| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,893.10 |
$8,605 |
1.5× |
| Abdomen 2 views (74019) |
$174.68 |
$794 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$373.56 |
$1,698 |
1.0× |
| Acute venous thrombus image (78456) |
$1,458.38 |
$6,629 |
1.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,658.16 |
$16,628 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,981.88 |
$13,554 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,478.64 |
$15,812 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$3,457.30 |
$15,715 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,975.40 |
$18,070 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,975.40 |
$18,070 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,975.40 |
$18,070 |
1.4× |
| Angiography Spinal Selective Rs&I (75705) |
$3,975.40 |
$18,070 |
0.8× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,975.40 |
$18,070 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,141.92 |
$9,736 |
0.7× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,757.16 |
$17,078 |
1.3× |
| Ankle 2 views (73600) |
$98.78 |
$449 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$286.88 |
$1,304 |
0.9× |
| Aortogram thoracic (75605) |
$3,975.40 |
$18,070 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,981.88 |
$13,554 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,975.40 |
$18,070 |
1.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,658.16 |
$16,628 |
1.3× |
| Artery X-Rays Adrenal Gland (75731) |
$3,757.16 |
$17,078 |
1.3× |
| Arthrogram elbow (73085) |
$492.80 |
$2,240 |
1.6× |
| Arthrogram hip (73525) |
$535.48 |
$2,434 |
1.7× |
| Arthrogram shoulder (73040) |
$535.48 |
$2,434 |
1.7× |
| Arthrogram wrist (73115) |
$535.48 |
$2,434 |
1.7× |
| Arthrography knee lt (73580) |
$535.48 |
$2,434 |
1.7× |
| Basic radiation dosimetry calculation (77300) |
$206.80 |
$940 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$349.58 |
$1,589 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$383.90 |
$1,745 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$417.12 |
$1,896 |
1.2× |
| Bone age studies (77072) |
$82.94 |
$377 |
0.9× |
| Bone Imaging 3 Phase (78315) |
$504.24 |
$2,292 |
1.4× |
| Bone Marrow Imaging Limited Area (78102) |
$445.94 |
$2,027 |
1.2× |
| Bone survey complete (77075) |
$127.60 |
$580 |
1.3× |
| Brachytx isodose complex (77318) |
$573.76 |
$2,608 |
1.7× |
| Brachytx isodose intermed (77317) |
$528 |
$2,400 |
1.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$206.80 |
$940 |
0.6× |
| Brain image w/flow 4 + views (78606) |
$729.74 |
$3,317 |
1.5× |
| Brain imaging < 4 static views (78600) |
$387.42 |
$1,761 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$729.74 |
$3,317 |
2.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$387.42 |
$1,761 |
0.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,740.86 |
$7,913 |
1.3× |
| Brain Imaging Vascular Flow Only (78610) |
$353.54 |
$1,607 |
0.7× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$13.86 |
$63 |
1.3× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$453.20 |
$2,060 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$984.28 |
$4,474 |
3.1× |
| Cardiac shunt detection (78428) |
$453.20 |
$2,060 |
1.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$353.54 |
$1,607 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$82.94 |
$377 |
1.1× |
| Chest 1 view (71045) |
$82.94 |
$377 |
1.1× |
| Chest 3 views (71047) |
$82.94 |
$377 |
1.1× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$148.50 |
$675 |
0.9× |
| Cineradiography/videoradiography (76120) |
$189.20 |
$860 |
2.0× |
| Cisternography Positive Contrast Rs&I (70015) |
$836.88 |
$3,804 |
1.2× |
| Clavicle complete (73000) |
$82.94 |
$377 |
1.1× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$13,035.88 |
$59,254 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$106.70 |
$485 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$206.80 |
$940 |
1.7× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$345.18 |
$1,569 |
2.2× |
| Corpora cavernosography (74445) |
$156.64 |
$712 |
1.7× |
| CT abdomen and pelvis without and with contrast (74178) |
$865.04 |
$3,932 |
2.7× |
| CT abdomen and pelvis without contrast (74176) |
$548.24 |
$2,492 |
2.5× |
| CT abdomen w contrast (74160) |
$532.62 |
$2,421 |
3.4× |
