| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,903.27 |
$7,258.17 |
1.6× |
| Abdomen 1 View (74018) |
$296.11 |
$740.27 |
2.6× |
| Abdomen 2 views (74019) |
$560.24 |
$1,400.61 |
4.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,561.40 |
$3,903.50 |
3.0× |
| Angio internal mammary (75756) |
$5,626.48 |
$14,066.21 |
1.4× |
| Angio pulmonary bilat (75743) |
$3,495.60 |
$8,739 |
0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$3,495.60 |
$8,739 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$4,202.52 |
$10,506.30 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,495.60 |
$8,739 |
0.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,495.60 |
$8,739 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,990.14 |
$7,475.34 |
0.7× |
| Ankle 2 views (73600) |
$369.48 |
$923.69 |
3.3× |
| Aortography thoracic serialography rs&i (75605) |
$6,003.20 |
$15,008 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$3,495.60 |
$8,739 |
0.9× |
| Artery X-Rays Abdomen (75726) |
$6,003.20 |
$15,008 |
0.8× |
| Artery X-Rays Adrenal Gland (75731) |
$3,495.60 |
$8,739 |
0.9× |
| Artery X-Rays Pelvis (75736) |
$6,003.20 |
$15,008 |
0.8× |
| Artery X-Rays Spine (75705) |
$6,003.20 |
$15,008 |
0.8× |
| Arthrogram ankle (73615) |
$562.73 |
$1,406.83 |
1.2× |
| Arthrogram hip (73525) |
$1,203.22 |
$3,008.06 |
2.7× |
| Arthrogram Wrist (73115) |
$707.20 |
$1,768 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$794.76 |
$1,986.90 |
4.6× |
| Bone age studies (77072) |
$264.35 |
$660.88 |
1.9× |
| Bone Imaging 3 Phase (78315) |
$2,716.31 |
$6,790.78 |
5.2× |
| Bone Imaging Limited Area (78300) |
$1,250.66 |
$3,126.64 |
2.4× |
| Bone Imaging Multiple Areas (78305) |
$1,646.29 |
$4,115.72 |
3.2× |
| Bone Imaging Whole Body (78306) |
$2,331.96 |
$5,829.91 |
4.5× |
| Bone marrow imaging limited area (78102) |
$742.80 |
$1,857 |
1.4× |
| Bone marrow imaging; multiple areas (78103) |
$910.18 |
$2,275.46 |
1.8× |
| Bone marrow imaging; whole body (78104) |
$816.66 |
$2,041.66 |
1.6× |
| Bone survey infant (77076) |
$208.40 |
$521 |
1.5× |
| Brachytx isodose complex (77318) |
$986.52 |
$2,466.29 |
2.0× |
| Brachytx isodose intermed (77317) |
$986.52 |
$2,466.29 |
2.0× |
| Brachytx Isodose Plan Simple (77316) |
$725.20 |
$1,813 |
1.5× |
| Brain Image W/Flow < 4 Views (78601) |
$753.06 |
$1,882.64 |
1.5× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$639.41 |
$1,598.53 |
0.9× |
| Brain Imaging Minimum 4 Static Views (78605) |
$995.20 |
$2,488 |
1.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,119.01 |
$7,797.52 |
1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,131.61 |
$2,829.02 |
2.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$3,528.05 |
$8,820.13 |
7.8× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$4,564.35 |
$11,410.88 |
4.5× |
| Cardiac Shunt Detection (78428) |
$742.80 |
$1,857 |
1.4× |
| Cardiovasc nucl exam unlisted (78499) |
$800.14 |
$2,000.36 |
1.5× |
| Cat Scan Follow-Up Study (76380) |
$550.27 |
$1,375.67 |
4.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$995.20 |
$2,488 |
1.4× |
| Cerebrospinal Fluid Scan (78630) |
$1,218.08 |
$3,045.21 |
1.7× |
| Chest 1 view (71045) |
$292.74 |
$731.85 |
2.6× |
| Chest 2 views (71046) |
$297.79 |
$744.47 |
2.6× |
| Chest 3 views (71047) |
$341.06 |
$852.66 |
3.0× |
| Chest 4 or more views (71048) |
$635.29 |
$1,588.23 |
4.7× |
| Cholecystography Oral Contrast (74290) |
$538.32 |
$1,345.79 |
2.4× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$454.74 |
$1,136.85 |
3.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$1,356 |
$3,390 |
1.3× |
| Clavicle complete (73000) |
$462.44 |
$1,156.09 |
4.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$252.80 |
$632 |
1.9× |
| Continuing medical physics consltj pr wk (77336) |
$800.82 |
$2,002.05 |
4.6× |
| Contrast Exam Abdominl Aorta (75625) |
$3,495.60 |
$8,739 |
0.9× |
| Contrast X-Ray Bladder (74430) |
$707.20 |
$1,768 |
1.6× |
| Contrast X-Ray Of Elbow (73085) |
$565.02 |
$1,412.54 |
1.2× |
| Contrast X-Ray Of Knee Joint (73580) |
$707.20 |
$1,768 |
1.6× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$409.63 |
$1,024.08 |
1.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$5,083.52 |
