| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,788 |
$7,980 |
3.6× |
| Abdomen 1 View (74018) |
$210.60 |
$351 |
2.5× |
| Abdomen 2 views (74019) |
$310.80 |
$518 |
3.1× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,660.20 |
$2,767 |
4.4× |
| Angio internal mammary (75756) |
$4,507.20 |
$7,512 |
1.5× |
| Angio pulmonary bilat (75743) |
$6,139.80 |
$10,233 |
2.0× |
| Angiography extremity bilateral rs&i (75716) |
$5,600.40 |
$9,334 |
1.9× |
| Angiography extremity unilateral rs&i (75710) |
$5,684.40 |
$9,474 |
1.9× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$4,522.20 |
$7,537 |
1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,082.80 |
$5,138 |
1.0× |
| Ankle 2 views (73600) |
$262.80 |
$438 |
3.2× |
| Aortography thoracic serialography rs&i (75605) |
$6,045 |
$10,075 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$6,592.20 |
$10,987 |
1.2× |
| Artery X-Rays Pelvis (75736) |
$6,787.80 |
$11,313 |
1.3× |
| Artery X-Rays Spine (75705) |
$7,681.20 |
$12,802 |
1.5× |
| Arthrogram hip (73525) |
$1,834.20 |
$3,057 |
5.5× |
| Arthrogram Wrist (73115) |
$711.60 |
$1,186 |
2.1× |
| Basic radiation dosimetry calculation (77300) |
$641.40 |
$1,069 |
5.0× |
| Bone age studies (77072) |
$220.80 |
$368 |
2.2× |
| Bone Imaging 3 Phase (78315) |
$1,435.80 |
$2,393 |
3.8× |
| Bone Imaging Limited Area (78300) |
$1,322.40 |
$2,204 |
3.5× |
| Bone Imaging Multiple Areas (78305) |
$1,327.80 |
$2,213 |
3.5× |
| Bone Imaging Whole Body (78306) |
$1,336.20 |
$2,227 |
3.5× |
| Bone marrow imaging limited area (78102) |
$575.40 |
$959 |
1.5× |
| Bone marrow imaging; multiple areas (78103) |
$700.20 |
$1,167 |
1.8× |
| Bone marrow imaging; whole body (78104) |
$825.60 |
$1,376 |
2.2× |
| Bone survey infant (77076) |
$318.60 |
$531 |
3.2× |
| Brachytx isodose complex (77318) |
$2,556.60 |
$4,261 |
7.2× |
| Brachytx isodose intermed (77317) |
$994.80 |
$1,658 |
2.8× |
| Brachytx Isodose Plan Simple (77316) |
$739.20 |
$1,232 |
2.1× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,002 |
$1,670 |
1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,955.20 |
$6,592 |
2.9× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$1,395.60 |
$2,326 |
3.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,952.40 |
$3,254 |
5.9× |
| Cat Scan Follow-Up Study (76380) |
$629.40 |
$1,049 |
7.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,081.20 |
$1,802 |
2.1× |
| Cerebrospinal Fluid Scan (78630) |
$2,750.40 |
$4,584 |
5.3× |
| Chest 1 view (71045) |
$213.60 |
$356 |
2.6× |
| Chest 2 views (71046) |
$287.40 |
$479 |
3.5× |
| Chest 3 views (71047) |
$289.80 |
$483 |
3.5× |
| Chest 4 or more views (71048) |
$291 |
$485 |
2.9× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$177 |
$295 |
1.8× |
| Clavicle complete (73000) |
$250.20 |
$417 |
3.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$550.80 |
$918 |
5.5× |
| Continuing medical physics consltj pr wk (77336) |
$880.20 |
$1,467 |
6.9× |
| Contrast Exam Abdominl Aorta (75625) |
$4,507.20 |
$7,512 |
1.5× |
| Contrast X-Ray Bladder (74430) |
$609 |
$1,015 |
1.8× |
| Contrast X-Ray Of Knee Joint (73580) |
$769.80 |
$1,283 |
2.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,770.20 |
$4,617 |
8.4× |
| CT abdomen and pelvis without contrast (74176) |
$2,204.40 |
$3,674 |
9.7× |
| CT abdomen w contrast (74160) |
$1,441.80 |
$2,403 |
8.7× |
| CT abdomen w wo contrast (74170) |
$1,593 |
$2,655 |
9.6× |
| CT abdomen w/o contrast (74150) |
$1,121.40 |
$1,869 |
11.3× |
| CT Angio Abdomen and Pelvis (74174) |
$2,704.80 |
$4,508 |
8.2× |
| CT Angio Chest (71275) |
$1,800.60 |
$3,001 |
10.8× |
| CT Angio Head (70496) |
$1,878 |
$3,130 |
11.3× |
