| Abdomen 2 views (74019) |
$60.38 |
$241.50 |
0.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$420 |
$1,680 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$37.25 |
$149 |
0.0× |
| Angiography extremity bilateral rs&i (75716) |
$919 |
$3,676 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$874.25 |
$3,497 |
0.3× |
| Angiography internal mammary rs&i (75756) |
$32.50 |
$130 |
0.0× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$31 |
$124 |
0.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,397.50 |
$5,590 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$35.25 |
$141 |
0.0× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$59 |
$236 |
0.0× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$30.50 |
$122 |
0.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$44.50 |
$178 |
0.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$30.50 |
$122 |
0.0× |
| Ankle 2 views (73600) |
$53.88 |
$215.50 |
0.7× |
| Antegrade urography radiological supvj & interpj (74425) |
$169 |
$676 |
0.5× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,562.25 |
$6,249 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,356.50 |
$5,426 |
0.5× |
| Aortography abdominal serialography rs&i (75625) |
$782.25 |
$3,129 |
0.3× |
| Aortography thoracic w/o serialography rs&i (75600) |
$14.50 |
$58 |
0.0× |
| Artery X-Rays Adrenal Gland (75731) |
$31.75 |
$127 |
0.0× |
| Arthrogram elbow (73085) |
$103.75 |
$415 |
0.3× |
| Arthrogram hip (73525) |
$220 |
$880 |
0.7× |
| Arthrogram shoulder (73040) |
$270 |
$1,080 |
0.8× |
| Arthrogram wrist (73115) |
$131.50 |
$526 |
0.4× |
| Arthrography knee lt (73580) |
$241 |
$964 |
0.8× |
| Bone &/Joint Imaging Limited Area (78300) |
$209.75 |
$839 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$486 |
$1,944 |
1.3× |
| Bone age studies (77072) |
$12.50 |
$50 |
0.1× |
| Bone Imaging 3 Phase (78315) |
$584.75 |
$2,339 |
1.6× |
| Brain imaging < 4 static views (78600) |
$125.75 |
$503 |
0.3× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,660.25 |
$6,641 |
1.3× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$5.50 |
$22 |
0.5× |
| Cervical spine 2 or 3 views (72040) |
$71.75 |
$287 |
0.9× |
| Chest 1 view (71045) |
$92.50 |
$370 |
1.2× |
| Chest 3 views (71047) |
$42.50 |
$170 |
0.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$90.50 |
$362 |
0.6× |
| Cineradiography/videoradiography (76120) |
$10.50 |
$42 |
0.1× |
| Clavicle complete (73000) |
$91 |
$364 |
1.1× |
Complete single session course of cranial lesion surgery using radiation (77371)
likely a partial charge, not the full procedure |
$578.50 |
$2,314 |
0.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$82.75 |
$331 |
0.9× |
| Corpora cavernosography (74445) |
$31.25 |
$125 |
0.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,772.50 |
$7,090 |
5.6× |
| CT abdomen and pelvis without contrast (74176) |
$1,340.75 |
$5,363 |
6.2× |
| CT abdomen w contrast (74160) |
$966.25 |
$3,865 |
6.1× |
| CT abdomen w wo contrast (74170) |
$1,283 |
$5,132 |
8.0× |
| CT abdomen w/o contrast (74150) |
$936 |
$3,744 |
9.8× |
| CT angiography upper extremity lt (73206) |
$979 |
$3,916 |
6.1× |
| CT c-spine w/o contrast (72125) |
$632.25 |
$2,529 |
6.6× |
| CT cervical spine w&w/o contrast (72127) |
$737.25 |
$2,949 |
4.6× |
| CT cervical spine with contrast (72126) |
$695.25 |
$2,781 |
2.2× |
| CT chest w/wo contrast (71270) |
$765.25 |
$3,061 |
4.8× |
| CT chest with contrast (71260) |
$739 |
$2,956 |
4.6× |
| CT head/brain with contrast (70460) |
$694.50 |
$2,778 |
4.3× |
| CT head/brain without and with contrast (70470) |
$968.75 |
$3,875 |
6.1× |
| CT iac w contrast (70481) |
$875 |
$3,500 |
5.5× |
| CT lower ext w/o (73700) |
$463 |
$1,852 |
4.9× |
| CT lower extremity w wo contrast (73702) |
$573.50 |
$2,294 |
3.6× |
| CT lower extremity with contrast (73701) |
$513.25 |
$2,053 |
3.2× |
| CT lumbar spine w & w/o contrast (72133) |
$827.50 |
$3,310 |
5.2× |
| CT lumbar spine w/o contrast (72131) |
$734.25 |
$2,937 |
7.7× |
| CT lumbar spine with contrast (72132) |
$812 |
$3,248 |
2.6× |
| CT maxillofacial w contrast (70487) |
$737.25 |
$2,949 |
4.6× |
| CT maxillofacial w/o contrast (70486) |
$688.75 |
$2,755 |
7.2× |
| CT maxillofacial w/wo contrast (70488) |
$793 |
$3,172 |
5.0× |
| CT neck soft tissue w contrast (70491) |
$813.50 |
$3,254 |