| CT abdomen w wo contrast (74170) |
$590.26 |
$2,683 |
3.7× |
| CT abdomen w/o contrast (74150) |
$311.52 |
$1,416 |
3.3× |
| CT angio hrt w/3d image (75574) |
$407.22 |
$1,851 |
1.3× |
| CT angiography upper extremity lt (73206) |
$760.32 |
$3,456 |
4.8× |
| CT c-spine w/o contrast (72125) |
$389.18 |
$1,769 |
4.1× |
| CT cervical spine w&w/o contrast (72127) |
$590.26 |
$2,683 |
3.7× |
| CT cervical spine with contrast (72126) |
$665.72 |
$3,026 |
2.1× |
| CT chest w/wo contrast (71270) |
$543.18 |
$2,469 |
3.4× |
| CT chest with contrast (71260) |
$532.62 |
$2,421 |
3.4× |
| CT colonography screening (74263) |
$161.70 |
$735 |
0.7× |
| CT colonography w/dye (74262) |
$345.18 |
$1,569 |
2.2× |
| CT colonography w/o cntrst (74261) |
$170.28 |
$774 |
1.8× |
| CT head/brain with contrast (70460) |
$665.72 |
$3,026 |
4.2× |
| CT head/brain without and with contrast (70470) |
$709.50 |
$3,225 |
4.5× |
| CT heart contrast eval cardiac structure&morph (75572) |
$478.94 |
$2,177 |
1.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$89.10 |
$405 |
1.1× |
| CT hrt w/3d image congen (75573) |
$440.66 |
$2,003 |
1.4× |
| CT iac w contrast (70481) |
$532.62 |
$2,421 |
3.4× |
| CT limited/localized follow up study (76380) |
$177.54 |
$807 |
2.3× |
| CT lower ext w/o (73700) |
$389.18 |
$1,769 |
4.1× |
| CT lower extremity w wo contrast (73702) |
$737.66 |
$3,353 |
4.6× |
| CT lower extremity with contrast (73701) |
$665.72 |
$3,026 |
4.2× |
| CT lumbar spine w & w/o contrast (72133) |
$737.66 |
$3,353 |
4.6× |
| CT lumbar spine w/o contrast (72131) |
$389.18 |
$1,769 |
4.1× |
| CT lumbar spine with contrast (72132) |
$608.96 |
$2,768 |
1.9× |
| CT maxillofacial w contrast (70487) |
$532.62 |
$2,421 |
3.4× |
| CT maxillofacial w/o contrast (70486) |
$311.52 |
$1,416 |
3.3× |
| CT maxillofacial w/wo contrast (70488) |
$590.26 |
$2,683 |
3.7× |
| CT neck soft tissue w contrast (70491) |
$532.62 |
$2,421 |
3.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$590.26 |
$2,683 |
3.7× |
| CT orbits w/o contrast (70480) |
$311.52 |
$1,416 |
3.3× |
| CT pelvis w & w/o contrast (72194) |
$590.26 |
$2,683 |
3.7× |
| CT pelvis w/o contrast (72192) |
$311.52 |
$1,416 |
3.3× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$122.10 |
$555 |
1.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$590.26 |
$2,683 |
3.7× |
| CT soft tissue neck w/o contrast (70490) |
$311.52 |
$1,416 |
3.3× |
| CT thoracic spine w/contrast (72129) |
$665.72 |
$3,026 |
4.2× |
| CT thoracic spine w/o contrast (72128) |
$389.18 |
$1,769 |
4.1× |
| CT thoracic spine w/wo contrast (72130) |
$737.66 |
$3,353 |
4.6× |
| CT thorax w/o contrast (71250) |
$311.52 |
$1,416 |
3.3× |
| CT unlisted procedure (76497) |
$220.66 |
$1,003 |
2.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$737.66 |
$3,353 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$389.18 |
$1,769 |
4.1× |
| CT upper extremity with contrast (73201) |
$665.72 |
$3,026 |
2.1× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$608.30 |
$2,765 |
3.8× |
| Cta Abdomen (74175) |
$608.30 |
$2,765 |
3.8× |
| CTA abdomen pelvis (74174) |
$590.80 |
$2,685.43 |
1.9× |
| CTA chest (71275) |
$608.30 |
$2,765 |
3.8× |
| Cta Head (70496) |
$624.36 |
$2,838 |
3.9× |
| CTA lwr ext w&w/o contrast (73706) |
$760.32 |
$3,456 |
4.8× |
| Cta Neck (70498) |
$760.32 |
$3,456 |
4.8× |
| Cta Pelvis (72191) |
$608.30 |
$2,765 |
3.8× |
| Cystography minimum 3 views rs&i (74430) |
$282.26 |
$1,283 |
0.9× |
| Dacryocystography (70170) |
$421.52 |
$1,916 |
2.0× |
| Diskogram cervical (72285) |
$2,852.74 |
$12,967 |
1.6× |
| Diskography lumbar (72295) |
$2,852.74 |
$12,967 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$106.92 |
$486 |
1.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$106.92 |
$486 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$106.48 |
$484 |
1.1× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$193.16 |
$878 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$173.58 |
$789 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$58.30 |
$265 |
0.7× |
| Dxa bone density study axial skeleton (77085) |
$159.72 |
$726 |
1.7× |
| Echo exam of fetal heart (76825) |
$350.46 |
$1,593 |
0.7× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$350.46 |
$1,593 |
1.6× |
| Echoencephalography real time imaging (76506) |
$106.48 |
