| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,038.60 |
$6,731 |
2.9× |
| Abdomen 2 views (74019) |
$330 |
$550 |
3.1× |
| Acute gastrointestinal blood loss imaging (78278) |
$625.20 |
$1,042 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$2,423.40 |
$4,039 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,405.80 |
$2,343 |
0.4× |
| Angiography internal mammary rs&i (75756) |
$1,831.80 |
$3,053 |
0.6× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,166.40 |
$1,944 |
0.2× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,708.40 |
$4,514 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,708.40 |
$4,514 |
0.8× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$472.80 |
$788 |
0.1× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,002.80 |
$3,338 |
0.4× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$825.60 |
$1,376 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,708.40 |
$4,514 |
0.8× |
| Ankle 2 views (73600) |
$267 |
$445 |
3.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$322.20 |
$537 |
0.9× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,252.80 |
$2,088 |
0.2× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,146.20 |
$3,577 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,787 |
$4,645 |
0.9× |
| Artery X-Rays Adrenal Gland (75731) |
$2,158.80 |
$3,598 |
0.7× |
| Arthrogram elbow (73085) |
$292.20 |
$487 |
0.8× |
| Arthrogram hip (73525) |
$504.60 |
$841 |
1.4× |
| Arthrogram shoulder (73040) |
$762.60 |
$1,271 |
2.2× |
| Arthrogram wrist (73115) |
$391.80 |
$653 |
1.1× |
| Arthrography knee lt (73580) |
$228 |
$380 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$439.80 |
$733 |
3.2× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,070.40 |
$1,784 |
2.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,581.60 |
$2,636 |
3.9× |
| Bone &/joint imaging whole body (78306) |
$1,581.60 |
$2,636 |
3.9× |
| Bone age studies (77072) |
$207.60 |
$346 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$1,498.20 |
$2,497 |
3.7× |
| Bone survey complete (77075) |
$556.20 |
$927 |
5.3× |
| Brachytx isodose complex (77318) |
$1,573.20 |
$2,622 |
4.1× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,099.80 |
$1,833 |
2.9× |
| Brain imaging < 4 static views w vascular flow (78601) |
$814.20 |
$1,357 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,675.50 |
$2,792.50 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,511 |
$4,185 |
7.1× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$654 |
$1,090 |
1.2× |
| Cervical spine 2 or 3 views (72040) |
$297.60 |
$496 |
3.4× |
| Chest 1 view (71045) |
$160.80 |
$268 |
1.8× |
| Chest 3 views (71047) |
$252 |
$420 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$240.60 |
$401 |
1.4× |
| Clavicle complete (73000) |
$255 |
$425 |
2.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$162 |
$270 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$496.20 |
$827 |
3.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,449 |
$7,415 |
12.6× |
| CT abdomen and pelvis without contrast (74176) |
$3,213 |
$5,355 |
13.3× |
| CT abdomen w contrast (74160) |
$1,904.40 |
$3,174 |
10.7× |
| CT abdomen w wo contrast (74170) |
$2,254.80 |
$3,758 |
12.7× |
| CT abdomen w/o contrast (74150) |
$1,496.40 |
$2,494 |
14.1× |
| CT angio hrt w/3d image (75574) |
$2,485.20 |
$4,142 |
7.0× |
| CT angiography upper extremity lt (73206) |
$2,384.40 |
$3,974 |
13.4× |
| CT c-spine w/o contrast (72125) |
$1,723.20 |
$2,872 |
16.3× |
| CT cervical spine w&w/o contrast (72127) |
$2,222.40 |
$3,704 |
12.5× |
| CT cervical spine with contrast (72126) |
$2,170.80 |
$3,618 |
6.1× |
| CT chest w/wo contrast (71270) |
$2,064 |
$3,440 |
11.6× |
| CT chest with contrast (71260) |
$1,755 |
$2,925 |
9.9× |
| CT head/brain with contrast (70460) |
$1,600.80 |
$2,668 |
9.0× |
| CT head/brain without and with contrast (70470) |
$1,958.40 |
$3,264 |
11.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,986 |
$3,310 |
5.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$2,410.80 |
$4,018 |
27.3× |
| CT hrt w/3d image congen (75573) |
$2,485.20 |
$4,142 |
7.0× |
| CT iac w contrast (70481) |
$1,765.20 |
$2,942 |
9.9× |
| CT limited/localized follow up study (76380) |
$785.40 |
$1,309 |
8.9× |
| CT lower ext w/o (73700) |
$1,506.60 |
$2,511 |
14.2× |