| CT angio hrt w/3d image (75574) |
$1,747.20 |
$2,912 |
5.3× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,208 |
$3,680 |
13.3× |
| CT Angio Neck (70498) |
$1,863 |
$3,105 |
11.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,737 |
$2,895 |
10.4× |
| CT cervical spine w/ contrast (72126) |
$1,546.80 |
$2,578 |
4.7× |
| CT cervical spine w/o contrast (72125) |
$1,360.80 |
$2,268 |
13.7× |
| CT cervical spine w/wo cont (72127) |
$1,548 |
$2,580 |
9.3× |
| CT chest w contrast (71260) |
$1,463.40 |
$2,439 |
8.8× |
| CT chest w/wo contrast (71270) |
$1,635.60 |
$2,726 |
9.8× |
| CT colonography screening (74263) |
$651 |
$1,085 |
2.9× |
| CT Colonogrphy Dx Image Postprocess W/Contrast (74262) |
$1,640.40 |
$2,734 |
9.8× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$1,254 |
$2,090 |
12.6× |
| CT head/brain with contrast (70460) |
$1,355.40 |
$2,259 |
8.1× |
| CT head/brain without and with contrast (70470) |
$1,384.80 |
$2,308 |
8.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$540 |
$900 |
6.5× |
| CT hrt w/3d image congen (75573) |
$1,175.40 |
$1,959 |
3.5× |
| CT iac w contrast (70481) |
$1,464 |
$2,440 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$1,660.80 |
$2,768 |
10.0× |
CT lower ext w/o (73700)
range across 3 matching MRF lines |
$1,142.40–$2,125.20 |
$1,904–$3,542 |
varies |
CT lower extremity w/contrast material (73701)
range across 8 matching MRF lines |
$1,676.40–$2,253 |
$2,794–$3,755 |
varies |
| CT lumbar spine w contrast (72132) |
$1,344.60 |
$2,241 |
4.1× |
| CT lumbar spine w/o contrast (72131) |
$1,327.80 |
$2,213 |
13.4× |
| CT maxillofacial w contrast (70487) |
$1,615.80 |
$2,693 |
9.7× |
| CT maxillofacial wo contrast (70486) |
$1,238.40 |
$2,064 |
12.5× |
| CT neck tissue combo (70492) |
$1,751.40 |
$2,919 |
10.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,501.20 |
$2,502 |
9.0× |
| CT orbits w/o contrast (70480) |
$1,144.80 |
$1,908 |
11.5× |
| CT pelvis w&w/o contrast (72194) |
$1,620 |
$2,700 |
9.7× |
| CT pelvis w/o contrast (72192) |
$1,172.40 |
$1,954 |
11.8× |
| CT scan of leg combo (73702) |
$2,028 |
$3,380 |
12.2× |
| CT scans face/jaw combo (70488) |
$1,567.20 |
$2,612 |
9.4× |
| CT soft tissue neck w contrast (70491) |
$1,285.80 |
$2,143 |
7.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,029 |
$1,715 |
10.4× |
| CT thoracic spine w contrast (72129) |
$1,344.60 |
$2,241 |
8.1× |
| CT thoracic spine w/o contrast (72128) |
$1,313.40 |
$2,189 |
13.2× |
| CT thoracic spine w/wo cont (72130) |
$1,596 |
$2,660 |
9.6× |
| CT thorax w/o contrast (71250) |
$985.80 |
$1,643 |
9.9× |
CT upper ext wo (73200)
range across 10 matching MRF lines |
$1,100.40–$2,427.60 |
$1,834–$4,046 |
varies |
| CT upper extremity w/o & w/contrast material (73202) |
$1,539 |
$2,565 |
9.2× |
| CT upper extremity with contrast (73201) |
$1,262.40 |
$2,104 |
3.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,794 |
$2,990 |
10.8× |
| Cta Abdomen (74175) |
$1,774.80 |
$2,958 |
10.7× |
| CTA pelvis (72191) |
$1,646.40 |
$2,744 |
9.9× |
| Dilation ureters/urethra rs&i (74485) |
$2,697.60 |
$4,496 |
1.4× |
| Discography Cerv/Thor Spine (72285) |
$3,664.80 |
$6,108 |
2.0× |
| Diskography lumbar (72295) |
$3,387.60 |
$5,646 |
1.8× |
| Dxa Bone Density Axial (77080) |
$400.20 |
$667 |
4.0× |
| Dxa bone density study (77085) |
$567 |
$945 |
5.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$270 |
$450 |
3.3× |
| Echo exam uterus (76831) |
$526.80 |
$878 |
2.3× |
| Echo Guide For Artery Repair (76936) |
$997.20 |
$1,662 |
4.9× |
| Echograp Trans R Pros Study (76873) |
$1,026 |
$1,710 |
10.3× |
| Esophagram (74220) |
$407.40 |
$679 |
2.4× |
