| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,056.50 |
$6,855 |
1.4× |
| Abdomen 1 View (74018) |
$102.30 |
$341 |
1.1× |
| Abdomen 2 views (74019) |
$123.30 |
$411 |
1.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,350 |
$4,500 |
3.1× |
| Angio internal mammary (75756) |
$3,758.70 |
$12,529 |
1.1× |
| Angio pulmonary bilat (75743) |
$3,652.50 |
$12,175 |
1.1× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,652.50 |
$12,175 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$3,652.50 |
$12,175 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,652.50 |
$12,175 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,652.50 |
$12,175 |
1.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,758.70 |
$12,529 |
1.1× |
| Ankle 2 views (73600) |
$350.10 |
$1,167 |
3.7× |
| Aortography thoracic serialography rs&i (75605) |
$6,924 |
$23,080 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$6,273 |
$20,910 |
1.0× |
| Artery X-Rays Adrenal Gland (75731) |
$3,652.50 |
$12,175 |
1.1× |
| Artery X-Rays Pelvis (75736) |
$6,273 |
$20,910 |
1.0× |
| Artery X-Rays Spine (75705) |
$6,273 |
$20,910 |
1.0× |
| Arthrogram ankle (73615) |
$523.50 |
$1,745 |
1.4× |
| Arthrogram hip (73525) |
$437.10 |
$1,457 |
1.1× |
| Arthrogram Wrist (73115) |
$315 |
$1,050 |
0.8× |
| Basic radiation dosimetry calculation (77300) |
$138 |
$460 |
0.9× |
| Bone age studies (77072) |
$325.80 |
$1,086 |
2.9× |
| Bone Imaging 3 Phase (78315) |
$1,220.10 |
$4,067 |
2.8× |
| Bone Imaging Limited Area (78300) |
$497.10 |
$1,657 |
1.1× |
| Bone Imaging Multiple Areas (78305) |
$466.20 |
$1,554 |
1.1× |
| Bone Imaging Whole Body (78306) |
$1,161.90 |
$3,873 |
2.7× |
| Bone survey infant (77076) |
$439.50 |
$1,465 |
3.8× |
| Brachytx isodose intermed (77317) |
$443.40 |
$1,478 |
1.1× |
| Brachytx Isodose Plan Simple (77316) |
$443.40 |
$1,478 |
1.1× |
| Brain Flow Imaging Only (78610) |
$624.60 |
$2,082 |
1.1× |
| Brain Image W/Flow < 4 Views (78601) |
$890.40 |
$2,968 |
2.0× |
| Cardiac Shunt Detection (78428) |
$495.90 |
$1,653 |
1.1× |
| Cat Scan Follow-Up Study (76380) |
$698.70 |
$2,329 |
7.3× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$890.40 |
$2,968 |
1.5× |
| Cerebrospinal Fluid Scan (78630) |
$890.40 |
$2,968 |
1.5× |
| Chest 1 view (71045) |
$102.30 |
$341 |
1.1× |
| Chest 2 views (71046) |
$102.30 |
$341 |
1.1× |
| Chest 3 views (71047) |
$124.80 |
$416 |
1.3× |
| Chest 4 or more views (71048) |
$133.50 |
$445 |
1.2× |
| Cisternography Positive Contrast Rs&I (70015) |
$916.80 |
$3,056 |
1.1× |
| Clavicle complete (73000) |
$414 |
$1,380 |
4.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,371.90 |
$4,573 |
12.0× |
| Continuing medical physics consltj pr wk (77336) |
$181.20 |
$604 |
1.2× |
| Contrast Exam Abdominl Aorta (75625) |
$3,652.50 |
$12,175 |
1.1× |
| Contrast X-Ray Bladder (74430) |
$486.90 |
$1,623 |
1.3× |
| Contrast X-Ray Of Elbow (73085) |
$414.30 |
$1,381 |
1.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$721.50 |
$2,405 |
1.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,756.40 |
$9,188 |
7.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,474.20 |
$4,914 |
5.7× |
| CT abdomen w contrast (74160) |
$1,794.90 |
$5,983 |
9.4× |
| CT abdomen w wo contrast (74170) |
$2,269.20 |
$7,564 |
11.8× |
| CT abdomen w/o contrast (74150) |
$1,371.30 |
$4,571 |
12.0× |