| CT lower extremity w wo contrast (73702) |
$2,541 |
$4,235 |
14.3× |
| CT lower extremity with contrast (73701) |
$1,938.60 |
$3,231 |
10.9× |
| CT lumbar spine w & w/o contrast (72133) |
$2,233.80 |
$3,723 |
12.6× |
| CT lumbar spine w/o contrast (72131) |
$1,573.20 |
$2,622 |
14.8× |
| CT lumbar spine with contrast (72132) |
$1,913.40 |
$3,189 |
5.4× |
| CT maxillofacial w contrast (70487) |
$1,857.60 |
$3,096 |
10.5× |
| CT maxillofacial w/o contrast (70486) |
$1,521.60 |
$2,536 |
14.4× |
| CT maxillofacial w/wo contrast (70488) |
$2,101.20 |
$3,502 |
11.8× |
| CT neck soft tissue w contrast (70491) |
$1,849.20 |
$3,082 |
10.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,969.20 |
$3,282 |
11.1× |
| CT orbits w/o contrast (70480) |
$1,470 |
$2,450 |
13.9× |
| CT pelvis w & w/o contrast (72194) |
$1,842.60 |
$3,071 |
10.4× |
| CT pelvis w/o contrast (72192) |
$1,375.20 |
$2,292 |
13.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,107.20 |
$3,512 |
11.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,550.40 |
$2,584 |
14.6× |
| CT thoracic spine w/contrast (72129) |
$1,637.40 |
$2,729 |
9.2× |
| CT thoracic spine w/o contrast (72128) |
$1,345.20 |
$2,242 |
12.7× |
| CT thoracic spine w/wo contrast (72130) |
$1,910.40 |
$3,184 |
10.7× |
| CT thorax w/o contrast (71250) |
$1,398.60 |
$2,331 |
13.2× |
| CT unlisted procedure (76497) |
$194.40 |
$324 |
2.2× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,605.80 |
$4,343 |
14.7× |
| CT upper extremity w/o contrast rt (73200) |
$1,760.40 |
$2,934 |
16.6× |
| CT upper extremity with contrast (73201) |
$2,413.20 |
$4,022 |
6.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,437.20 |
$4,062 |
13.7× |
| Cta Abdomen (74175) |
$2,435.40 |
$4,059 |
13.7× |
| CTA abdomen pelvis (74174) |
$4,416.60 |
$7,361 |
12.5× |
| CTA chest (71275) |
$2,324.40 |
$3,874 |
13.1× |
| Cta Head (70496) |
$2,512.80 |
$4,188 |
14.1× |
| CTA lwr ext w&w/o contrast (73706) |
$2,956.20 |
$4,927 |
16.6× |
| Cta Neck (70498) |
$2,382.60 |
$3,971 |
13.4× |
| Cta Pelvis (72191) |
$1,810.80 |
$3,018 |
10.2× |
| Cystography minimum 3 views rs&i (74430) |
$58.80 |
$98 |
0.2× |
| Dacryocystography (70170) |
$265.20 |
$442 |
1.1× |
| Diskogram cervical (72285) |
$1,248.60 |
$2,081 |
0.6× |
| Diskography lumbar (72295) |
$1,248.60 |
$2,081 |
0.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$546.60 |
$911 |
5.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$174.60 |
$291 |
2.0× |
| Echoencephalography real time imaging (76506) |
$192 |
$320 |
1.8× |
| Esophageal motility (78258) |
$940.20 |
$1,567 |
2.3× |
| Esophagus (74220) |
$469.20 |
$782 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$400.80 |
$668 |
3.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$323.40 |
$539 |
3.1× |
| Fluoroscopy up to 1 hr (76000) |
$571.80 |
$953 |
2.4× |
| Foot 2 views (73620) |
$318 |
$530 |
3.6× |
| Forearm 2 views (73090) |
$227.40 |
$379 |
2.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$1,209.60 |
$2,016 |
2.2× |
| Gated Heart Planar Single (78472) |
$863.40 |
$1,439 |
2.1× |
| Hand 2 views (73120) |
$258.60 |
$431 |
2.4× |
| Hand 3 views (73130) |
$236.40 |
$394 |
2.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$2,251.80 |
$3,753 |
3.2× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$2,589.60 |
$4,316 |
3.7× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$2,589.60 |
$4,316 |
3.7× |
| Heart Infarct Image (78466) |
$498.60 |
$831 |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$479.40 |
$799 |
0.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,639.80 |
$2,733 |
3.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,426.80 |
$2,378 |
3.5× |
| Ht muscle image spect sing (78451) |
$2,325.60 |
$3,876 |
1.8× |
| Humerus Min 2 Views Left (73060) |
$264 |
$440 |
3.0× |
| Hysterosalpingogram (74740) |
$486 |
$810 |
2.0× |
| Interstitial radiation source applic complex (77778) |
$1,799.40 |
$2,999 |
2.5× |
| Intracavitary radiation source applic simple (77761) |
$1,474.80 |
$2,458 |
2.6× |
| Kidney imaging morphology (78700) |
$696 |
$1,160 |
1.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$696 |
$1,160 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$966.60 |
$1,611 |
1.8× |
| Knee 3 views (73562) |
$222.60 |
$371 |
2.5× |
| Liver & spleen imaging static only (78215) |
$961.20 |