$12,708.79 |
11.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,625.04 |
$6,562.61 |
8.5× |
| CT abdomen w contrast (74160) |
$2,002.26 |
$5,005.65 |
8.8× |
| CT abdomen w wo contrast (74170) |
$2,459.13 |
$6,147.82 |
10.8× |
| CT abdomen w/o contrast (74150) |
$1,206.49 |
$3,016.23 |
8.9× |
| CT Angio Abdomen and Pelvis (74174) |
$6,131.21 |
$15,328.03 |
13.5× |
| CT Angio Chest (71275) |
$2,449.87 |
$6,124.67 |
10.8× |
| CT Angio Head (70496) |
$4,623.49 |
$11,558.73 |
20.3× |
| CT angio hrt w/3d image (75574) |
$1,524.42 |
$3,811.04 |
3.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$3,467.20 |
$8,668.01 |
15.2× |
| CT Angio Neck (70498) |
$4,602.67 |
$11,506.67 |
20.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$3,742.99 |
$9,357.48 |
16.4× |
| CT cervical spine w/ contrast (72126) |
$2,367.20 |
$5,918.01 |
5.2× |
| CT cervical spine w/o contrast (72125) |
$1,858.41 |
$4,646.02 |
13.7× |
| CT cervical spine w/wo cont (72127) |
$2,722.58 |
$6,806.46 |
12.0× |
| CT chest w contrast (71260) |
$3,146.30 |
$7,865.76 |
13.8× |
| CT chest w/wo contrast (71270) |
$3,678.30 |
$9,195.74 |
16.2× |
| CT colonography screening (74263) |
$419.18 |
$1,047.94 |
1.4× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,705.12 |
$4,262.80 |
7.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$880.88 |
$2,202.20 |
6.5× |
| CT head/brain with contrast (70460) |
$1,543.66 |
$3,859.15 |
6.8× |
| CT head/brain without and with contrast (70470) |
$1,806.20 |
$4,515.50 |
7.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,673.88 |
$4,184.69 |
3.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$244.72 |
$611.79 |
2.2× |
| CT hrt w/3d image congen (75573) |
$1,280.63 |
$3,201.57 |
2.8× |
| CT iac w contrast (70481) |
$2,402.38 |
$6,005.95 |
10.6× |
| CT l-spine w&w/o contrast (72133) |
$2,543.75 |
$6,359.38 |
11.2× |
| CT lower ext w/o (73700) |
$2,024.24 |
$5,060.61 |
14.9× |
| CT lower extremity w/contrast material (73701) |
$2,749.64 |
$6,874.09 |
12.1× |
| CT lumbar spine w contrast (72132) |
$2,424.67 |
$6,061.68 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$1,788.10 |
$4,470.26 |
13.2× |
| CT maxillofacial w contrast (70487) |
$1,780.54 |
$4,451.36 |
7.8× |
| CT maxillofacial wo contrast (70486) |
$1,485.03 |
$3,712.57 |
10.9× |
| CT neck tissue combo (70492) |
$1,973.06 |
$4,932.64 |
8.7× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$2,659.60 |
$6,649.01 |
11.7× |
| CT orbits w/o contrast (70480) |
$2,077.34 |
$5,193.35 |
15.3× |
| CT pelvis w&w/o contrast (72194) |
$2,990.62 |
$7,476.55 |
13.1× |
| CT pelvis w/o contrast (72192) |
$1,817.13 |
$4,542.82 |
13.4× |
| CT scan of leg combo (73702) |
$3,011.48 |
$7,528.71 |
13.2× |
| CT scans face/jaw combo (70488) |
$1,817.09 |
$4,542.72 |
8.0× |
| CT soft tissue neck w contrast (70491) |
$1,792 |
$4,480 |
7.9× |
| CT soft tissue neck w/o contrast (70490) |
$1,318.26 |
$3,295.64 |
9.7× |
| CT thoracic spine w contrast (72129) |
$2,016.10 |
$5,040.26 |
8.9× |
| CT thoracic spine w/o contrast (72128) |
$1,799.78 |
$4,499.46 |
13.3× |
| CT thoracic spine w/wo cont (72130) |
$2,532.72 |
$6,331.79 |
11.1× |
| CT thorax w/o contrast (71250) |
$1,437.88 |
$3,594.70 |
10.6× |
| CT upper ext wo (73200) |
$857.16 |
$2,142.89 |
6.3× |
| CT upper extremity w/o & w/contrast material (73202) |
$883.51 |
$2,208.78 |
3.9× |
| CT upper extremity with contrast (73201) |
$1,004.11 |
$2,510.27 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$4,989.22 |
$12,473.04 |
21.9× |
| Cta Abdomen (74175) |
$2,384.71 |
$5,961.78 |
10.5× |
| CTA pelvis (72191) |
$3,140.26 |
$7,850.65 |
13.8× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Non-Facility (70170) |
$510.80 |
$1,277 |
1.6× |
| Dilation ureters/urethra rs&i (74485) |
$2,071.88 |
$5,179.69 |
0.8× |
| Discography Cerv/Thor Spine (72285) |
$2,366 |
$5,915 |
0.9× |
| Diskography lumbar (72295) |
$2,366 |
$5,915 |
0.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$280.98 |
$702.45 |
2.1× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$499.54 |
$1,248.86 |
3.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$252.80 |
$632 |
1.9× |
| Dxa Bone Density Axial (77080) |
$252.80 |