5.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$728.75 |
$2,915 |
4.6× |
| CT orbits w/o contrast (70480) |
$671.25 |
$2,685 |
7.1× |
| CT pelvis w & w/o contrast (72194) |
$736 |
$2,944 |
4.6× |
| CT pelvis w/o contrast (72192) |
$606.25 |
$2,425 |
6.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$889.25 |
$3,557 |
5.6× |
| CT soft tissue neck w/o contrast (70490) |
$620 |
$2,480 |
6.5× |
| CT thoracic spine w/contrast (72129) |
$585.50 |
$2,342 |
3.7× |
| CT thoracic spine w/o contrast (72128) |
$508.25 |
$2,033 |
5.3× |
| CT thoracic spine w/wo contrast (72130) |
$620 |
$2,480 |
3.9× |
| CT thorax w/o contrast (71250) |
$637.75 |
$2,551 |
6.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$731.50 |
$2,926 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$577.75 |
$2,311 |
6.1× |
| CT upper extremity with contrast (73201) |
$689.25 |
$2,757 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$717 |
$2,868 |
4.5× |
| Cta Abdomen (74175) |
$712.50 |
$2,850 |
4.5× |
| CTA abdomen pelvis (74174) |
$979 |
$3,916 |
3.1× |
| CTA chest (71275) |
$638.75 |
$2,555 |
4.0× |
| Cta Head (70496) |
$1,116.50 |
$4,466 |
7.0× |
| CTA lwr ext w&w/o contrast (73706) |
$621.50 |
$2,486 |
3.9× |
| Cta Neck (70498) |
$702 |
$2,808 |
4.4× |
| Cta Pelvis (72191) |
$448.25 |
$1,793 |
2.8× |
| Cystography minimum 3 views rs&i (74430) |
$189.75 |
$759 |
0.6× |
| Diskography lumbar (72295) |
$142.50 |
$570 |
0.1× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$15.25 |
$61 |
0.2× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$18.50 |
$74 |
0.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$55.38 |
$221.50 |
0.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$17.50 |
$70 |
0.2× |
| Echo exam of eye (76529) |
$15.75 |
$63 |
0.2× |
| Echo exam of fetal heart (76825) |
$44.25 |
$177 |
0.1× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$29.75 |
$119 |
0.1× |
| Echoencephalography real time imaging (76506) |
$17.75 |
$71 |
0.2× |
| Esophagus (74220) |
$103.25 |
$413 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$142.25 |
$569 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$52 |
$208 |
0.5× |
| Fluoroscopy up to 1 hr (76000) |
$169.50 |
$678 |
0.8× |
| Foot 2 views (73620) |
$50.38 |
$201.50 |
0.6× |
| Forearm 2 views (73090) |
$104.75 |
$419 |
1.3× |
| Gated Heart Planar Single (78472) |
$259.50 |
$1,038 |
0.7× |
| Hand 2 views (73120) |
$87 |
$348 |
0.9× |
| Hand 3 views (73130) |
$121.25 |
$485 |
1.5× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$30.50 |
$122 |
0.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$474.50 |
$1,898 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$933.50 |
$3,734 |
2.6× |
| Ht muscle image spect sing (78451) |
$906.25 |
$3,625 |
0.8× |
| Humerus Min 2 Views Left (73060) |
$75 |
$300 |
0.9× |
| Hyperthermia ntrstl prb 5/< (77610) |
$329 |
$1,316 |
0.7× |
| Hysterosalpingogram (74740) |
$135.50 |
$542 |
0.6× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$24 |
$96 |
0.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$255.25 |
$1,021 |
0.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$101.25 |
$405 |
0.2× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$318.50 |
$1,274 |
0.6× |
| Knee 3 views (73562) |
$44.25 |
$177 |
0.6× |
| Liver & spleen imaging static only (78215) |
$312.25 |
$1,249 |
0.9× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$363.50 |
$1,454 |
1.0× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$31 |
$124 |
0.0× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$22.25 |
$89 |
0.0× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$31 |
$124 |
0.0× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$22 |
$88 |
0.0× |
| Lymphoscintigraphy (78195) |
$353.25 |
$1,413 |
0.7× |
| Mammary ductogram or galactogram multiple (77054) |
$60 |
$240 |
0.3× |
| Mammary ductogram or galactogram single (77053) |
$42 |
$168 |
0.2× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$22.50 |
$90 |
0.3× |
| Meckels Diverticulum (78290) |
$242.50 |
$970 |
0.7× |
| MRA head w & w/o contrast (70546) |
$1,003.75 |
$4,015 |
3.2× |
| MRA head w/o contrast (70544) |
$791.25 |
$3,165 |
3.6× |
| MRA head with contrast (70545) |
$899.25 |
$3,597 |
2.8× |
| MRA neck w contrast (70548) |
$512 |
$2,048 |
1.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$596.50 |
$2,386 |
1.9× |