| CT Angio Abdomen and Pelvis (74174) |
$2,462.70 |
$8,209 |
6.5× |
| CT Angio Chest (71275) |
$1,911.60 |
$6,372 |
10.0× |
| CT Angio Head (70496) |
$2,263.50 |
$7,545 |
11.8× |
| CT angio hrt w/3d image (75574) |
$5,466.60 |
$18,222 |
14.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,985.70 |
$6,619 |
10.4× |
| CT Angio Neck (70498) |
$2,404.20 |
$8,014 |
12.5× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,985.70 |
$6,619 |
10.4× |
| CT cervical spine w/ contrast (72126) |
$1,942.50 |
$6,475 |
5.1× |
| CT cervical spine w/o contrast (72125) |
$1,672.20 |
$5,574 |
14.6× |
| CT cervical spine w/wo cont (72127) |
$2,458.50 |
$8,195 |
12.8× |
| CT chest w contrast (71260) |
$1,794.90 |
$5,983 |
9.4× |
| CT chest w/wo contrast (71270) |
$2,052.60 |
$6,842 |
10.7× |
| CT head/brain with contrast (70460) |
$2,173.50 |
$7,245 |
11.3× |
| CT head/brain without and with contrast (70470) |
$2,505 |
$8,350 |
13.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$3,920.10 |
$13,067 |
10.3× |
| CT iac w contrast (70481) |
$1,745.10 |
$5,817 |
9.1× |
| CT l-spine w&w/o contrast (72133) |
$2,310.90 |
$7,703 |
12.1× |
| CT lower ext w/o (73700) |
$1,381.20 |
$4,604 |
12.1× |
| CT lower extremity w/contrast material (73701) |
$1,570.50 |
$5,235 |
8.2× |
| CT lumbar spine w contrast (72132) |
$1,794.90 |
$5,983 |
4.7× |
| CT lumbar spine w/o contrast (72131) |
$1,381.20 |
$4,604 |
12.1× |
| CT maxillofacial w contrast (70487) |
$1,998.60 |
$6,662 |
10.4× |
| CT maxillofacial wo contrast (70486) |
$1,672.20 |
$5,574 |
14.6× |
| CT neck tissue combo (70492) |
$2,311.20 |
$7,704 |
12.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,111.70 |
$7,039 |
11.0× |
| CT orbits w/o contrast (70480) |
$1,632.60 |
$5,442 |
14.3× |
| CT pelvis w&w/o contrast (72194) |
$1,905 |
$6,350 |
9.9× |
| CT pelvis w/o contrast (72192) |
$1,381.20 |
$4,604 |
12.1× |
| CT scan of leg combo (73702) |
$2,166.90 |
$7,223 |
11.3× |
| CT scans face/jaw combo (70488) |
$2,046.60 |
$6,822 |
10.7× |
| CT soft tissue neck w contrast (70491) |
$2,171.70 |
$7,239 |
11.3× |
| CT soft tissue neck w/o contrast (70490) |
$1,602.90 |
$5,343 |
14.0× |
| CT thoracic spine w contrast (72129) |
$1,728 |
$5,760 |
9.0× |
| CT thoracic spine w/o contrast (72128) |
$1,381.20 |
$4,604 |
12.1× |
| CT thorax w/o contrast (71250) |
$1,371.30 |
$4,571 |
12.0× |
| CT unlisted procedure (76497) |
$108.90 |
$363 |
1.1× |
| CT upper ext wo (73200) |
$1,381.20 |
$4,604 |
12.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,148.30 |
$7,161 |
11.2× |
| CT upper extremity with contrast (73201) |
$1,533.30 |
$5,111 |
4.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,985.70 |
$6,619 |
10.4× |
| Cta Abdomen (74175) |
$1,985.70 |
$6,619 |
10.4× |
| CTA pelvis (72191) |
$1,526.40 |
$5,088 |
8.0× |
| Dilation ureters/urethra rs&i (74485) |
$2,377.20 |
$7,924 |
1.0× |
| Diskography lumbar (72295) |
$2,268 |
$7,560 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$259.20 |
$864 |
2.3× |
| Echo exam of fetal heart (76825) |
$650.40 |
$2,168 |
1.1× |
| Echo Guide For Artery Repair (76936) |
$907.50 |
$3,025 |
3.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$650.40 |
$2,168 |
2.5× |
| Esophagram (74220) |
$475.20 |
$1,584 |
2.5× |
| Fetal Biophys Profile W/Nst (76818) |
$287.40 |
$958 |
2.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$276 |