$484 |
1.1× |
| Esophageal motility (78258) |
$375.98 |
$1,709 |
1.0× |
| Esophagus (74220) |
$148.50 |
$675 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$177.54 |
$807 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$177.54 |
$807 |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$205.70 |
$935 |
1.0× |
| Foot 2 views (73620) |
$82.94 |
$377 |
1.1× |
| Forearm 2 views (73090) |
$103.18 |
$469 |
1.3× |
| Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) |
$317.46 |
$1,443 |
1.5× |
| Functional MRI brain by phys/psych (70555) |
$557.70 |
$2,535 |
2.6× |
| Functional MRI brain by tech (70554) |
$557.70 |
$2,535 |
2.6× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$597.52 |
$2,716 |
1.2× |
| Gastric mucosa imaging (78261) |
$343.64 |
$1,562 |
0.9× |
| Gastrointestinal Protein Loss (78282) |
$375.98 |
$1,709 |
1.0× |
| Gated Heart Planar Single (78472) |
$614.68 |
$2,794 |
1.7× |
| Hand 2 views (73120) |
$82.94 |
$377 |
0.9× |
| Hand 3 views (73130) |
$82.94 |
$377 |
1.1× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,154.12 |
$5,246 |
1.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,154.12 |
$5,246 |
1.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,061.94 |
$4,827 |
1.7× |
| Heart Infarct Image (78466) |
$453.20 |
$2,060 |
1.3× |
| Heart infarct image w ef (78468) |
$453.20 |
$2,060 |
0.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,658.16 |
$16,628 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$405.02 |
$1,841 |
0.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$500.50 |
$2,275 |
1.4× |
| Ht muscle image spect sing (78451) |
$1,082.18 |
$4,919 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$103.18 |
$469 |
1.3× |
| Hyperthermia ntrstl prb 5/< (77610) |
$647.02 |
$2,941 |
1.3× |
| Hysterosalpingogram (74740) |
$545.82 |
$2,481 |
2.5× |
| Interstitial radiation source applic complex (77778) |
$1,736.46 |
$7,893 |
2.8× |
| Intracavitary Radiation Source Applic Complex (77763) |
$664.40 |
$3,020 |
1.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$664.40 |
$3,020 |
1.3× |
| Intracavitary radiation source applic simple (77761) |
$664.40 |
$3,020 |
1.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$76.34 |
$347 |
0.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$288.20 |
$1,310 |
0.8× |
| Kidney imaging morphology (78700) |
$530.20 |
$2,410 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$530.20 |
$2,410 |
1.1× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$397.76 |
$1,808 |
0.8× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$463.98 |
$2,109 |
0.9× |
| Knee 3 views (73562) |
$82.94 |
$377 |
1.1× |
| Liver & spleen imaging static only (78215) |
$420.20 |
$1,910 |
1.2× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$420.20 |
$1,910 |
1.2× |
| Liver imaging static only (78201) |
$1,458.38 |
$6,629 |
3.0× |
| Liver imaging w/vascular flow (78202) |
$1,458.38 |
$6,629 |
3.0× |
| Lung perf&ventilat diferentl (78598) |
$535.70 |
$2,435 |
1.1× |
| Lung perfusion differential (78597) |
$321.20 |
$1,460 |
0.9× |
| Lung Ventilation Imaging (78579) |
$323.84 |
$1,472 |
0.9× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$3,916.44 |
$17,802 |
1.4× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$531.08 |
$2,414 |
0.9× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,699.06 |
$7,723 |
1.2× |
| Lymphoscintigraphy (78195) |
$406.78 |
$1,849 |
0.8× |
| Mammary ductogram or galactogram multiple (77054) |
$421.52 |
$1,916 |
2.0× |
| Mammary ductogram or galactogram single (77053) |
$421.52 |
$1,916 |
2.0× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$76.34 |
$347 |
1.0× |
| Meckels Diverticulum (78290) |
$375.98 |
$1,709 |
1.0× |
| Mlc imrt design & construction per imrt plan (77338) |
$573.76 |
$2,608 |
1.7× |
| Mr safety determination physician/other qhp (76016) |
$77.44 |
$352 |
1.0× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$52.36 |
$238 |
1.0× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$21.56 |
$98 |
0.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$80.74 |
$367 |
0.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$212.74 |
$967 |
1.0× |
| MRA head w & w/o contrast (70546) |
$984.28 |
$4,474 |
3.1× |
| MRA head w/o contrast (70544) |
$606.10 |
$2,755 |
2.8× |
| MRA head with contrast (70545) |
$814 |
$3,700 |
2.6× |
