| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$6,543 |
— |
| Abdomen 1 View (74018) |
— |
$565 |
— |
| Abdomen 2 views (74019) |
— |
$587 |
— |
| Angio internal mammary (75756) |
— |
$3,292 |
— |
| Angio pulmonary bilat (75743) |
— |
$5,013 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$4,636 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$3,885 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$3,639 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$4,011 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$198 |
— |
| Ankle 2 views (73600) |
— |
$243 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$3,639 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$7,718 |
— |
| Artery X-Rays Adrenal Gland (75731) |
— |
$3,709 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$3,709 |
— |
| Artery X-Rays Spine (75705) |
— |
$6,002 |
— |
| Arthrogram hip (73525) |
— |
$1,655 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$891 |
— |
| Bone age studies (77072) |
— |
$356 |
— |
| Bone survey infant (77076) |
— |
$400 |
— |
| Brachytx isodose complex (77318) |
— |
$4,287 |
— |
| Brachytx isodose intermed (77317) |
— |
$3,283 |
— |
| Brachytx Isodose Plan Simple (77316) |
— |
$2,363 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$8,814 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$3,285 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,060 |
— |
| Chest 1 view (71045) |
— |
$564 |
— |
| Chest 2 views (71046) |
— |
$591 |
— |
| Chest 4 or more views (71048) |
— |
$616 |
— |
| Clavicle complete (73000) |
— |
$328 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$1,470 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$1,011 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$3,639 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$995 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$7,944 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$5,606 |
— |
| CT abdomen w contrast (74160) |
— |
$3,884 |
— |
| CT abdomen w wo contrast (74170) |
— |
$4,628 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,857 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$7,103 |
— |
| CT Angio Chest (71275) |
— |
$4,164 |
— |
| CT Angio Head (70496) |
— |
$4,240 |
— |
| CT angio hrt w/3d image (75574) |
— |
$3,885 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$3,447 |
— |
| CT Angio Neck (70498) |
— |
$4,095 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$2,970 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$3,749 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$3,407 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$4,087 |
— |
| CT chest w contrast (71260) |
— |
$3,704 |
— |
| CT chest w/wo contrast (71270) |
— |
$4,371 |
— |
| CT colonography screening (74263) |
— |
$2,578 |
— |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
— |
$2,483 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$2,488 |
— |
| CT head/brain with contrast (70460) |
— |
$3,406 |
— |
| CT head/brain without and with contrast (70470) |
— |
$3,599 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$3,332 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$1,004 |
— |
| CT iac w contrast (70481) |
— |
$3,413 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$4,498 |
— |
| CT lower ext w/o (73700) |
— |
$2,754 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$3,173 |
— |
| CT lumbar spine w contrast (72132) |
— |
$3,885 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$3,408 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,702 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,045 |
— |
| CT neck tissue combo (70492) |
— |
$3,935 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$3,753 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,084 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$3,725 |
— |
| CT pelvis w/o contrast (72192) |
— |
$3,035 |
— |
| CT scan of leg combo (73702) |
— |
$3,315 |
— |
| CT scans face/jaw combo (70488) |
— |
$4,072 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,701 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$3,142 |
— |
| CT thoracic spine w contrast (72129) |
— |
$3,885 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$3,408 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$4,087 |
— |
| CT thorax w/o contrast (71250) |
— |
$3,125 |
— |
| CT upper ext wo (73200) |
— |
$2,843 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$3,277 |
— |
| CT upper extremity with contrast (73201) |
— |
$3,123 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$4,643 |
— |
| Cta Abdomen (74175) |
— |
$4,503 |
— |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
— |
$5,485 |
— |
| CTA pelvis (72191) |
— |
$4,082 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$1,250 |
— |
| Discography Cerv/Thor Spine (72285) |
— |
$4,628 |
— |
| Diskography lumbar (72295) |
— |
$4,775 |
— |
| Dxa Bone Density Axial (77080) |
— |
$657 |
— |
| Dxa bone density study (77085) |
— |
$826 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$312 |
— |
| Echo exam uterus (76831) |
— |
$251 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$1,133 |
— |
| Echograp Trans R Pros Study (76873) |
— |
$582 |
— |
| Esophagram (74220) |
— |
$641 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$495 |
— |
| Follow-Up Angiography (75898) |
— |
$1,200 |
— |
| Foot 2 views (73620) |
— |
$237 |
— |
| Forearm 2 views (73090) |
— |
$484 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
— |
$9,148 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
— |
$8,146 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
— |
$6,394 |
— |
| Heart Image (Pet) Multiple (78492) |
— |
$8,185 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$3,639 |
— |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
— |
$3,639 |
— |
| Hysterosalpingogram (74740) |
— |
$1,251 |
— |
| Interstitial radiation source applic complex (77778) |
— |
$2,567 |
— |
| Intracavitary Radiation Source Applic Complex (77763) |
— |
$2,709 |
— |
| Intracavitary Radiation Source Applic Intermed (77762) |
— |
$2,329 |
— |
| Knee 3 Views (73562) |
— |
$371 |
— |
| Lymphangiography Extremity Only Bilateral Rs&I (75803) |
— |
$154 |
— |
| Lymphangiography extremity only unilateral rs&i (75801) |
— |
$1,504 |
— |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
— |
$1,699 |
— |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