$920 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$669.60 |
$2,232 |
2.6× |
| Follow-Up Angiography (75898) |
$3,652.50 |
$12,175 |
1.1× |
| Foot 2 views (73620) |
$386.40 |
$1,288 |
4.1× |
| Forearm 2 views (73090) |
$322.50 |
$1,075 |
3.4× |
| Gastric emptying imaging study (78264) |
$1,113.60 |
$3,712 |
2.5× |
| Gated Heart Planar Single (78472) |
$597 |
$1,990 |
1.4× |
| Hand 2 views (73120) |
$322.50 |
$1,075 |
2.8× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,652.50 |
$12,175 |
1.1× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,652.50 |
$12,175 |
1.1× |
| Hepatobil Syst Image W/Drug (78227) |
$1,519.50 |
$5,065 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,481.70 |
$4,939 |
3.4× |
| Ht Musc Image Planar Mult (78454) |
$2,077.20 |
$6,924 |
1.5× |
| Ht Muscle Image Spect Sing (78451) |
$1,538.10 |
$5,127 |
1.1× |
| Hysterosalpingogram (74740) |
$370.80 |
$1,236 |
1.4× |
| Image fusion (77399) |
$154.20 |
$514 |
1.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$316.50 |
$1,055 |
3.3× |
| Infant hip ultrasound, limited static exam (76886) |
$316.50 |
$1,055 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$860.40 |
$2,868 |
1.1× |
| K Flow/Funct Image Multiple (78709) |
$672.60 |
$2,242 |
1.1× |
| K Flow/Funct Image W/Drug (78708) |
$672.60 |
$2,242 |
1.1× |
| K Flow/Funct Image W/O Drug (78707) |
$637.50 |
$2,125 |
1.1× |
| Knee 3 Views (73562) |
$458.70 |
$1,529 |
4.8× |
| Leveen/Shunt Patency Exam (78291) |
$701.40 |
$2,338 |
1.6× |
| Liver & Spleen Imaging Static Only (78215) |
$596.40 |
$1,988 |
1.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,336.20 |
$4,454 |
2.3× |
| Lung perfusion differential (78597) |
$553.50 |
$1,845 |
1.3× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,368.60 |
$4,562 |
2.3× |
| Lung Ventilation Imaging (78579) |
$504.60 |
$1,682 |
1.2× |
| Lymph System Imaging (78195) |
$630.30 |
$2,101 |
1.1× |
| Meckels Divert Exam (78290) |
$1,143 |
$3,810 |
2.6× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$615.60 |
$2,052 |
1.5× |
| Mlc imrt design & construction per imrt plan (77338) |
$183 |
$610 |
0.4× |
| Mr safety determination physician/other qhp (76016) |
$107.40 |
$358 |
1.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$30 |
$100 |
0.9× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$111.90 |
$373 |
1.1× |
| Mr safety implt pos&/immoblj (76019) |
$72.60 |
$242 |
1.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$294.60 |
$982 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,535.30 |
$8,451 |
6.6× |
| MRA head w/o contrast (70544) |
$1,850.70 |
$6,169 |
7.1× |
| MRA head with contrast (70545) |
$2,277.90 |
$7,593 |
6.0× |
| MRA neck w contrast (70548) |
$1,827.30 |
$6,091 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,145.60 |
$7,152 |
5.6× |
| MRA neck w/o contrast (70547) |
$1,465.80 |
$4,886 |
5.6× |
| MRI abdomen w contrast (74182) |
$1,757.10 |
$5,857 |
4.6× |
| MRI abdomen w/o contrast (74181) |
$1,409.40 |
$4,698 |
5.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,757.10 |
$5,857 |
2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,063.40 |
$6,878 |
5.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,713.60 |
$5,712 |
2.0× |
| MRI cervical spine w contrast (72142) |
$1,757.10 |
$5,857 |
4.6× |
| MRI cervical spine w/o cont (72141) |
$1,409.40 |
$4,698 |
5.4× |
| MRI chest w/o contrast (71550) |
