1,140 |
0.2× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$2,212.20 |
$3,687 |
0.4× |
| Wrist 2 views (73100) |
$224.40 |
$374 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$450 |
$750 |
4.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$313.20 |
$522 |
3.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$277.80 |
$463 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$732.60 |
$1,221 |
4.2× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$244.20 |
$407 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$265.20 |
$442 |
3.1× |
| X-ray exam entire spi 4/5 vw (72083) |
$520.80 |
$868 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$281.40 |
$469 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$296.40 |
$494 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$316.80 |
$528 |
3.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$444 |
$740 |
4.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$648.60 |
$1,081 |
6.3× |
| X-ray exam of femur 1 (73551) |
$137.40 |
$229 |
1.6× |
| X-ray eye for foreign body (70030) |
$194.40 |
$324 |
2.3× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$360.60 |
$601 |
3.5× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$291.60 |
$486 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$277.80 |
$463 |
3.2× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$402.60 |
$671 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$240.60 |
$401 |
2.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$238.80 |
$398 |
2.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$289.20 |
$482 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$190.80 |
$318 |
2.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$130.80 |
$218 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$295.20 |
$492 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$526.20 |
$877 |
5.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$351.60 |
$586 |
3.4× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$236.40 |
$394 |
2.7× |
| X-ray of voice box or throat (70370) |
$76.20 |
$127 |
0.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$300 |
$500 |
2.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$323.40 |
$539 |
3.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$214.80 |
$358 |
0.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,217.40 |
$2,029 |
3.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$289.80 |
$483 |
3.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$350.40 |
$584 |
3.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$350.40 |
$584 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$221.40 |
$369 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$220.80 |
$368 |
2.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$277.20 |
$462 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$351.60 |
$586 |
4.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$214.20 |
$357 |
2.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402.60 |
$671 |
3.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$300.60 |
$501 |
2.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$265.20 |
$442 |
3.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$184.80 |
$308 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$231 |
$385 |
2.7× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$114 |
$190 |
1.3× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$262.20 |
$437 |
2.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$330 |
$550 |
3.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$194.40 |
$324 |
2.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$208.20 |
$347 |
2.4× |
| Xr c-spine 6 or more views (72052) |
$558.60 |
$931 |
5.4× |
| Xr chest 4+ views (71048) |
$201 |
$335 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$165.60 |
$276 |
1.9× |
| Xr shoulder 1 view (73020) |
$274.20 |
$457 |
3.2× |
| Xr spine cervical 4 or 5 views (72050) |
$396 |
$660 |
3.8× |
| Xr tibia/fibula 2 views (73590) |
$212.40 |
$354 |
2.5× |
| Xr tmj bilateral (70330) |
$163.20 |
$272 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$257.40 |
$429 |
3.0× |