| Fetal Biophys Profile W/Nst (76818) |
$420.60 |
$701 |
4.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$400.80 |
$668 |
4.0× |
| Fluoroscopy up to 1 hr (76000) |
$462.60 |
$771 |
2.0× |
| Follow-Up Angiography (75898) |
$3,082.80 |
$5,138 |
1.0× |
| Foot 2 views (73620) |
$228 |
$380 |
2.8× |
| Forearm 2 views (73090) |
$294 |
$490 |
3.6× |
| Gastric emptying imaging study (78264) |
$1,262.40 |
$2,104 |
3.3× |
| Gastroesophageal Reflux Exam (78262) |
$1,153.20 |
$1,922 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,113.60 |
$1,856 |
2.9× |
| Hand 2 views (73120) |
$297 |
$495 |
3.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$4,293.60 |
$7,156 |
6.5× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$3,980.40 |
$6,634 |
6.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$3,085.20 |
$5,142 |
4.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$4,507.20 |
$7,512 |
1.5× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$4,507.20 |
$7,512 |
1.5× |
| Hepatobil Syst Image W/Drug (78227) |
$1,435.80 |
$2,393 |
2.8× |
| Hepatobiliary System Imaging (78226) |
$1,029 |
$1,715 |
2.7× |
| Ht Musc Image Planar Mult (78454) |
$3,888.60 |
$6,481 |
3.2× |
| Ht Muscle Image Spect Sing (78451) |
$2,836.80 |
$4,728 |
2.3× |
| Hyperthermia generated by intracavitary probe(s) Non-Facility (77620) |
$828.60 |
$1,381 |
1.6× |
| Hysterosalpingogram (74740) |
$478.20 |
$797 |
2.1× |
| Image fusion (77399) |
$984.60 |
$1,641 |
7.7× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$435 |
$725 |
5.3× |
| Joint Survey Single View (77077) |
$450 |
$750 |
4.5× |
| K Flow/Funct Image W/Drug (78708) |
$1,311 |
$2,185 |
2.5× |
| K Flow/Funct Image W/O Drug (78707) |
$972 |
$1,620 |
1.9× |
| Kidney Imaging Morphol (78700) |
$710.40 |
$1,184 |
1.9× |
| Knee 3 Views (73562) |
$313.20 |
$522 |
3.8× |
| Liver & Spleen Imaging Static Only (78215) |
$837.60 |
$1,396 |
2.2× |
| Lung perfusion differential (78597) |
$1,504.80 |
$2,508 |
4.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,743.60 |
$2,906 |
3.4× |
| Lymph System Imaging (78195) |
$2,050.80 |
$3,418 |
4.0× |
| Magnetic Image Jaw Joint (70336) |
$1,409.40 |
$2,349 |
6.2× |
| Meckels Divert Exam (78290) |
$822.60 |
$1,371 |
2.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,601.60 |
$4,336 |
7.3× |
| Mr safety determination physician/other qhp (76016) |
$113.40 |
$189 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$31.80 |
$53 |
1.2× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$120.60 |
$201 |
1.3× |
| Mr safety implt pos&/immoblj (76019) |
$76.80 |
$128 |
1.4× |
| Mr safety med physics xm customization plng&mntr (76017) |
$311.40 |
$519 |
1.4× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,651.20 |
$2,752 |
5.0× |
| MRA head w/o contrast (70544) |
$1,486.80 |
$2,478 |
6.6× |
| MRA head with contrast (70545) |
$1,500 |
$2,500 |
4.5× |
| MRA neck w contrast (70548) |
$1,748.40 |
$2,914 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,200.80 |
$3,668 |
6.6× |
| MRA neck w/o contrast (70547) |
$1,510.20 |
$2,517 |
6.7× |
| MRI abdomen w contrast (74182) |
$1,735.80 |
$2,893 |
5.2× |
| MRI abdomen w/o contrast (74181) |
$1,797.60 |
$2,996 |
7.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,460 |
$4,100 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,497.20 |
$4,162 |
7.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,893 |
$3,155 |
2.5× |
| MRI brain functional w/o physician admnistration (70554) |
$908.40 |
$1,514 |
4.0× |
| MRI brain functional w/physician admnistration (70555) |
$1,749.60 |
$2,916 |
7.7× |
| MRI cardiac w/o contrast (75557) |
$1,660.80 |
$2,768 |
7.3× |
| MRI cervical spine w contrast (72142) |