$1,465.80 |
$4,886 |
5.6× |
| MRI chest with contrast (71551) |
$1,827.30 |
$6,091 |
2.1× |
| MRI chest wo w contrast (71552) |
$2,145.60 |
$7,152 |
5.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,757.10 |
$5,857 |
4.6× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,063.40 |
$6,878 |
5.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,409.40 |
$4,698 |
5.4× |
| MRI lumbar spine w contrast (72149) |
$1,757.10 |
$5,857 |
4.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,063.40 |
$6,878 |
5.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,465.80 |
$4,886 |
5.6× |
| MRI orbit face neck w contrast (70542) |
$1,827.30 |
$6,091 |
4.8× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,086.50 |
$6,955 |
5.5× |
| MRI pelvis w contrast (72196) |
$1,757.10 |
$5,857 |
4.6× |
| MRI pelvis w/o & w contrast (72197) |
$2,063.40 |
$6,878 |
5.4× |
| MRI pelvis w/o contrast (72195) |
$1,465.80 |
$4,886 |
5.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,576.50 |
$5,255 |
6.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$1,757.10 |
$5,857 |
4.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,409.40 |
$4,698 |
5.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,063.40 |
$6,878 |
5.4× |
| MRI, abdomen, combo (74183) |
$2,063.40 |
$6,878 |
5.4× |
| MRI, dorsal spine combo (72157) |
$2,063.40 |
$6,878 |
5.4× |
| MRI, dorsal spine contrast (72147) |
$1,757.10 |
$5,857 |
4.6× |
| MRI, joint upper extrem (73221) |
$1,409.40 |
$4,698 |
5.4× |
| MRI, joint upper extrem combo (73223) |
$2,063.40 |
$6,878 |
5.4× |
| MRI, lumbar spine combo (72158) |
$2,063.40 |
$6,878 |
5.4× |
| Myelogram cervical (72240) |
$1,331.10 |
$4,437 |
1.6× |
| Myelogram Lumbar (72265) |
$1,280.10 |
$4,267 |
1.5× |
| Myelography thoracic (72255) |
$1,088.70 |
$3,629 |
1.3× |
| Myelograpy 2/more regions rs&i (72270) |
$1,358.40 |
$4,528 |
1.6× |
| Myocardial Spect Multiple Studies (78452) |
$3,430.80 |
$11,436 |
2.4× |
| Neck soft tissue (70360) |
$258.30 |
$861 |
2.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$466.20 |
$1,554 |
1.1× |
| Nm unlisted gi procedure (78299) |
$495 |
$1,650 |
1.1× |
| Nonvascular Shunt X-Ray (75809) |
$152.40 |
$508 |
1.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,659.60 |
$5,532 |
1.1× |
| Nuclear Rx Intra-Arterial (79445) |
$298.50 |
$995 |
1.2× |
| Nuclear Rx Oral Admin (79005) |
$1,255.80 |
$4,186 |
4.9× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$126 |
$420 |
1.1× |
| Ophthalmic Ultrasonic Foreign Body Localization (76529) |
$156.60 |
$522 |
1.6× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$137.10 |
$457 |
1.2× |
| Panoramic X-ray of jaws (70355) |
$240 |
$800 |
2.5× |
| Parathyroid Planar Imaging (78070) |
$466.20 |
$1,554 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$295.80 |
$986 |
2.6× |
| Peritoneogram Rs&I (74190) |
$636.30 |
$2,121 |
1.1× |
| Pet Image W/Ct Lmtd (78814) |
$1,692.60 |
$5,642 |
1.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,652.50 |
$12,175 |
1.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$568.20 |
$1,894 |
1.3× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$559.80 |
$1,866 |
4.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$701.10 |
$2,337 |
1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$448.20 |
$1,494 |
4.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$386.40 |