$632 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$209.60 |
$524 |
1.9× |
| Echo exam of fetal heart (76825) |
$1,066.06 |
$2,665.14 |
1.5× |
| Echo exam uterus (76831) |
$569.17 |
$1,422.93 |
1.8× |
| Echo Guide For Artery Repair (76936) |
$1,330.03 |
$3,325.08 |
4.7× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$510.80 |
$1,277 |
1.6× |
| Echograp Trans R Pros Study (76873) |
$555.92 |
$1,389.79 |
4.1× |
| Esophageal Motility Study (78258) |
$779.03 |
$1,947.57 |
1.5× |
| Esophagram (74220) |
$905.07 |
$2,262.67 |
4.0× |
| Fetal Biophys Profile W/Nst (76818) |
$666.96 |
$1,667.39 |
4.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$687.32 |
$1,718.31 |
5.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$783.18 |
$1,957.94 |
2.5× |
| Fluoroscopy up to 1 hr (76000) |
$997.41 |
$2,493.53 |
3.2× |
| Follow-Up Angiography (75898) |
$3,495.60 |
$8,739 |
0.9× |
| Foot 2 views (73620) |
$420.96 |
$1,052.40 |
3.7× |
| Forearm 2 views (73090) |
$315.61 |
$789.03 |
2.8× |
| Gastric emptying imaging study (78264) |
$1,987.55 |
$4,968.88 |
3.8× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$1,629.36 |
$4,073.41 |
3.1× |
| Gastroesophageal Reflux Exam (78262) |
$910.96 |
$2,277.40 |
1.8× |
| Gated Heart Planar Single (78472) |
$1,994.62 |
$4,986.55 |
3.8× |
| Gated Heart, Multiple (78473) |
$2,312.71 |
$5,781.78 |
4.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$665.70 |
$1,664.26 |
0.9× |
| Hand 2 views (73120) |
$272.32 |
$680.81 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$2,562.02 |
$6,405.06 |
2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$2,562.02 |
$6,405.06 |
2.8× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$2,562.02 |
$6,405.06 |
2.8× |
| Heart Image (Pet) Multiple (78492) |
$3,664 |
$9,159.99 |
2.0× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,495.60 |
$8,739 |
0.9× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$3,495.60 |
$8,739 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$1,596.49 |
$3,991.23 |
2.3× |
| Hepatobiliary System Imaging (78226) |
$1,265.45 |
$3,163.62 |
2.4× |
| Ht Musc Image Planar Mult (78454) |
$1,980.04 |
$4,950.11 |
1.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,471.89 |
$6,179.73 |
1.5× |
| Hysterosalpingogram (74740) |
$556.01 |
$1,390.02 |
1.8× |
| Image fusion (77399) |
$354.11 |
$885.28 |
2.0× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$582.34 |
$1,455.85 |
5.2× |
| Infant hip ultrasound, limited static exam (76886) |
$221.16 |
$552.90 |
2.0× |
| Infusion Ivp (74410) |
$399.60 |
$999 |
1.8× |
| Interstitial radiation source applic complex (77778) |
$3,190.29 |
$7,975.73 |
3.5× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,707.04 |
$4,267.59 |
1.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,324.34 |
$3,310.85 |
1.8× |
| Intracavitary radiation source applic simple (77761) |
$1,069.20 |
$2,673 |
1.5× |
| Joint Survey Single View (77077) |
$252.80 |
$632 |
1.9× |
| K Flow/Funct Image Multiple (78709) |
$1,467.96 |
$3,669.89 |
2.1× |
| K Flow/Funct Image W/Drug (78708) |
$2,160 |
$5,399.99 |
3.1× |
| K Flow/Funct Image W/O Drug (78707) |
$1,714.38 |
$4,285.94 |
2.4× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$742.80 |
$1,857 |
1.4× |
| Kidney Imaging Morphol (78700) |
$935.58 |
$2,338.95 |
1.8× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$1,143.38 |
$2,858.45 |
2.2× |
| Knee 3 Views (73562) |
$358.23 |
$895.57 |
3.2× |
| Labeled RBC Sequestration Differntl Organ/Tissue (78140) |
$742.80 |
$1,857 |
1.4× |
| Leveen/Shunt Patency Exam (78291) |
$1,069.36 |
$2,673.39 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$742.80 |
$1,857 |
1.4× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$1,037.18 |
$2,592.95 |
2.0× |
| Liver imaging static only (78201) |
$995.20 |
$2,488 |
1.4× |
| Liver imaging w/vascular flow (78202) |
$995.20 |
$2,488 |
1.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,063.70 |
$2,659.26 |
1.5× |
| Lung perfusion differential (78597) |
$826.99 |
$2,067.48 |
1.6× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,721.52 |
$4,303.80 |
2.4× |
| Lung Ventilation Imaging (78579) |
$1,075.45 |
$2,688.63 |
2.1× |
| Lymph System Imaging (78195) |
$2,001.51 |
$5,003.78 |