| MRA neck w contrast (70548) |
$670.78 |
$3,049 |
2.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$916.08 |
$4,164 |
2.9× |
| MRA neck w/o contrast (70547) |
$606.10 |
$2,755 |
2.8× |
| MRI abdomen w contrast (74182) |
$814 |
$3,700 |
2.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$984.28 |
$4,474 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$606.10 |
$2,755 |
2.8× |
| MRI any jnt lwr ext with con lt (73722) |
$814 |
$3,700 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$814 |
$3,700 |
1.1× |
| MRI breast w/o contrast bilateral (77047) |
$342.10 |
$1,555 |
1.6× |
| MRI breast w/o contrast unilat (77046) |
$190.52 |
$866 |
0.9× |
| MRI c-spine with contrast (72142) |
$814 |
$3,700 |
2.6× |
| MRI cardiac w/o cont stress (75559) |
$317.46 |
$1,443 |
0.6× |
| MRI cardiac w/o contrast (75557) |
$606.10 |
$2,755 |
2.8× |
| MRI cervical spine w/o contrast (72141) |
$606.10 |
$2,755 |
2.8× |
| MRI chest w/o & w/contrast material (71552) |
$984.28 |
$4,474 |
3.1× |
| MRI chest w/o contrast (71550) |
$606.10 |
$2,755 |
2.8× |
| MRI chest with contrast (71551) |
$749.10 |
$3,405 |
1.1× |
| MRI fetal sngl/1st gestation (74712) |
$323.40 |
$1,470 |
1.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$814 |
$3,700 |
2.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$814 |
$3,700 |
2.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$606.10 |
$2,755 |
2.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$632.06 |
$2,873 |
2.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,138.72 |
$5,176 |
3.6× |
| MRI orbit/face/neck w/contrast (70542) |
$848.32 |
$3,856 |
2.7× |
| MRI pelvis w contrast (72196) |
$814 |
$3,700 |
2.6× |
| MRI pelvis w/o & w/contrast material (72197) |
$984.28 |
$4,474 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$606.10 |
$2,755 |
2.8× |
| MRI scan of arm joint before and after contrast (73223) |
$984.28 |
$4,474 |
3.1× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$984.28 |
$4,474 |
1.4× |
| MRI scan of leg joint before and after contrast (73723) |
$984.28 |
$4,474 |
3.1× |
| MRI spectroscopy (76390) |
$1,057.10 |
$4,805 |
13.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$984.28 |
$4,474 |
3.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$814 |
$3,700 |
2.6× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$984.28 |
$4,474 |
3.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$814 |
$3,700 |
2.6× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$984.28 |
$4,474 |
3.1× |
| MRI thoracic spine w/o contrast (72146) |
$606.10 |
$2,755 |
2.8× |
| MRI tmj (70336) |
$606.10 |
$2,755 |
2.8× |
| MRI upper ext joint w/o contrast (73221) |
$606.10 |
$2,755 |
2.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$984.28 |
$4,474 |
3.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$606.10 |
$2,755 |
2.8× |
| Myelogram Cervical (72240) |
$836.88 |
$3,804 |
1.2× |
| Myelogram Lumbar (72265) |
$627.88 |
$2,854 |
0.9× |
| Myelogram thoracic (72255) |
$836.88 |
$3,804 |
1.2× |
| Myelography 2 or more regions (72270) |
$836.88 |
$3,804 |
1.2× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,891.78 |
$8,599 |
1.6× |
| Myocardial infarct spect (78469) |
$453.20 |
$2,060 |
0.9× |
| Myocardial Spect Multiple Studies (78452) |
$1,079.10 |
$4,905 |
0.9× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$1,287.88 |
$5,854 |
1.0× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$1,685.42 |
$7,661 |
0.8× |
| Neck soft tissue (70360) |
$62.48 |
$284 |
0.8× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$322.08 |
$1,464 |
0.9× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$288.20 |
$1,310 |
0.8× |
| Nm adrenal scan (78075) |
$1,400.08 |
$6,364 |
1.2× |
| Nm bone marrow multiple (78103) |
$410.30 |
$1,865 |
1.1× |
| Nm bone marrow wb (78104) |
$410.30 |
$1,865 |
1.1× |
| Nm cisternogram (78630) |
$671.44 |
$3,052 |
1.4× |
| Nm csf leak detection (78650) |
$1,458.38 |
$6,629 |
1.2× |
| Nm gastric emptying study (78264) |
$408.54 |
$1,857 |
1.1× |
| Nm gastroesophageal reflux study (78262) |
$375.98 |
$1,709 |
1.0× |
| Nm peritoneal-venous shunt patency (78291) |
$375.98 |
$1,709 |
1.0× |
| Nm red cell sequestration (78140) |
$638.66 |
$2,903 |
1.8× |
| Nm whole blood volume (78122) |
$638.66 |
$2,903 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,893.10 |
$8,605 |