$1,288 |
4.1× |
| Radex elbow complete minimum 3 views (73080) |
$471.90 |
$1,573 |
5.0× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$505.50 |
$1,685 |
4.4× |
| Radex fingr minimum 2 views (73140) |
$266.70 |
$889 |
2.8× |
| Radex foot complete minimum 3 views (73630) |
$442.80 |
$1,476 |
4.7× |
| Radex Hand Minimum 3 Views (73130) |
$400.80 |
$1,336 |
4.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$406.50 |
$1,355 |
4.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$184.20 |
$614 |
1.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$301.50 |
$1,005 |
3.2× |
| Radex shoulder complete minimum 2 views (73030) |
$429 |
$1,430 |
4.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$240 |
$800 |
2.5× |
| Radex Spine 1 View Specify Level (72020) |
$297.60 |
$992 |
3.1× |
| Radex Sternum Minimum 2 Views (71120) |
$421.20 |
$1,404 |
4.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$240.30 |
$801 |
2.5× |
| Radex Toe Minimum 2 Views (73660) |
$263.10 |
$877 |
2.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$356.40 |
$1,188 |
3.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$400.80 |
$1,336 |
4.2× |
| Radiation treatment delivery level 1 (77402) |
$159.90 |
$533 |
1.4× |
| Radiation treatment delivery level 2 (77407) |
$234.90 |
$783 |
0.6× |
| Radiation treatment delivery level 3 (77412) |
$179.10 |
$597 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$198.90 |
$663 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$123.30 |
$411 |
1.1× |
| Radiologic exam colon double contrast study (74280) |
$627 |
$2,090 |
3.3× |
| Radiologic exam colon single contrast study (74270) |
$615 |
$2,050 |
3.2× |
| Radiologic exam knee complete 4/more views (73564) |
$547.80 |
$1,826 |
4.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$449.70 |
$1,499 |
3.9× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$604.20 |
$2,014 |
3.2× |
| Radiologic exam swallow function contrast study (74230) |
$589.20 |
$1,964 |
3.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$206.70 |
$689 |
1.1× |
| Radiologic examination femur 1 view (73551) |
$524.70 |
$1,749 |
5.5× |
| Radiologic examination femur minimum 2 views (73552) |
$524.70 |
$1,749 |
5.5× |
| Radiologic examination knee 1/2 views (73560) |
$394.20 |
$1,314 |
4.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$439.50 |
$1,465 |
3.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$394.20 |
$1,314 |
4.1× |
| Renal Cyst Study (74470) |
$1,299 |
$4,330 |
2.2× |
| Ribs bilateral 3 views (71110) |
$615.30 |
$2,051 |
5.4× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$603.30 |
$2,011 |
1.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$466.20 |
$1,554 |
1.1× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,515 |
$5,050 |
2.6× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,515 |
$5,050 |
2.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,515 |
$5,050 |
2.6× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,515 |
$5,050 |
1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,692.60 |
$5,642 |
1.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,703.70 |
$5,679 |
1.2× |
| Scapula (73010) |
$456 |
$1,520 |
4.0× |
| Sella turcica (70240) |
$114.30 |
$381 |
1.2× |
| Shoulder 1 view (73020) |
$328.50 |
$1,095 |
3.5× |
| Shoulder Arthrography (73040) |
$561.90 |
$1,873 |
1.5× |