2.8× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$3,495.60 |
$8,739 |
0.9× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,705.37 |
$6,763.42 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$1,736.26 |
$4,340.66 |
5.6× |
| Magnetic Resonance Elastography (76391) |
$750.34 |
$1,875.86 |
2.4× |
| Meckels Divert Exam (78290) |
$940.77 |
$2,351.93 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,125.78 |
$5,314.45 |
4.4× |
| Mr safety determination physician/other qhp (76016) |
$213.42 |
$533.55 |
1.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$65.95 |
$164.87 |
1.8× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$222.48 |
$556.20 |
1.8× |
| Mr safety implt pos&/immoblj (76019) |
$149.20 |
$373 |
1.9× |
| Mr safety med physics xm customization plng&mntr (76017) |
$520.77 |
$1,301.93 |
1.7× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,929.68 |
$7,324.19 |
6.5× |
| MRA head w/o contrast (70544) |
$1,946.88 |
$4,867.20 |
6.3× |
| MRA head with contrast (70545) |
$2,121.71 |
$5,304.27 |
4.7× |
| MRA neck w contrast (70548) |
$2,312.96 |
$5,782.40 |
5.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,821.08 |
$9,552.70 |
8.4× |
| MRA neck w/o contrast (70547) |
$2,067 |
$5,167.50 |
6.7× |
| MRI abdomen w contrast (74182) |
$2,301.41 |
$5,753.52 |
5.1× |
| MRI abdomen w/o contrast (74181) |
$2,151.52 |
$5,378.80 |
6.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,952.60 |
$7,381.51 |
2.9× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,578.80 |
$8,947 |
7.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,304.05 |
$8,260.12 |
3.2× |
| MRI bone marrow blood supply (77084) |
$2,090 |
$5,224.99 |
6.7× |
| MRI brain functional w/o physician admnistration (70554) |
$1,243.18 |
$3,107.96 |
4.0× |
| MRI brain functional w/physician admnistration (70555) |
$720.59 |
$1,801.48 |
2.3× |
| MRI Breast W/O Contrast Bilateral (77047) |
$750.34 |
$1,875.86 |
2.4× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$750.34 |
$1,875.86 |
2.4× |
| MRI cardiac w/o contrast (75557) |
$3,188.76 |
$7,971.91 |
10.3× |
| MRI cervical spine w contrast (72142) |
$3,144.64 |
$7,861.61 |
6.9× |
| MRI cervical spine w/o cont (72141) |
$2,408.94 |
$6,022.35 |
7.8× |
| MRI chest w/o contrast (71550) |
$2,569.49 |
$6,423.73 |
8.3× |
| MRI chest with contrast (71551) |
$2,621.45 |
$6,553.62 |
2.6× |
| MRI chest wo w contrast (71552) |
$3,423.92 |
$8,559.79 |
7.6× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,495.21 |
$6,238.02 |
5.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,407.91 |
$8,519.77 |
7.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,010.91 |
$5,027.28 |
6.5× |
| MRI lumbar spine w contrast (72149) |
$4,165.62 |
$10,414.05 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,818.92 |
$9,547.29 |
8.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,339.82 |
$3,349.54 |
4.3× |
| MRI orbit face neck w contrast (70542) |
$2,527.80 |
$6,319.50 |
5.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$4,026.15 |
$10,065.37 |
8.9× |
| MRI pelvis w contrast (72196) |
$2,142.67 |
$5,356.67 |
4.7× |
| MRI pelvis w/o & w contrast (72197) |
$4,144.80 |
$10,361.99 |
9.2× |
| MRI pelvis w/o contrast (72195) |
$2,305.11 |
$5,762.77 |
7.4× |
| MRI spectroscopy (76390) |
$814.89 |
$2,037.23 |
7.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,296.02 |
$5,740.06 |
7.4× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,598.48 |
$6,496.19 |
5.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,896.70 |
$4,741.74 |
6.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,056.17 |
$7,640.43 |
6.7× |
| MRI, abdomen, combo (74183) |
$3,484.48 |
$8,711.21 |
7.7× |
| MRI, dorsal spine combo (72157) |
$4,168.95 |
$10,422.38 |
9.2× |
| MRI, dorsal spine contrast (72147) |
$3,051.63 |
$7,629.07 |
6.7× |
| MRI, joint upper extrem (73221) |
$2,055.26 |
$5,138.15 |
6.6× |
| MRI, joint upper extrem combo (73223) |
$3,359.45 |
$8,398.63 |
7.4× |
| MRI, lumbar spine combo (72158) |
$3,501.79 |
$8,754.48 |
7.7× |
| Myelogram cervical (72240) |
$1,356 |
$3,390 |
1.3× |
| Myelogram Lumbar (72265) |
$1,356 |
$3,390 |
1.3× |
| Myelography thoracic (72255) |
$1,329.01 |
$3,322.53 |
1.3× |
| Myelograpy 2/more regions rs&i (72270) |