$1,602 |
2.4× |
| Liver imaging static only (78201) |
$961.20 |
$1,602 |
1.7× |
| Liver imaging w/vascular flow (78202) |
$1,374 |
$2,290 |
2.5× |
| Lung perf&ventilat diferentl (78598) |
$878.40 |
$1,464 |
1.6× |
| Lung perfusion differential (78597) |
$466.80 |
$778 |
1.2× |
| Lung Ventilation Imaging (78579) |
$776.40 |
$1,294 |
1.9× |
| Lymphoscintigraphy (78195) |
$1,247.40 |
$2,079 |
2.3× |
| Mammary ductogram or galactogram multiple (77054) |
$387.60 |
$646 |
1.6× |
| Mammary ductogram or galactogram single (77053) |
$193.80 |
$323 |
0.8× |
| Meckels Diverticulum (78290) |
$688.80 |
$1,148 |
1.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,495.20 |
$7,492 |
11.8× |
| MRA head w & w/o contrast (70546) |
$3,204 |
$5,340 |
9.1× |
| MRA head w/o contrast (70544) |
$2,080.80 |
$3,468 |
8.6× |
| MRA head with contrast (70545) |
$2,202.60 |
$3,671 |
6.2× |
| MRA neck w contrast (70548) |
$2,159.40 |
$3,599 |
6.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,999.40 |
$4,999 |
8.5× |
| MRA neck w/o contrast (70547) |
$1,947 |
$3,245 |
8.1× |
| MRI abdomen w contrast (74182) |
$2,700.60 |
$4,501 |
7.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,140.40 |
$5,234 |
8.9× |
| MRI abdomen w/o contrast (74181) |
$2,553.60 |
$4,256 |
10.6× |
| MRI any jnt lwr ext with con lt (73722) |
$2,227.20 |
$3,712 |
2.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,445.60 |
$4,076 |
3.1× |
| MRI breast w/o contrast bilateral (77047) |
$1,431 |
$2,385 |
5.9× |
| MRI breast w/o contrast unilat (77046) |
$1,440 |
$2,400 |
6.0× |
| MRI c-spine with contrast (72142) |
$2,481 |
$4,135 |
7.0× |
| MRI cardiac w/o contrast (75557) |
$1,751.40 |
$2,919 |
7.2× |
| MRI cervical spine w/o contrast (72141) |
$2,414.40 |
$4,024 |
10.0× |
| MRI chest w/o & w/contrast material (71552) |
$3,676.20 |
$6,127 |
10.4× |
| MRI chest w/o contrast (71550) |
$1,975.20 |
$3,292 |
8.2× |
| MRI chest with contrast (71551) |
$3,041.40 |
$5,069 |
3.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$2,259 |
$3,765 |
6.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,335.20 |
$3,892 |
6.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,224.80 |
$3,708 |
9.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,514 |
$4,190 |
10.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,351.60 |
$5,586 |
9.5× |
| MRI orbit/face/neck w/contrast (70542) |
$2,782.20 |
$4,637 |
7.9× |
| MRI pelvis w contrast (72196) |
$3,103.80 |
$5,173 |
8.8× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,232.80 |
$5,388 |
9.1× |
| MRI pelvis w/o contrast (72195) |
$2,075.40 |
$3,459 |
8.6× |
| MRI scan of arm joint before and after contrast (73223) |
$2,819.40 |
$4,699 |
8.0× |
| MRI scan of leg joint before and after contrast (73723) |
$3,094.80 |
$5,158 |
8.8× |
| MRI spectroscopy (76390) |
$1,903.20 |
$3,172 |
21.6× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,062.40 |
$5,104 |
8.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,430.60 |
$4,051 |
6.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,272.40 |
$5,454 |
9.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,564.40 |
$4,274 |
7.3× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$2,947.20 |
$4,912 |
8.3× |
| MRI thoracic spine w/o contrast (72146) |
$2,109.60 |
$3,516 |
8.7× |
| MRI tmj (70336) |
$1,687.80 |
$2,813 |
7.0× |
| MRI upper ext joint w/o contrast (73221) |
$2,083.20 |
$3,472 |
8.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,094.80 |
$5,158 |
8.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,162.40 |
$3,604 |
8.9× |
| Myelogram Cervical (72240) |
$726.60 |
$1,211 |
0.9× |
| Myelogram Lumbar (72265) |
$801.60 |
$1,336 |
1.0× |
| Myelogram thoracic (72255) |
$451.20 |
$752 |
0.6× |
| Myelography 2 or more regions (72270) |
$1,135.20 |
$1,892 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,831.60 |
$6,386 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$2,906.40 |
$4,844 |
2.2× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,796 |
$4,660 |
1.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,505.60 |
$4,176 |
1.7× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$3,631.20 |
$6,052 |
1.6× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$5,337.60 |
$8,896 |
2.4× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,434.80 |
$4,058 |
2.8× |
| Neck soft tissue (70360) |