1.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,740.86 |
$7,913 |
1.3× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$995.72 |
$4,526 |
0.8× |
| Nuclear medicine of heart pumping function (78473) |
$453.20 |
$2,060 |
1.3× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$453.20 |
$2,060 |
0.9× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$2,130.26 |
$9,683 |
1.6× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,740.86 |
$7,913 |
1.3× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$995.72 |
$4,526 |
0.8× |
| Nuclear medicine study of kidney and blood flow (78701) |
$483.56 |
$2,198 |
1.3× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$440 |
$2,000 |
1.2× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$485.10 |
$2,205 |
1.3× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$1,458.38 |
$6,629 |
3.0× |
| Nuclear Rx Oral Admin (79005) |
$376.86 |
$1,713 |
1.8× |
| Nuclr Rx Interstit Colloid (79300) |
$346.72 |
$1,576 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$115.72 |
$526 |
1.2× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$259.82 |
$1,181 |
2.2× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$115.72 |
$526 |
1.2× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$163.46 |
$743 |
1.7× |
| Orthopantogram (70355) |
$64.90 |
$295 |
0.8× |
| Osseous survey infant (77076) |
$117.48 |
$534 |
1.2× |
| Osseous survey limited (77074) |
$127.60 |
$580 |
1.3× |
| Parathyrd planar w/spect&CT (78072) |
$472.12 |
$2,146 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$467.72 |
$2,126 |
1.3× |
| Parathyroid imaging (78070) |
$370.92 |
$1,686 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$90.42 |
$411 |
1.0× |
| Perineogram (74775) |
$345.62 |
$1,571 |
1.6× |
| Peritoneogram rs&i (74190) |
$421.52 |
$1,916 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$2,130.26 |
$9,683 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,130.26 |
$9,683 |
1.6× |
| PET imaging for CT attenuation whole body (78816) |
$2,130.26 |
$9,683 |
1.6× |
| PET imaging limited area chest head/neck (78811) |
$1,960.20 |
$8,910 |
1.7× |
| PET whole body (78813) |
$2,130.26 |
$9,683 |
1.6× |
| Platelet survival study (78191) |
$324.28 |
$1,474 |
0.9× |
| Pr csf ventriculography (78635) |
$755.48 |
$3,434 |
1.5× |
| Pr gi endoscopic ultrasound (76975) |
$317.24 |
$1,442 |
1.5× |
| Pr heart first pass single,planar (78481) |
$453.20 |
$2,060 |
0.9× |
| Pr MRI brain w/ dye (70558) |
$345.18 |
$1,569 |
2.2× |
| Pr MRI brain w/o & w/ dye (70559) |
$345.18 |
$1,569 |
2.2× |
| Pr MRI brain w/o dye (70557) |
$317.46 |
$1,443 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$984.28 |
$4,474 |
3.1× |
| Pr non-imaging heart function (78414) |
$509.52 |
$2,316 |
1.0× |
| Pr red cell survival study (78130) |
$638.66 |
$2,903 |
1.8× |
| Pr sono bone density measure,peripheral (76977) |
$87.78 |
$399 |
0.9× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,658.16 |
$16,628 |
1.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,282.60 |
$5,830 |
0.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$321.20 |
$1,460 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$535.70 |
$2,435 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$458.04 |
$2,082 |
0.9× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$100.98 |
$459 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$167.42 |
$761 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$167.42 |
$761 |
1.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$156.64 |
$712 |
1.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$318.56 |
$1,448 |
3.4× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$11,214.28 |
$50,974 |
1.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$352.66 |
$1,603 |
0.7× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$168.52 |
$766 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$168.52 |
$766 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$151.58 |
$689 |
1.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$91.96 |
$418 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$174.68 |
$794 |
1.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$82.94 |
$377 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$168.08 |
$764 |
1.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$239.80 |
$1,090 |
1.5× |