$1,356 |
$3,390 |
1.3× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$742.80 |
$1,857 |
1.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,059.42 |
$7,648.54 |
1.8× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,980.04 |
$4,950.11 |
1.2× |
| Myocardial Spect Multiple Studies (78452) |
$4,612.23 |
$11,530.57 |
2.7× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$3,893.76 |
$9,734.40 |
2.1× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$2,929.80 |
$7,324.50 |
1.6× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$4,547.48 |
$11,368.70 |
1.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,118.96 |
$12,797.39 |
1.8× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$5,118.96 |
$12,797.39 |
2.6× |
| N-invas est c ffr sw aly CTA (75580) |
$1,939.53 |
$4,848.83 |
1.7× |
| Neck soft tissue (70360) |
$242.71 |
$606.78 |
2.1× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$615.84 |
$1,539.60 |
1.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$498.18 |
$1,245.45 |
1.0× |
| Nm csf leak detection (78650) |
$1,707.51 |
$4,268.77 |
1.0× |
| Nm myocard infarct spect (78469) |
$1,338.44 |
$3,346.09 |
1.9× |
| Nm unlisted gi procedure (78299) |
$1,022.50 |
$2,556.25 |
2.0× |
| Nonvascular Shunt X-Ray (75809) |
$397 |
$992.51 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$10,205.96 |
$25,514.90 |
5.7× |
| Nuclear Rx Intra-Arterial (79445) |
$876.53 |
$2,191.33 |
2.9× |
| Nuclear Rx Oral Admin (79005) |
$1,339.02 |
$3,347.56 |
4.4× |
| Ob us nuchal meas 1 gest (76813) |
$448.30 |
$1,120.74 |
3.3× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$252.80 |
$632 |
1.9× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$316.98 |
$792.46 |
2.3× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$552.61 |
$1,381.53 |
3.2× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$323.16 |
$807.89 |
2.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$259.86 |
$649.64 |
1.9× |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
$64.80 |
$162 |
1.7× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$252.80 |
$632 |
1.9× |
| Optic foramina (70190) |
$258.98 |
$647.45 |
2.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,613.75 |
$4,034.37 |
2.3× |
| Parathyroid Planar Imaging (78070) |
$1,070.12 |
$2,675.31 |
2.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,070.12 |
$2,675.31 |
2.1× |
| Pelvis 1 or 2 views (72170) |
$294.85 |
$737.12 |
2.2× |
| Peritoneogram Rs&I (74190) |
$1,249.01 |
$3,122.52 |
1.8× |
| Pet Image W/Ct Lmtd (78814) |
$4,262.85 |
$10,657.13 |
2.3× |
| PET image w/CT, full body (78816) |
$4,262.85 |
$10,657.13 |
2.3× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,262.85 |
$10,657.13 |
2.3× |
| Pet Myocardial Sngl Study (78491) |
$3,161.97 |
$7,904.92 |
1.7× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,754.60 |
$4,386.51 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,495.60 |
$8,739 |
0.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,147.58 |
$2,868.96 |
2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$584.97 |
$1,462.43 |
4.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$848.87 |
$2,122.18 |
1.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$341.13 |
$852.82 |
3.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$251.36 |
$628.41 |
2.2× |
| Radex elbow complete minimum 3 views (73080) |
$379.29 |
$948.23 |
3.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$408.71 |
$1,021.78 |
3.0× |
| Radex fingr minimum 2 views (73140) |
$229.10 |
$572.76 |
2.0× |
| Radex foot complete minimum 3 views (73630) |
$422.04 |
$1,055.11 |
3.7× |
| Radex Hand Minimum 3 Views (73130) |
$363.42 |
$908.55 |
3.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$365.26 |
$913.16 |
3.2× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$272.17 |
$680.43 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$491.92 |
$1,229.81 |
4.4× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$455.28 |
$1,138.21 |
4.0× |
| Radex shoulder complete minimum 2 views (73030) |
$432.39 |
$1,080.97 |
3.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$209.60 |
$524 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$300.69 |
$751.72 |
2.7× |