— |
$1,048 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$4,294 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
— |
$5,528 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
— |
$4,510 |
— |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
— |
$6,950 |
— |
| Magnetic Resonance Elastography (76391) |
— |
$4,942 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$789 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$668 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$4,989 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$93 |
— |
| Mr safety med physics xm customization plng&mntr (76017) |
— |
$387 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$3,764 |
— |
| MRA head w/o contrast (70544) |
— |
$2,976 |
— |
| MRA head with contrast (70545) |
— |
$3,326 |
— |
| MRA neck w contrast (70548) |
— |
$3,327 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$3,730 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,976 |
— |
| MRI abdomen w contrast (74182) |
— |
$5,362 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$4,719 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$6,427 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$4,667 |
— |
| MRI bone marrow blood supply (77084) |
— |
$10,617 |
— |
| MRI brain functional w/o physician admnistration (70554) |
— |
$4,982 |
— |
| MRI brain functional w/physician admnistration (70555) |
— |
$4,560 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$4,856 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$4,670 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$2,149 |
— |
| MRI cervical spine w contrast (72142) |
— |
$5,480 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$4,971 |
— |
| MRI chest w/o contrast (71550) |
— |
$4,268 |
— |
| MRI chest with contrast (71551) |
— |
$4,766 |
— |
| MRI chest wo w contrast (71552) |
— |
$6,553 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$4,758 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$6,176 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$4,495 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$5,277 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$7,004 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$4,603 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$4,814 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$6,564 |
— |
| MRI pelvis w contrast (72196) |
— |
$5,786 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$6,469 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$4,715 |
— |
| MRI spectroscopy (76390) |
— |
$3,585 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$4,459 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$4,248 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$5,932 |
— |
| MRI, abdomen, combo (74183) |
— |
$6,781 |
— |
| MRI, dorsal spine combo (72157) |
— |
$7,079 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$5,050 |
— |
| MRI, joint upper extrem (73221) |
— |
$4,317 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$6,193 |
— |
| MRI, lumbar spine combo (72158) |
— |
$6,878 |
— |
| Myelogram cervical (72240) |
— |
$2,609 |
— |
| Myelogram Lumbar (72265) |
— |
$2,526 |
— |
| Myelography thoracic (72255) |
— |
$2,955 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$3,788 |
— |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
— |
$6,970 |
— |
| Neck soft tissue (70360) |
— |
$353 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$10,147 |
— |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
— |
$501 |
— |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
— |
$441 |
— |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
— |
$635 |
— |
| Ophthalmic US Dx Corneal Pachymetry Uni/Bi (76514) |
— |
$64 |
— |
| Ophthalmic us dx quantitative a-scan only (76511) |
— |
$571 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$338 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$385 |
— |
| Peritoneogram Rs&I (74190) |
— |
$292 |
— |
| Pet Image Skull-Thigh (78812) |
— |
$8,715 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$8,109 |
— |
| PET image w/CT, full body (78816) |
— |
$9,085 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$9,085 |
— |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
— |
$8,109 |
— |
| Pet Myocardial Sngl Study (78491) |
— |
$3,230 |
— |
| PET whole body (78813) |
— |
$9,291 |
— |
| Proton trmt simple w/comp (77522) |
— |
$5,331 |
— |
| Proton tx delivery complex (77525) |
— |
$7,535 |
— |
| Proton tx delivery intermediate (77523) |
— |
$6,380 |
— |
| Proton tx delivery simple w/o compensation (77520) |
— |
$4,531 |
— |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
— |
$4,841 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$580 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$971 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$313 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$289 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$375 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$237 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$342 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$302 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$297 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$272 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$233 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$356 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$267 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$358 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$434 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$225 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$264 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$337 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$802 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$31,182 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$2,713 |
— |
| Radiation treatment delivery level 2 (77407) |
— |
$4,178 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$4,730 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$411 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$616 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,040 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$881 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$797 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$505 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$790 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$690 |