| Radiologic exam teeth prtl exam < full mouth (70310) |
$317.46 |
$1,443 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$220.44 |
$1,002 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$220.44 |
$1,002 |
1.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$100.98 |
$459 |
1.3× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$76.34 |
$347 |
1.0× |
| Radiological examination surgical specimen (76098) |
$398.42 |
$1,811 |
0.8× |
| Radiopharm Dacryocystography (78660) |
$387.42 |
$1,761 |
1.1× |
| Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) |
$440.88 |
$2,004 |
2.1× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$496.10 |
$2,255 |
2.3× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$638.66 |
$2,903 |
1.8× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$638.66 |
$2,903 |
1.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$3,658.16 |
$16,628 |
1.3× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,975.40 |
$18,070 |
1.4× |
| Ribs bilateral 3 views (71110) |
$115.28 |
$524 |
1.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$671.44 |
$3,052 |
1.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$729.74 |
$3,317 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$600.82 |
$2,731 |
1.2× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$496.10 |
$2,255 |
2.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$376.86 |
$1,713 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$448.80 |
$2,040 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$82.94 |
$377 |
0.9× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$277.42 |
$1,261 |
1.3× |
| Salivary gland function study (78232) |
$423.06 |
$1,923 |
1.2× |
| Salivary gland imaging (78230) |
$408.54 |
$1,857 |
1.1× |
| Salivary gland imaging serial images (78231) |
$375.98 |
$1,709 |
1.0× |
| Scanogram (77073) |
$163.46 |
$743 |
1.7× |
| Scapula complete (73010) |
$98.78 |
$449 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$103.18 |
$469 |
4.4× |
| Sella turcica (70240) |
$76.34 |
$347 |
1.0× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$117.48 |
$534 |
1.2× |
| Sialogram (70390) |
$421.52 |
$1,916 |
2.0× |
| Simulation intermediate (77285) |
$573.76 |
$2,608 |
1.7× |
| Small bowel series (74250) |
$148.50 |
$675 |
0.9× |
| Spec medical radj physics consltj (77370) |
$206.80 |
$940 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$573.76 |
$2,608 |
1.7× |
| Special dosimetry (77331) |
$206.80 |
$940 |
1.7× |
| Special treatment procedure (77470) |
$925.98 |
$4,209 |
1.9× |
| Speech evaluation complex (70371) |
$205.70 |
$935 |
1.0× |
| Spine thoracic 3 views (72072) |
$102.30 |
$465 |
1.1× |
| Spleen imaging only (78185) |
$410.30 |
$1,865 |
1.1× |
| Splenoportograpy rs&i (75810) |
$1,457.50 |
$6,625 |
0.5× |
| Stereotactic body radiation delivery (77373) |
$3,469.62 |
$15,771 |
2.1× |
| Superior sagittal sinus venogram (75870) |
$3,757.16 |
$17,078 |
1.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$170.50 |
$775 |
1.8× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$206.80 |
$940 |
0.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$441.32 |
$2,006 |
1.3× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$492.80 |
$2,240 |
2.3× |
| Testicular Imaging With Vascular Flow (78761) |
$487.96 |
$2,218 |
1.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$573.76 |
$2,608 |
1.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$206.80 |
$940 |
1.7× |
| Therapeutic Enema (74283) |
$202.84 |
$922 |
1.3× |
| Thoracolumbar 2 views (72080) |
$82.94 |
$377 |
1.1× |
| Thyroid carcinoma metastases img addl study (78016) |
$440 |
$2,000 |
1.2× |
| Thyroid carcinoma metastases img whole body (78018) |
$478.28 |
$2,174 |
1.0× |
| Thyroid Imaging With Vascular Flow (78013) |
$200.64 |
$912 |
0.6× |
| Thyroid uptake measurement (78012) |
$428.78 |
$1,949 |
1.2× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$338.36 |
$1,538 |
0.9× |
| Tmj unilateral (70328) |
$82.94 |
$377 |
1.1× |
| Tomogram (76100) |
$117.48 |
$534 |
1.2× |
| Treatment device intermediate (77333) |
$186.34 |
$847 |
1.5× |
| Treatment devices simple (77332) |
$393.36 |
$1,788 |
3.2× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,276.66 |
$5,803 |
2.6× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$478.28 |
$2,174 |
1.3× |
| Tx devices design & construction complex (77334) |