| Radex Sternum Minimum 2 Views (71120) |
$369.12 |
$922.80 |
3.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$336.96 |
$842.40 |
3.0× |
| Radex Toe Minimum 2 Views (73660) |
$282.28 |
$705.71 |
2.5× |
| Radex upper extremity infant minimum 2 views (73092) |
$252.80 |
$632 |
1.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$325.96 |
$814.90 |
2.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$252.80 |
$632 |
1.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$15,317.19 |
$38,292.97 |
1.6× |
| Radiation treatment delivery level 1 (77402) |
$379.96 |
$949.91 |
2.9× |
| Radiation treatment delivery level 2 (77407) |
$555.60 |
$1,389 |
1.1× |
| Radiation treatment delivery level 3 (77412) |
$718.62 |
$1,796.54 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$252.80 |
$632 |
1.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$563.60 |
$1,409.01 |
4.2× |
| Radiologic exam colon double contrast study (74280) |
$1,510.47 |
$3,776.18 |
6.6× |
| Radiologic exam colon single contrast study (74270) |
$732.66 |
$1,831.66 |
3.2× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$524.06 |
$1,310.14 |
2.3× |
| Radiologic exam knee complete 4/more views (73564) |
$490.18 |
$1,225.46 |
3.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$384.84 |
$962.09 |
2.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$456.76 |
$1,141.89 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$424.86 |
$1,062.14 |
1.9× |
| Radiologic exam teeth complete full mouth (70320) |
$510.80 |
$1,277 |
1.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$510.80 |
$1,277 |
1.6× |
| Radiologic exam upr gi trc double contrast study (74246) |
$524.06 |
$1,310.14 |
2.3× |
| Radiologic examination femur 1 view (73551) |
$171.04 |
$427.59 |
1.5× |
| Radiologic examination femur minimum 2 views (73552) |
$171.04 |
$427.59 |
1.5× |
| Radiologic examination knee 1/2 views (73560) |
$239.58 |
$598.96 |
2.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$257.06 |
$642.66 |
1.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$273.22 |
$683.04 |
2.4× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$656.96 |
$1,642.41 |
0.9× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$209.60 |
$524 |
1.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$738.46 |
$1,846.16 |
1.5× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$615.30 |
$1,538.25 |
1.2× |
| Renal Cyst Study (74470) |
$824.54 |
$2,061.34 |
1.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$812.97 |
$2,032.43 |
1.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,051.89 |
$2,629.72 |
2.0× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,595.41 |
$6,488.52 |
3.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,068.40 |
$5,171 |
2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,372.93 |
$5,932.32 |
3.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,582.72 |
$6,456.79 |
1.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,878.40 |
$9,696.01 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$3,343.88 |
$8,359.69 |
2.0× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$1,225.22 |
$3,063.06 |
4.0× |
| Rp Therapy Intravenous Administration (79101) |
$737.22 |
$1,843.05 |
2.4× |
| Salivary Gland Function Study (78232) |
$742.80 |
$1,857 |
1.4× |
| Salivary Gland Imaging (78230) |
$498.18 |
$1,245.45 |
1.0× |
| Salivary Gland Imaging Serial Images (78231) |
$923.65 |
$2,309.12 |
1.8× |
| Scapula (73010) |
$430.78 |
$1,076.96 |
3.2× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$94.04 |
$235.09 |
4.0× |
| Sella turcica (70240) |
$209.60 |
$524 |
1.9× |
| Shoulder 1 view (73020) |
$459.96 |
$1,149.90 |
4.1× |
| Shoulder Arthrography (73040) |
$1,023.01 |
$2,557.52 |
2.3× |
| Sialogram (70390) |
$510.80 |
$1,277 |
1.6× |
| Skull less than 4 views (70250) |
$381.60 |
$953.99 |
2.8× |
| Special dosimetry (77331) |
$450.24 |
$1,125.59 |
2.6× |
| Special Physics Consult (77370) |
$2,636.03 |
$6,590.08 |
15.1× |
| Special teletherapy port plan (77321) |
$988.80 |
$2,472 |
2.0× |
| Special treatment procedure (77470) |
$3,267.28 |
$8,168.19 |
4.6× |
| Speech evaluation, complex (70371) |
$510.80 |
$1,277 |
1.6× |
| Spleen Imaging (78185) |
$536.98 |