| MRA neck w/o contrast (70547) |
$429.25 |
$1,717 |
2.0× |
| MRI abdomen w contrast (74182) |
$910.75 |
$3,643 |
2.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,062 |
$4,248 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$876.75 |
$3,507 |
4.0× |
| MRI any jnt lwr ext with con lt (73722) |
$958.25 |
$3,833 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$953 |
$3,812 |
1.3× |
| MRI breast w/o contrast bilateral (77047) |
$745 |
$2,980 |
3.4× |
| MRI breast w/o contrast unilat (77046) |
$611 |
$2,444 |
2.8× |
| MRI c-spine with contrast (72142) |
$874 |
$3,496 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$845.25 |
$3,381 |
3.9× |
| MRI chest w/o & w/contrast material (71552) |
$696 |
$2,784 |
2.2× |
| MRI chest w/o contrast (71550) |
$603.25 |
$2,413 |
2.8× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$827.88 |
$3,311.50 |
2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$949 |
$3,796 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$912.50 |
$3,650 |
4.2× |
| MRI orbit face &/neck w/o contrast (70540) |
$494 |
$1,976 |
2.3× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,154.25 |
$4,617 |
3.6× |
| MRI pelvis w contrast (72196) |
$930 |
$3,720 |
2.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,012.50 |
$4,050 |
3.2× |
| MRI pelvis w/o contrast (72195) |
$791 |
$3,164 |
3.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,014 |
$4,056 |
3.2× |
| MRI scan of leg joint before and after contrast (73723) |
$990.25 |
$3,961 |
3.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,313 |
$5,252 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$851.75 |
$3,407 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,313 |
$5,252 |
4.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$877.25 |
$3,509 |
2.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,317.50 |
$5,270 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$850.50 |
$3,402 |
3.9× |
| MRI upper ext joint w/o contrast (73221) |
$897.75 |
$3,591 |
4.1× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$794.75 |
$3,179 |
2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$611 |
$2,444 |
2.8× |
| Myelogram Cervical (72240) |
$281 |
$1,124 |
0.4× |
| Myelogram Lumbar (72265) |
$238.25 |
$953 |
0.3× |
| Myelogram thoracic (72255) |
$397.25 |
$1,589 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,345.75 |
$5,383 |
1.1× |
| Neck soft tissue (70360) |
$83 |
$332 |
1.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$183.75 |
$735 |
0.5× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$23.25 |
$93 |
0.1× |
| Nm gastric emptying study (78264) |
$516.25 |
$2,065 |
1.4× |
| Nuclear Rx Oral Admin (79005) |
$65.25 |
$261 |
0.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$32.25 |
$129 |
0.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$42.25 |
$169 |
0.3× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$15 |
$60 |
0.2× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$25.50 |
$102 |
0.3× |
| Osseous survey infant (77076) |
$49.50 |
$198 |
0.5× |
| Osseous survey limited (77074) |
$134.50 |
$538 |
1.4× |
| Parathyroid imaging (78070) |
$136.50 |
$546 |
0.4× |
| Pelvis 1 or 2 views (72170) |
$69.50 |
$278 |
0.7× |
| PET image w/CT, skull-thigh (78815) |
$1,419.38 |
$5,677.50 |
1.1× |
| PET imaging CT for attenuation limited area (78814) |
$1,889.25 |
$7,557 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$1,419.38 |
$5,677.50 |
1.1× |
| Pr gi endoscopic ultrasound (76975) |
$22.25 |
$89 |
0.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$981.50 |
$3,926 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$38.50 |
$154 |
0.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$300 |
$1,200 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$450.50 |
$1,802 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$40.25 |
$161 |
0.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$20 |
$80 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$21.38 |
$85.50 |
0.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$40.12 |
$160.50 |
0.4× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$26.25 |
$105 |
0.3× |
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure |
$426.75 |
$1,707 |
0.1× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$111.50 |
$446 |
0.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$72.25 |