$393.36 |
$1,788 |
1.2× |
| Ultrasound elastography first target lesion (76982) |
$167.42 |
$761 |
1.8× |
| Ultrasound scan of cornea to determine thickness (76514) |
$177.54 |
$807 |
6.8× |
| Ultrasound scan to determine eye length and lens power (76519) |
$177.54 |
$807 |
1.9× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$299.42 |
$1,361 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$171.16 |
$778 |
1.8× |
| Umbilical-artery Doppler (OB) (76820) |
$106.92 |
$486 |
1.1× |
| Unlisted fluoroscopic procedure (76496) |
$104.94 |
$477 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$96.58 |
$439 |
1.2× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$405.24 |
$1,842 |
1.1× |
| Upper Extremity Infant (73092) |
$76.34 |
$347 |
0.8× |
| Urea breath test, C-14 (isotopic); analysis (78268) |
$114.84 |
$522 |
1.2× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$445.06 |
$2,023 |
1.2× |
| Urethrocystography retrograde rs&i (74450) |
$375.54 |
$1,707 |
1.7× |
| Urethrocystography voiding (74455) |
$308.66 |
$1,403 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$345.62 |
$1,571 |
2.2× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$345.62 |
$1,571 |
2.2× |
| Us abdl aorta screen aaa (76706) |
$170.28 |
$774 |
1.8× |
| Us breast unilateral complete (76641) |
$167.86 |
$763 |
1.8× |
| Us breast unilateral limited (76642) |
$167.86 |
$763 |
2.1× |
| Us chest (76604) |
$115.72 |
$526 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$245.96 |
$1,118 |
2.6× |
| Us elastography parenchyma (76981) |
$167.42 |
$761 |
1.8× |
| Us fetal nuchal translucency 1st gestation (76813) |
$106.48 |
$484 |
1.1× |
| Us guided compression repair (76936) |
$179.30 |
$815 |
0.9× |
| Us infant hips dynamic (76885) |
$106.92 |
$486 |
1.4× |
| Us infant hips limited static (76886) |
$106.92 |
$486 |
1.4× |
| Us kidney transplant (76776) |
$178.20 |
$810 |
1.9× |
| Us ob detailed single fetus (76811) |
$277.42 |
$1,261 |
1.3× |
| Us ob transvaginal (76817) |
$116.16 |
$528 |
1.2× |
| Us pelvic non ob complete (76856) |
$177.98 |
$809 |
1.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$116.16 |
$528 |
1.2× |
| Us pregnancy ltd (76815) |
$116.16 |
$528 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$178.20 |
$810 |
1.9× |
| Us retroperitoneal complete (76770) |
$151.58 |
$689 |
1.6× |
| Us retroperitoneal limited (76775) |
$178.20 |
$810 |
1.9× |
| Us scrotum and contents (76870) |
$171.82 |
$781 |
1.8× |
| Us soft tissue head/neck (76536) |
$176.44 |
$802 |
1.9× |
| Us spinal canal and contents (76800) |
$163.90 |
$745 |
1.7× |
| Us transrectal (76872) |
$178.20 |
$810 |
1.9× |
| Us transrectal prostate volume (76873) |
$277.42 |
$1,261 |
2.9× |
| Us xtr non-vasc lmtd (76882) |
$167.86 |
$763 |
1.8× |
| Us, eye b-scan (76512) |
$177.54 |
$807 |
1.9× |
| Use of body cavity probe generated heat to increase temperature of cancer cell (77620) |
$647.02 |
$2,941 |
1.3× |
| Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) |
$647.02 |
$2,941 |
1.0× |
| Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) |
$647.02 |
$2,941 |
1.3× |
| Vascular flow imaging (78445) |
$363.88 |
$1,654 |
1.0× |
| Vasogram (74440) |
$345.62 |
$1,571 |
1.6× |
| Venogram extremity bilateral (75822) |
$1,282.60 |
$5,830 |
0.9× |
| Venogram orbital (75880) |
$1,180.30 |
$5,365 |
2.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,975.40 |
$18,070 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$1,282.60 |
$5,830 |
0.9× |
| Venography epidural rs&i (75872) |
$1,180.30 |
$5,365 |
2.1× |
| Venography extremity unilateral rs&i (75820) |
$1,282.60 |
$5,830 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,975.40 |
$18,070 |
1.4× |
| Venography renal unilateral selective rs&i (75831) |
$3,975.40 |
$18,070 |
1.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,282.60 |
$5,830 |
0.4× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,975.40 |
$18,070 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$99.88 |
$454 |
1.3× |
| Wrist 2 views (73100) |
$82.94 |
$377 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$151.58 |
$689 |
1.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$82.94 |
$377 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$94.16 |
$428 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$220.44 |
$1,002 |