$1,342.45 |
1.0× |
| Srs Multisource (77371) |
$31,648.84 |
$79,122.11 |
3.3× |
| Stereotactic Body Radiation Delivery (77373) |
$7,438.38 |
$18,595.95 |
3.2× |
| Sternoclavicular joints (71130) |
$425.12 |
$1,062.80 |
3.8× |
| Superior sagittal sinus venogram (75870) |
$3,495.60 |
$8,739 |
0.9× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$386.56 |
$966.39 |
2.9× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$725.20 |
$1,813 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$725.20 |
$1,813 |
1.5× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$692.84 |
$1,732.09 |
2.2× |
| Testicular Imaging W/Flow (78761) |
$742.80 |
$1,857 |
1.4× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,325.36 |
$5,813.41 |
4.8× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,054.09 |
$2,635.23 |
2.2× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,069.97 |
$2,674.92 |
6.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$695.58 |
$1,738.94 |
3.1× |
| Thoracic spine 2 views (72070) |
$432.16 |
$1,080.40 |
3.2× |
| Thoracic spine 3 views (72072) |
$499.51 |
$1,248.77 |
3.7× |
| Thoracolumbar 2 views (72080) |
$475.37 |
$1,188.43 |
4.2× |
| Thyroid carcinoma metastases imaging; with additional studies (eg, urinary recovery) Non-Facility (78016) |
$1,269.26 |
$3,173.16 |
2.4× |
| Thyroid Carcinoma Metastases Img Lmtd Area (78015) |
$742.80 |
$1,857 |
1.4× |
| Thyroid Imaging With Vascular Flow (78013) |
$742.80 |
$1,857 |
1.4× |
| Thyroid Met Imaging Body (78018) |
$1,469.52 |
$3,673.79 |
2.1× |
| Thyroid Uptake Measurement (78012) |
$742.80 |
$1,857 |
1.4× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,254.30 |
$3,135.75 |
2.4× |
| Tx Devices Design & Construction Complex (77334) |
$1,781.60 |
$4,454 |
3.7× |
| Tx devices design & construction intermediate (77333) |
$641.69 |
$1,604.22 |
3.7× |
| Tx devices design & construction simple (77332) |
$608.15 |
$1,520.37 |
3.5× |
| Ultrasound Breast Limited (76642) |
$351.64 |
$879.10 |
3.1× |
| Ultrasound Elastography Parenchyma (76981) |
$411.93 |
$1,029.82 |
3.0× |
| Ultrasound Exam Aaa Screen (76706) |
$603.63 |
$1,509.08 |
4.4× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$592.97 |
$1,482.42 |
1.3× |
| Ultrasound, abdomen limited (76705) |
$643.34 |
$1,608.34 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$308.48 |
$771.20 |
2.3× |
Unlisted Dx Radiographic Procedure (76499)
range across 4 matching MRF lines |
$2,320.69–$4,368.09 |
$5,801.72–$10,920.22 |
varies |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
$1,438.28 |
$3,595.69 |
2.8× |
| Unlisted magnetic resonance procedure (76498) |
$760.16 |
$1,900.40 |
6.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$886.10 |
$2,215.25 |
1.7× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$2,752.05 |
$6,880.13 |
20.8× |
| Upper gi w/o kub (74240) |
$562.87 |
$1,407.17 |
2.5× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$119.44 |
$298.60 |
10.8× |
| Ureteral Reflux Study (78740) |
$742.80 |
$1,857 |
1.4× |
| Urethrocystogram voiding (74455) |
$1,067.49 |
$2,668.73 |
3.4× |
| Urethrocystography retrograde (74450) |
$872.36 |
$2,180.90 |
2.8× |
| Us breast unilateral complete (76641) |
$449.95 |
$1,124.87 |
3.3× |
| Us chest (76604) |
$365.91 |
$914.78 |
2.7× |
| Us complete joint (76881) |
$556.67 |
$1,391.67 |
4.1× |
| Us exam, pelvic, limited (76857) |
$497.54 |
$1,243.84 |
3.7× |
| Us head (76506) |
$271.67 |
$679.17 |
2.0× |
| Us kidney transplant (76776) |
$963.63 |
$2,409.07 |
7.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$375.38 |
$938.45 |
2.8× |
| Us ob detailed single fetus (76811) |
$731.21 |
$1,828.03 |
2.4× |
| Us ob limited 1 or more fetuses (76815) |
$453.20 |
$1,133 |
3.3× |
| Us ob transvaginal (76817) |
$674.06 |
$1,685.14 |
5.0× |
| Us pelvic non ob complete (76856) |
$768.37 |
$1,920.93 |
5.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$572.60 |
$1,431.50 |
4.2× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$413.77 |
$1,034.42 |
3.0× |
| Us retroperitoneal complete (76770) |
$561.14 |
$1,402.84 |
4.1× |
| Us retroperitoneal limited (76775) |
$798.47 |
$1,996.17 |
5.9× |
| Us scrotum and contents (76870) |
$733.76 |
$1,834.40 |
5.4× |