| Skull less than 4 views (70250) |
$390.90 |
$1,303 |
3.4× |
| Special dosimetry (77331) |
$181.20 |
$604 |
1.2× |
| Special Physics Consult (77370) |
$181.20 |
$604 |
1.2× |
| Special treatment procedure (77470) |
$793.80 |
$2,646 |
1.3× |
| Sternoclavicular joints (71130) |
$442.20 |
$1,474 |
4.6× |
| Superior sagittal sinus venogram (75870) |
$3,835.20 |
$12,784 |
1.1× |
| Testicular Imaging W/Flow (78761) |
$672.60 |
$2,242 |
1.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$675.30 |
$2,251 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$181.20 |
$604 |
1.2× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$550.80 |
$1,836 |
2.9× |
| Thoracic spine 2 views (72070) |
$411.90 |
$1,373 |
3.6× |
| Thoracic spine 3 views (72072) |
$528.30 |
$1,761 |
4.6× |
| Thoracolumbar 2 views (72080) |
$379.20 |
$1,264 |
4.0× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$608.70 |
$2,029 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$466.20 |
$1,554 |
1.1× |
| Thyroid Met Imaging Body (78018) |
$624.60 |
$2,082 |
1.1× |
| Thyroid Uptake Measurement (78012) |
$466.20 |
$1,554 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$466.20 |
$1,554 |
1.1× |
| Tx Devices Design & Construction Complex (77334) |
$516.60 |
$1,722 |
1.3× |
| Tx devices design & construction intermediate (77333) |
$344.70 |
$1,149 |
2.3× |
| Ultrasound Breast Limited (76642) |
$107.40 |
$358 |
1.1× |
| Ultrasound Elastography Parenchyma (76981) |
$161.70 |
$539 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$661.20 |
$2,204 |
5.8× |
| Umbilical-artery Doppler (OB) (76820) |
$271.80 |
$906 |
2.4× |
| Unlisted fluoroscopic procedure (76496) |
$107.40 |
$358 |
1.1× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$466.20 |
$1,554 |
1.1× |
| Unlisted us procedure (76999) |
$102.30 |
$341 |
1.1× |
| Upper gi w/o kub (74240) |
$732.30 |
$2,441 |
3.8× |
| Urethrocystogram voiding (74455) |
$527.10 |
$1,757 |
2.0× |
| Urethrocystography retrograde (74450) |
$527.10 |
$1,757 |
2.0× |
| Us breast unilateral complete (76641) |
$465.90 |
$1,553 |
4.1× |
| Us chest (76604) |
$474.90 |
$1,583 |
4.2× |
| Us complete joint (76881) |
$548.40 |
$1,828 |
4.8× |
| Us exam, pelvic, limited (76857) |
$143.70 |
$479 |
1.3× |
| Us head (76506) |
$610.20 |
$2,034 |
5.3× |
| Us kidney transplant (76776) |
$516.90 |
$1,723 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$123.30 |
$411 |
1.1× |
| Us ob detailed single fetus (76811) |
$425.70 |
$1,419 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$484.20 |
$1,614 |
4.2× |
| Us ob transvaginal (76817) |
$727.20 |
$2,424 |
6.4× |
| Us pelvic non ob complete (76856) |
$940.20 |
$3,134 |
8.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$596.10 |
$1,987 |
5.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$381.60 |
$1,272 |
3.3× |
| Us retroperitoneal complete (76770) |
$911.40 |
$3,038 |
8.0× |
| Us retroperitoneal limited (76775) |
$274.80 |
$916 |
2.4× |
| Us scrotum and contents (76870) |
$818.40 |
$2,728 |
7.2× |
| Us spinal canal and contents (76800) |
$231.60 |
$772 |
2.0× |
| Us thyroid (76536) |
$597.60 |
$1,992 |
5.2× |
| Vein X-Ray Chest (75827) |
$1,802.70 |
$6,009 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$4,015.80 |
$13,386 |
1.2× |
| Vein X-Ray Skull Epidural (75872) |
$1,084.20 |
$3,614 |
1.6× |
| Vein X-Ray Spleen/Liver (75810) |
$3,652.50 |
$12,175 |