— |
| Radiologic exam teeth complete full mouth (70320) |
— |
$218 |
— |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
— |
$130 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$878 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$390 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$432 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$300 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$723 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$346 |
— |
| Radiologic examination, teeth; single view Non-Facility (70300) |
— |
$98 |
— |
| Ribs bilateral 3 views (71110) |
— |
$497 |
— |
| Scapula (73010) |
— |
$341 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$180 |
— |
| Shoulder 1 view (73020) |
— |
$285 |
— |
| Shoulder Arthrography (73040) |
— |
$1,295 |
— |
| Skull less than 4 views (70250) |
— |
$312 |
— |
| Special dosimetry (77331) |
— |
$1,007 |
— |
| Special Physics Consult (77370) |
— |
$1,431 |
— |
| Special teletherapy port plan (77321) |
— |
$1,684 |
— |
| Special treatment procedure (77470) |
— |
$3,582 |
— |
| Srs Multisource (77371) |
— |
$71,624 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$18,191 |
— |
| Sternoclavicular joints (71130) |
— |
$353 |
— |
| Superior sagittal sinus venogram (75870) |
— |
$212 |
— |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
— |
$124 |
— |
| Tbs technical calculation only (77091) |
— |
$67 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$4,129 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$3,900 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$3,026 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$2,185 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$1,443 |
— |
| Thoracic spine 2 views (72070) |
— |
$387 |
— |
| Thoracic spine 3 views (72072) |
— |
$452 |
— |
| Thoracolumbar 2 views (72080) |
— |
$315 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$1,358 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$1,059 |
— |
| Tx devices design & construction simple (77332) |
— |
$700 |
— |
| Ultrasound Breast Limited (76642) |
— |
$1,124 |
— |
| Ultrasound elastography first target lesion (76982) |
— |
$1,390 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$1,390 |
— |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
— |
$1,776 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$795 |
— |
| Unlisted Dx Radiographic Procedure (76499) |
— |
$547 |
— |
Unlisted fluoroscopic procedure (76496)
range across 3 matching MRF lines |
— |
$371–$3,909 |
— |
| Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine (78199) |
— |
$2,864 |
— |
Unlisted magnetic resonance procedure (76498)
range across 2 matching MRF lines |
— |
$5,019–$10,652 |
— |
| Upper gi w/o kub (74240) |
— |
$669 |
— |
| Urethrocystogram voiding (74455) |
— |
$792 |
— |
| Urethrocystography retrograde (74450) |
— |
$189 |
— |
| Us breast unilateral complete (76641) |
— |
$1,401 |
— |
| Us chest (76604) |
— |
$642 |
— |
| Us complete joint (76881) |
— |
$774 |
— |
| Us exam, pelvic, limited (76857) |
— |
$627 |
— |
| Us kidney transplant (76776) |
— |
$979 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$593 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$126 |
— |
| Us ob transvaginal (76817) |
— |
$668 |
— |
| Us pelvic non ob complete (76856) |
— |
$1,082 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$519 |
— |
| Us retroperitoneal complete (76770) |
— |
$812 |
— |
| Us retroperitoneal limited (76775) |
— |
$719 |
— |
| Us scrotum and contents (76870) |
— |
$894 |
— |
| Us thyroid (76536) |
— |
$911 |
— |
| Us transrectal (76872) |
— |
$756 |
— |
| Vein X-Ray Chest (75827) |
— |
$1,177 |
— |
| Vein X-Ray Liver W/O Hemodyn (75887) |
— |
$3,547 |
— |
| Vein X-Ray Skull Epidural (75872) |
— |
$210 |
— |
| Vein X-Ray Spleen/Liver (75810) |
— |
$193 |
— |
| Venogram Sinus/Jugular (75860) |
— |
$263 |
— |
| Venography Adrenal Unilateral (75840) |
— |
$3,333 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$3,639 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,177 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,153 |
— |
| Venography Renal Bilateral (75833) |
— |
$4,548 |
— |
| Venography Renal Unilateral (75831) |
— |
$3,639 |
— |
| Venous sampling by catheter (75893) |
— |
$3,639 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$826 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$311 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,095 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$7,521 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$319 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$326 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$577 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$650 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$779 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$379 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$420 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$520 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$513 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$578 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$641 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$405 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$254 |
— |
| X-ray eye for foreign body (70030) |
— |
$470 |
— |
| X-ray humerus (73060) |
— |
$328 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,231 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$295 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$369 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$350 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$422 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$231 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$387 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$289 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$510 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$561 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,231 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$531 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,142 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$551 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$292 |
— |
| Xr myelogram posterior fossa (70010) |
— |
$645 |
— |
| Xr orbits complete 4 views (70200) |
— |
$363 |
— |