$217.20 |
$362 |
2.5× |
| Nm bone marrow multiple (78103) |
$856.80 |
$1,428 |
2.1× |
| Nm bone marrow wb (78104) |
$1,119.60 |
$1,866 |
2.8× |
| Nm cisternogram (78630) |
$518.40 |
$864 |
0.9× |
| Nm csf leak detection (78650) |
$479.40 |
$799 |
0.4× |
| Nm gastric emptying study (78264) |
$1,347 |
$2,245 |
3.3× |
| Nm gastroesophageal reflux study (78262) |
$738 |
$1,230 |
1.8× |
| Nm peritoneal-venous shunt patency (78291) |
$753 |
$1,255 |
1.9× |
| Nm red cell sequestration (78140) |
$608.40 |
$1,014 |
1.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,281 |
$7,135 |
3.1× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,836.60 |
$3,061 |
1.3× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$918.60 |
$1,531 |
0.6× |
| Nuclear medicine study of endocrine organs (78099) |
$430.20 |
$717 |
1.1× |
| Nuclear medicine study of kidney and blood flow (78701) |
$792.60 |
$1,321 |
2.0× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$349.80 |
$583 |
0.9× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$1,209.60 |
$2,016 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$985.80 |
$1,643 |
4.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$256.20 |
$427 |
2.4× |
| Orthopantogram (70355) |
$181.20 |
$302 |
2.1× |
| Osseous survey infant (77076) |
$183.60 |
$306 |
1.7× |
| Osseous survey limited (77074) |
$160.80 |
$268 |
1.5× |
| Parathyrd planar w/spect&CT (78072) |
$585.60 |
$976 |
1.1× |
| Parathyrd planar w/wo subtrj (78071) |
$655.80 |
$1,093 |
1.6× |
| Parathyroid imaging (78070) |
$896.40 |
$1,494 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$204.60 |
$341 |
1.9× |
| Peritoneogram rs&i (74190) |
$297 |
$495 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$3,894.60 |
$6,491 |
2.7× |
| PET imaging CT for attenuation limited area (78814) |
$2,509.20 |
$4,182 |
1.7× |
| PET imaging for CT attenuation whole body (78816) |
$3,690 |
$6,150 |
2.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,199.20 |
$5,332 |
9.0× |
| Pr sono bone density measure,peripheral (76977) |
$30.60 |
$51 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$969.60 |
$1,616 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$955.20 |
$1,592 |
2.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,491.60 |
$2,486 |
2.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$561.60 |
$936 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$370.20 |
$617 |
4.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$487.20 |
$812 |
4.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$454.80 |
$758 |
4.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$211.20 |
$352 |
2.0× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,042.30 |
$15,070.50 |
1.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$843.60 |
$1,406 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$533.40 |
$889 |
5.2× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$697.80 |
$1,163 |
1.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$327 |
$545 |
3.1× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$255.60 |
$426 |
2.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$324 |
$540 |
3.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$224.40 |
$374 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$556.80 |
$928 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$471 |
$785 |
2.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$357.60 |
$596 |
2.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$369 |
$615 |
2.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$259.20 |
$432 |
2.9× |
| Radiological examination surgical specimen (76098) |
$183.60 |
$306 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$618.60 |
$1,031 |
0.2× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$580.20 |
$967 |
0.2× |
| Ribs bilateral 3 views (71110) |
$647.40 |
$1,079 |
6.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,344 |
$2,240 |
3.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,404.60 |
$2,341 |
2.6× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$963 |
$1,605 |
1.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,006.40 |
$3,344 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,006.40 |
$3,344 |
1.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,006.40 |
$3,344 |
1.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,219.80 |