1.1× |
| Venogram Sinus/Jugular (75860) |
$3,652.50 |
$12,175 |
1.1× |
| Venography Adrenal Unilateral (75840) |
$3,652.50 |
$12,175 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,652.50 |
$12,175 |
1.1× |
| Venography extremity bilateral rs&i (75822) |
$1,802.70 |
$6,009 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,802.70 |
$6,009 |
1.0× |
| Venography Orbital Rs&I (75880) |
$1,084.20 |
$3,614 |
1.6× |
| Venography Renal Bilateral (75833) |
$3,758.70 |
$12,529 |
1.1× |
| Venography Renal Unilateral (75831) |
$3,652.50 |
$12,175 |
1.1× |
| Venous sampling by catheter (75893) |
$6,273 |
$20,910 |
1.0× |
| Wrist 2 views (73100) |
$322.50 |
$1,075 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$294 |
$980 |
3.1× |
| X-ray antegrade pyelogram tube (74425) |
$681.90 |
$2,273 |
1.8× |
| X-Ray Aorta Leg Arteries (75630) |
$3,652.50 |
$12,175 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$143.10 |
$477 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$414.30 |
$1,381 |
4.4× |
| X-Ray Exam Breast Specimen (76098) |
$636.30 |
$2,121 |
1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$113.10 |
$377 |
1.2× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$147.30 |
$491 |
1.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$197.10 |
$657 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$197.10 |
$657 |
2.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$197.10 |
$657 |
1.7× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$207.30 |
$691 |
1.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$225.90 |
$753 |
2.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$1,050.30 |
$3,501 |
9.2× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$515.70 |
$1,719 |
5.4× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$605.40 |
$2,018 |
5.3× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$477.30 |
$1,591 |
4.2× |
| X-ray eye for foreign body (70030) |
$102.30 |
$341 |
1.1× |
| X-ray humerus (73060) |
$254.70 |
$849 |
2.7× |
| X-ray IV pyelogram (ivp) (74400) |
$708.90 |
$2,363 |
3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$143.40 |
$478 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$394.20 |
$1,314 |
4.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$528.30 |
$1,761 |
4.6× |
| X-ray nose-rectum child f.b. (76010) |
$342 |
$1,140 |
3.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$793.50 |
$2,645 |
6.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$427.80 |
$1,426 |
3.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$134.70 |
$449 |
1.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$361.20 |
$1,204 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$440.70 |
$1,469 |
4.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$576.90 |
$1,923 |
5.0× |
| X-Ray Stress View (77071) |
$794.70 |
$2,649 |
8.4× |
| X-Ray Tmj Unilat (70328) |
$240.30 |
$801 |
2.5× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$640.80 |
$2,136 |
1.7× |
| X-Rays Bone Length Studies (77073) |
$439.50 |
$1,465 |
3.8× |
| X-Rays Bone Survey Complete (77075) |
$738 |
$2,460 |
6.5× |
| Xr c-spine 4 or 5 views (72050) |
$605.40 |
$2,018 |
5.3× |
| Xr facial bones less than 3 views (70140) |
$395.70 |
$1,319 |
4.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$123.30 |
$411 |
1.1× |
| Xr orbits complete 4 views (70200) |
$597.60 |
$1,992 |
5.2× |