1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$103.18 |
$469 |
1.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$103.18 |
$469 |
1.3× |
| X-ray exam entire spi 4/5 vw (72083) |
$318.56 |
$1,448 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$100.98 |
$459 |
1.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$100.98 |
$459 |
1.3× |
| X-ray exam hip uni 4/> views (73503) |
$167.42 |
$761 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$167.42 |
$761 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$318.56 |
$1,448 |
3.4× |
| X-ray exam of femur 1 (73551) |
$92.84 |
$422 |
1.2× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$202.84 |
$922 |
1.3× |
| X-ray eye for foreign body (70030) |
$82.94 |
$377 |
1.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$127.60 |
$580 |
1.3× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$82.94 |
$377 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$82.94 |
$377 |
1.1× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$2,026.42 |
$9,211 |
1.1× |
| X-ray head for orthodontia (70350) |
$76.34 |
$347 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$82.94 |
$377 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$345.62 |
$1,571 |
2.2× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98.78 |
$449 |
1.3× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$127.60 |
$580 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$78.76 |
$358 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$90.86 |
$413 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$82.94 |
$377 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$127.60 |
$580 |
1.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$127.60 |
$580 |
1.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$82.94 |
$377 |
1.1× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$76.34 |
$347 |
1.0× |
| X-ray of voice box or throat (70370) |
$189.20 |
$860 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$127.60 |
$580 |
1.3× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$99.44 |
$452 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$421.52 |
$1,916 |
0.9× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$313.06 |
$1,423 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$82.94 |
$377 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$95.92 |
$436 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$127.60 |
$580 |
1.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$82.94 |
$377 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$82.94 |
$377 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$103.18 |
$469 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$104.94 |
$477 |
1.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$82.94 |
$377 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$127.60 |
$580 |
1.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$103.18 |
$469 |
1.1× |
| X-Ray Spine One View - Xr Spine (72020) |
$73.48 |
$334 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$76.34 |
$347 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$98.78 |
$449 |
1.3× |
| X-Ray Teeth Single - Xr Teeth 1 View (70300) |
$59.62 |
$271 |
0.8× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$82.94 |
$377 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$76.34 |
$347 |
0.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$82.94 |
$377 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$82.94 |
$377 |
1.1× |
| Xr arthrogram ankle (73615) |
$492.80 |
$2,240 |
1.6× |
| Xr c-spine 6 or more views (72052) |
$127.60 |
$580 |
1.3× |
| Xr chest 4+ views (71048) |
$115.28 |
$524 |
1.2× |
| Xr Cholecystography Oral Contrast (74290) |
$136.62 |
$621 |
0.9× |
| Xr finger(s) 2+ views (73140) |
$82.94 |
$377 |
1.1× |
| Xr internal auditory meati complete (70134) |
$317.46 |
$1,443 |
0.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$117.48 |
$534 |
1.2× |
| Xr myelogram posterior fossa (70010) |
$836.88 |
$3,804 |
2.6× |
| Xr optic foramina (70190) |
$76.34 |
$347 |
1.0× |
| Xr shoulder 1 view (73020) |
$88.22 |
$401 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$127.60 |
$580 |
1.3× |
| Xr tibia/fibula 2 views (73590) |
$100.76 |
$458 |
1.3× |
| Xr tmj bilateral (70330) |
$76.34 |
$347 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$82.94 |
$377 |
1.1× |