$2,033 |
5.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$282 |
$470 |
1.2× |
| Rp Therapy Intravenous Administration (79101) |
$311.40 |
$519 |
1.3× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$394.80 |
$658 |
1.6× |
| Salivary gland imaging (78230) |
$513.60 |
$856 |
1.3× |
| Scanogram (77073) |
$145.80 |
$243 |
1.4× |
| Scapula complete (73010) |
$229.20 |
$382 |
2.2× |
| Screening digital breast tomosynthesis (77063) |
$83.40 |
$139 |
3.6× |
| Sella turcica (70240) |
$72 |
$120 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$111 |
$185 |
1.0× |
| Sialogram (70390) |
$498.60 |
$831 |
2.1× |
| Simulation intermediate (77285) |
$977.40 |
$1,629 |
2.6× |
| Small bowel series (74250) |
$298.20 |
$497 |
1.7× |
| Spec medical radj physics consltj (77370) |
$1,243.20 |
$2,072 |
9.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$1,108.80 |
$1,848 |
2.9× |
| Special dosimetry (77331) |
$522.60 |
$871 |
3.8× |
| Special treatment procedure (77470) |
$1,446 |
$2,410 |
2.6× |
| Spine thoracic 3 views (72072) |
$196.20 |
$327 |
1.9× |
| Stereotactic body radiation delivery (77373) |
$3,456.90 |
$5,761.50 |
1.9× |
| Superior sagittal sinus venogram (75870) |
$482.40 |
$804 |
0.2× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$189.60 |
$316 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,577.40 |
$2,629 |
4.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,352.40 |
$2,254 |
3.6× |
| Testicular Imaging With Vascular Flow (78761) |
$553.80 |
$923 |
1.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,405.80 |
$2,343 |
3.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$626.40 |
$1,044 |
4.6× |
| Therapeutic Enema (74283) |
$148.20 |
$247 |
0.8× |
| Thoracolumbar 2 views (72080) |
$338.40 |
$564 |
3.8× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,750.20 |
$2,917 |
3.2× |
| Thyroid Imaging With Vascular Flow (78013) |
$411 |
$685 |
1.0× |
| Thyroid uptake measurement (78012) |
$406.20 |
$677 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$662.40 |
$1,104 |
1.6× |
| Tomogram (76100) |
$204.60 |
$341 |
1.9× |
| Treatment device intermediate (77333) |
$483 |
$805 |
3.5× |
| Treatment devices simple (77332) |
$329.40 |
$549 |
2.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,765.80 |
$2,943 |
3.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$261 |
$435 |
0.6× |
| Tx devices design & construction complex (77334) |
$751.20 |
$1,252 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$561.60 |
$936 |
5.3× |
| Umbilical-artery Doppler (OB) (76820) |
$345 |
$575 |
3.3× |
| Unlisted fluoroscopic procedure (76496) |
$85.80 |
$143 |
1.0× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$1,612.80 |
$2,688 |
4.0× |
| Unlisted Ultrasound Procedure (76999) |
$253.20 |
$422 |
2.9× |
| Upper Extremity Infant (73092) |
$178.80 |
$298 |
1.7× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$762.60 |
$1,271 |
1.9× |
| Urethrocystography retrograde rs&i (74450) |
$385.80 |
$643 |
1.6× |
| Urethrocystography voiding (74455) |
$490.80 |
$818 |
2.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$592.80 |
$988 |
3.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$624.60 |
$1,041 |
3.5× |
| Us abdl aorta screen aaa (76706) |
$277.80 |
$463 |
2.6× |
| Us breast unilateral complete (76641) |
$275.40 |
$459 |
2.6× |
| Us breast unilateral limited (76642) |
$295.20 |
$492 |
3.3× |
| Us chest (76604) |
$344.40 |
$574 |
3.3× |
| Us compl joint r-t w/image documentation (76881) |
$706.80 |
$1,178 |
6.7× |
| Us infant hips dynamic (76885) |
$150 |
$250 |
1.7× |
| Us infant hips limited static (76886) |
$138.60 |
$231 |
1.6× |
| Us kidney transplant (76776) |
$502.20 |
$837 |
4.7× |
| Us ob detailed single fetus (76811) |
$576.60 |
$961 |
2.4× |
| Us ob transvaginal (76817) |
$501 |
$835 |
4.7× |
| Us pelvic non ob complete (76856) |
$622.20 |
$1,037 |
5.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$493.80 |
$823 |
4.7× |
| Us pregnancy ltd (76815) |
$382.20 |
$637 |
3.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$454.80 |
$758 |
4.3× |
| Us retroperitoneal complete (76770) |
$634.80 |
$1,058 |
6.0× |
| Us retroperitoneal limited (76775) |
$462.60 |
$771 |
4.4× |
| Us scrotum and contents (76870) |
$551.40 |
$919 |
5.2× |
| Us soft tissue head/neck (76536) |
$536.40 |