$289 |
0.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$117.25 |
$469 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$75 |
$300 |
0.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$63 |
$252 |
0.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$59.88 |
$239.50 |
0.8× |
| Radiologic exam colon single contrast study (74270) |
$181.50 |
$726 |
1.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$222.50 |
$890 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$28.62 |
$114.50 |
0.4× |
| Radiological examination surgical specimen (76098) |
$62.25 |
$249 |
0.1× |
| Review by radiologist of adrenal gland vein image (75840) |
$30.50 |
$122 |
0.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$30.50 |
$122 |
0.0× |
| Ribs bilateral 3 views (71110) |
$115 |
$460 |
1.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$695.25 |
$2,781 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$14.88 |
$59.50 |
0.2× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$62.25 |
$249 |
0.3× |
| Scanogram (77073) |
$20 |
$80 |
0.2× |
| Scapula complete (73010) |
$52.88 |
$211.50 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$28.25 |
$113 |
1.2× |
| Sella turcica (70240) |
$46.50 |
$186 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$12.50 |
$50 |
0.1× |
| Small bowel series (74250) |
$174.25 |
$697 |
1.1× |
| Spine thoracic 3 views (72072) |
$129.75 |
$519 |
1.4× |
| Splenoportograpy rs&i (75810) |
$30.50 |
$122 |
0.0× |
| Stereotactic body radiation delivery (77373) |
$791.75 |
$3,167 |
0.5× |
| Superior sagittal sinus venogram (75870) |
$30.75 |
$123 |
0.0× |
| Thoracolumbar 2 views (72080) |
$12.75 |
$51 |
0.2× |
| Thyroid uptake measurement (78012) |
$322.50 |
$1,290 |
0.9× |
| Tomogram (76100) |
$15.75 |
$63 |
0.2× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$516.50 |
$2,066 |
1.4× |
| Ultrasound scan of cornea to determine thickness (76514) |
$5 |
$20 |
0.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$15 |
$60 |
0.2× |
| Ultrasound, abdomen limited (76705) |
$24.50 |
$98 |
0.3× |
| Umbilical-artery Doppler (OB) (76820) |
$24.75 |
$99 |
0.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$28.25 |
$113 |
0.4× |
| Unlisted Ultrasound Procedure (76999) |
$48.25 |
$193 |
0.6× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$34.75 |
$139 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$9.25 |
$37 |
0.0× |
| Urethrocystography voiding (74455) |
$144.25 |
$577 |
0.7× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$212.50 |
$850 |
1.3× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$13.25 |
$53 |
0.1× |
| Us abdl aorta screen aaa (76706) |
$62.50 |
$250 |
0.7× |
| Us breast unilateral complete (76641) |
$63.25 |
$253 |
0.7× |
| Us breast unilateral limited (76642) |
$61.50 |
$246 |
0.8× |
| Us chest (76604) |
$146.25 |
$585 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$214.75 |
$859 |
2.3× |
| Us elastography parenchyma (76981) |
$55 |
$220 |
0.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$65.25 |
$261 |
0.7× |
| Us guided compression repair (76936) |
$54 |
$216 |
0.3× |
| Us kidney transplant (76776) |
$75.50 |
$302 |
0.8× |
| Us ob detailed single fetus (76811) |
$55.75 |
$223 |
0.3× |
| Us ob transvaginal (76817) |
$117.25 |
$469 |
1.2× |
| Us pelvic non ob complete (76856) |
$213.75 |
$855 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$56.75 |
$227 |
0.6× |
| Us pregnancy ltd (76815) |
$27.25 |
$109 |
0.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$125 |
$500 |
1.3× |
| Us retroperitoneal complete (76770) |
$158.75 |
$635 |
1.7× |
| Us scrotum and contents (76870) |
$179.25 |
$717 |
1.9× |
| Us soft tissue head/neck (76536) |
$210.75 |
$843 |
2.2× |
| Us transrectal (76872) |
$124.25 |
$497 |
1.3× |
| Us transrectal prostate volume (76873) |
$42.25 |
$169 |
0.4× |
| Us xtr non-vasc lmtd (76882) |
$19.25 |
$77 |
0.2× |
| Us, eye b-scan (76512) |
$25.50 |
$102 |
0.3× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$219.50 |
$878 |
0.4× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) |
$200 |
$800 |
0.6× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$401.25 |
$1,605 |
0.6× |
| Vasogram (74440) |
$10.50 |
$42 |
0.0× |
| Venogram extremity bilateral (75822) |
$489.75 |
$1,959 |
0.3× |
| Venogram orbital (75880) |
$19 |
$76 |
0.0× |