| Us spinal canal and contents (76800) |
$252.80 |
$632 |
1.9× |
| Us thyroid (76536) |
$684.87 |
$1,712.18 |
5.0× |
| Us transrectal (76872) |
$689.80 |
$1,724.51 |
5.1× |
| Vascular Flow Imaging (78445) |
$742.80 |
$1,857 |
1.4× |
| Vein X-Ray Chest (75827) |
$2,018.27 |
$5,045.67 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,402.09 |
$8,505.22 |
0.8× |
| Vein X-Ray Skull Epidural (75872) |
$2,899.70 |
$7,249.26 |
3.6× |
| Vein X-Ray Spleen/Liver (75810) |
$3,495.60 |
$8,739 |
0.9× |
| Venogram Sinus/Jugular (75860) |
$3,495.60 |
$8,739 |
0.9× |
| Venography Adrenal Unilateral (75840) |
$3,495.60 |
$8,739 |
0.9× |
| Venography caval inferior serialography rs&i (75825) |
$3,495.60 |
$8,739 |
0.9× |
| Venography extremity bilateral rs&i (75822) |
$1,882 |
$4,705 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,882 |
$4,705 |
0.9× |
| Venography Renal Bilateral (75833) |
$3,495.60 |
$8,739 |
0.9× |
| Venography Renal Unilateral (75831) |
$3,495.60 |
$8,739 |
0.9× |
| Venous sampling by catheter (75893) |
$6,003.20 |
$15,008 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$209.60 |
$524 |
1.9× |
| Wrist 2 views (73100) |
$273.43 |
$683.58 |
2.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$516.60 |
$1,291.49 |
4.6× |
| X-ray antegrade pyelogram tube (74425) |
$1,149.35 |
$2,873.38 |
2.5× |
| X-Ray Aorta Leg Arteries (75630) |
$4,823.93 |
$12,059.82 |
1.2× |
| X-Ray Bend Only L-S Spine (72120) |
$358.60 |
$896.49 |
2.6× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$307.57 |
$768.93 |
2.7× |
| X-Ray Exam Breast Specimen (76098) |
$820.29 |
$2,050.72 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$184.82 |
$462.05 |
1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$252.80 |
$632 |
1.9× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$252.80 |
$632 |
1.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$171.04 |
$427.59 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$187.50 |
$468.75 |
1.7× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$243.93 |
$609.82 |
1.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$227.70 |
$569.26 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$252.80 |
$632 |
1.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$252.80 |
$632 |
1.9× |
| X-Ray Exam L-S Spine Bending (72114) |
$330.48 |
$826.20 |
2.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$426.58 |
$1,066.46 |
3.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$732.83 |
$1,832.07 |
5.4× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$373.37 |
$933.43 |
2.8× |
| X-ray eye for foreign body (70030) |
$317.69 |
$794.22 |
2.8× |
| X-ray humerus (73060) |
$363.43 |
$908.58 |
3.2× |
| X-ray IV pyelogram (ivp) (74400) |
$399.60 |
$999 |
1.8× |
| X-ray IV pyelogram+tomography (74415) |
$399.60 |
$999 |
1.8× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$209.60 |
$524 |
1.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$209.60 |
$524 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$357.36 |
$893.41 |
2.6× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$440 |
$1,099.99 |
3.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$386.18 |
$965.44 |
2.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$322.78 |
$806.96 |
2.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$418.83 |
$1,047.08 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$292.38 |
$730.95 |
2.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$576.50 |
$1,441.24 |
4.2× |
| X-ray thoracic spine 4 vw (72074) |
$636.28 |
$1,590.71 |
4.7× |
| X-Ray Tmj Unilat (70328) |
$209.60 |
$524 |
1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$864.54 |
$2,161.36 |
1.9× |
| X-Rays Bone Length Studies (77073) |
$252.80 |
$632 |
1.9× |
| X-Rays Bone Survey Complete (77075) |
$1,008.67 |
$2,521.68 |
7.4× |
| Xr c-spine 4 or 5 views (72050) |
$552.38 |
$1,380.95 |
4.1× |
| Xr facial bones less than 3 views (70140) |
$301.04 |
$752.61 |
2.7× |
| XR Mastoids < 3 Views Bilateral (70120) |
$252.80 |
$632 |
1.9× |
| Xr myelogram posterior fossa (70010) |
$944.54 |
$2,361.35 |
2.1× |
| Xr orbits complete 4 views (70200) |
$514.41 |
$1,286.03 |
3.8× |
| Xr Tomogram Single Plane (76100) |
$548.10 |
$1,370.26 |
4.0× |