$894 |
5.1× |
| Us spinal canal and contents (76800) |
$189 |
$315 |
1.8× |
| Us transrectal (76872) |
$180.60 |
$301 |
1.7× |
| Us xtr non-vasc lmtd (76882) |
$458.40 |
$764 |
4.3× |
| Vascular flow imaging (78445) |
$645 |
$1,075 |
1.6× |
| Vasogram (74440) |
$348 |
$580 |
1.4× |
| Venogram extremity bilateral (75822) |
$837 |
$1,395 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$2,428.20 |
$4,047 |
0.8× |
| Venography caval superior serialography rs&i (75827) |
$3,447.60 |
$5,746 |
2.2× |
| Venography extremity unilateral rs&i (75820) |
$820.80 |
$1,368 |
0.5× |
| Venography Renal Bilateral (75833) |
$1,543.20 |
$2,572 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$795.60 |
$1,326 |
0.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$964.80 |
$1,608 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$663.60 |
$1,106 |
0.1× |
| Wrist 2 views (73100) |
$225 |
$375 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$451.20 |
$752 |
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) |
$829.20 |
$1,382 |
4.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$243.60 |
$406 |
2.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$265.20 |
$442 |
3.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$516.60 |
$861 |
4.9× |
| X-ray exam hip uni 1 view (73501) |
$280.20 |
$467 |
3.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$296.40 |
$494 |
3.4× |
| X-ray exam hip uni 4/> views (73503) |
$313.80 |
$523 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$441.60 |
$736 |
4.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$647.40 |
$1,079 |
6.1× |
| X-ray exam of femur 1 (73551) |
$137.40 |
$229 |
1.6× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$348.60 |
$581 |
2.0× |
| X-ray eye for foreign body (70030) |
$194.40 |
$324 |
2.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$360.60 |
$601 |
3.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$288.60 |
$481 |
3.3× |
| 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) |
$399.60 |
$666 |
0.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$240.60 |
$401 |
2.7× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$289.20 |
$482 |
2.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$189.60 |
$316 |
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) |
$525 |
$875 |
5.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$349.20 |
$582 |
3.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$236.40 |
$394 |
2.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$101.40 |
$169 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$300 |
$500 |
2.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$324.60 |
$541 |
3.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$644.40 |
$1,074 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$289.80 |
$483 |
3.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$350.40 |
$584 |
3.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$351 |
$585 |
3.3× |
| 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 |
2.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$277.20 |
$462 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$162 |
$270 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$91.20 |
$152 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$402.60 |
$671 |
3.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$300.60 |
$501 |
2.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$265.20 |
$442 |
3.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$183 |
$305 |
2.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$231 |
$385 |
2.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$262.20 |
$437 |
2.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$194.40 |
$324 |
2.2× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$208.20 |
$347 |
2.4× |
| Xr arthrogram ankle (73615) |
$228 |
$380 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$557.40 |
$929 |
5.3× |
| Xr chest 4+ views (71048) |
$199.20 |
$332 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$165.60 |
$276 |
1.9× |
| Xr shoulder 1 view (73020) |
$275.40 |
$459 |
3.1× |
| Xr spine cervical 4 or 5 views (72050) |
$396 |
$660 |
3.7× |
| Xr tibia/fibula 2 views (73590) |
$212.40 |
$354 |
2.4× |
| Xr tmj bilateral (70330) |
$107.40 |
$179 |
1.2× |
| Xray knee 1 or 2 views rt (73560) |
$256.20 |
$427 |
2.9× |