| Venography caval inferior serialography rs&i (75825) |
$1,356.50 |
$5,426 |
0.5× |
| Venography caval superior serialography rs&i (75827) |
$30 |
$120 |
0.0× |
| Venography epidural rs&i (75872) |
$32.50 |
$130 |
0.1× |
| Venography extremity unilateral rs&i (75820) |
$371.50 |
$1,486 |
0.3× |
| Venography Renal Bilateral (75833) |
$40 |
$160 |
0.0× |
| Venography renal unilateral selective rs&i (75831) |
$30.50 |
$122 |
0.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$31.25 |
$125 |
0.0× |
Venous sampling thru cath w/wo angiography rs& (75893)
likely a partial charge, not the full procedure |
$14.75 |
$59 |
0.0× |
| Wrist 2 views (73100) |
$97.75 |
$391 |
1.2× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$76.75 |
$307 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$43.50 |
$174 |
0.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$22.25 |
$89 |
0.3× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$253.75 |
$1,015 |
1.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$91.25 |
$365 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$108 |
$432 |
1.4× |
| X-ray exam hip uni 1 view (73501) |
$39.75 |
$159 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$21.25 |
$85 |
0.3× |
| X-ray exam hip uni 4/> views (73503) |
$20.25 |
$81 |
0.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$66 |
$264 |
0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$88.50 |
$354 |
0.9× |
| X-ray exam of femur 1 (73551) |
$35.25 |
$141 |
0.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$80.50 |
$322 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$10.50 |
$42 |
0.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$31.25 |
$125 |
0.4× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$15 |
$60 |
0.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$43.88 |
$175.50 |
0.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$11.50 |
$46 |
0.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$67.12 |
$268.50 |
0.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$45.50 |
$182 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$73.88 |
$295.50 |
0.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$149 |
$596 |
1.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$64.75 |
$259 |
0.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$67.75 |
$271 |
0.9× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$81 |
$324 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$16.25 |
$65 |
0.2× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$17.75 |
$71 |
0.2× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$14.50 |
$58 |
0.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$44.38 |
$177.50 |
0.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$104.50 |
$418 |
1.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$17.50 |
$70 |
0.2× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$20 |
$80 |
0.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$59.75 |
$239 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$99.50 |
$398 |
1.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$31.75 |
$127 |
0.4× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$84 |
$336 |
1.1× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$54.50 |
$218 |
0.7× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$87.25 |
$349 |
0.9× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$74.50 |
$298 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$43.38 |
$173.50 |
0.5× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$106.25 |
$425 |
1.3× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$95 |
$380 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$72.75 |
$291 |
0.8× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$21.38 |
$85.50 |
0.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$89.25 |
$357 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$114.25 |
$457 |
1.4× |
| Xr arthrogram ankle (73615) |
$277 |
$1,108 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$177 |
$708 |
1.9× |
| Xr finger(s) 2+ views (73140) |
$72.75 |
$291 |
0.9× |
| Xr optic foramina (70190) |
$68 |
$272 |
0.9× |
| Xr shoulder 1 view (73020) |
$64.75 |
$259 |
0.8× |
| Xr spine cervical 4 or 5 views (72050) |
$154.50 |
$618 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$43 |
$172 |
0.5× |
| Xray knee 1 or 2 views rt (73560) |
$44.25 |
$177 |
0.6× |