$1,788.60 |
$2,981 |
5.4× |
| MRI cervical spine w/o cont (72141) |
$1,726.80 |
$2,878 |
7.6× |
| MRI chest w/o contrast (71550) |
$1,575 |
$2,625 |
6.9× |
| MRI chest with contrast (71551) |
$2,149.80 |
$3,583 |
2.9× |
| MRI chest wo w contrast (71552) |
$2,928 |
$4,880 |
8.8× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,939.20 |
$3,232 |
5.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,289.60 |
$3,816 |
6.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,724.40 |
$2,874 |
7.6× |
| MRI lumbar spine w contrast (72149) |
$2,095.80 |
$3,493 |
6.3× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,910.60 |
$4,851 |
8.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,333.20 |
$2,222 |
5.9× |
| MRI orbit face neck w contrast (70542) |
$1,540.80 |
$2,568 |
4.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,289 |
$3,815 |
6.9× |
| MRI pelvis w contrast (72196) |
$2,038.20 |
$3,397 |
6.1× |
| MRI pelvis w/o & w contrast (72197) |
$2,562 |
$4,270 |
7.7× |
| MRI pelvis w/o contrast (72195) |
$1,510.80 |
$2,518 |
6.7× |
| MRI spectroscopy (76390) |
$1,812.60 |
$3,021 |
21.9× |
| MRI thoracic spine w/o contrast (72146) |
$1,829.40 |
$3,049 |
8.1× |
MRI upper extremity oth than jt w/contr matrl (73219)
range across 6 matching MRF lines |
$1,818.60–$2,020.80 |
$3,031–$3,368 |
varies |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,683 |
$2,805 |
7.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,266.80 |
$3,778 |
6.8× |
| MRI, abdomen, combo (74183) |
$2,172.60 |
$3,621 |
6.6× |
| MRI, dorsal spine combo (72157) |
$3,804.60 |
$6,341 |
11.5× |
| MRI, dorsal spine contrast (72147) |
$3,522 |
$5,870 |
10.6× |
| MRI, joint upper extrem (73221) |
$1,672.80 |
$2,788 |
7.4× |
| MRI, joint upper extrem combo (73223) |
$2,073.60 |
$3,456 |
6.3× |
| MRI, lumbar spine combo (72158) |
$2,895 |
$4,825 |
8.7× |
| Myocardial Imaging Infarct Avid Planar Qual/Quan (78466) |
$718.20 |
$1,197 |
1.9× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$8,871 |
$14,785 |
7.2× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$2,610 |
$4,350 |
2.1× |
| Myocardial Spect Multiple Studies (78452) |
$4,200.60 |
$7,001 |
3.4× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$10,432.80 |
$17,388 |
7.7× |
| N-invas est c ffr sw aly CTA (75580) |
$1,882.20 |
$3,137 |
2.3× |
| Neck soft tissue (70360) |
$291 |
$485 |
3.5× |
| Nonvascular Shunt X-Ray (75809) |
$487.80 |
$813 |
4.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,082.80 |
$10,138 |
4.6× |
| Nuclear Rx Oral Admin (79005) |
$1,657.20 |
$2,762 |
7.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,612.80 |
$2,688 |
3.1× |
| Parathyroid Planar Imaging (78070) |
$1,341 |
$2,235 |
3.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,363.20 |
$2,272 |
3.6× |
| Pelvis 1 or 2 views (72170) |
$277.20 |
$462 |
2.8× |
| Pet Image W/Ct Lmtd (78814) |
$4,015.20 |
$6,692 |
3.0× |
| PET image w/CT, full body (78816) |
$4,289.40 |
$7,149 |
3.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,246.80 |
$7,078 |
3.1× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,507.20 |
$7,512 |
1.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,693.80 |
$2,823 |
4.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$448.20 |
$747 |
4.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$986.40 |
$1,644 |
1.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$333 |
$555 |
4.0× |
| Radex Calcaneus Minimum 2 Views (73650) |
$399.60 |
$666 |
4.8× |
| Radex elbow complete minimum 3 views (73080) |
$337.20 |
$562 |
4.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$366.60 |
$611 |
3.7× |
| Radex fingr minimum 2 views (73140) |
$214.80 |
$358 |
2.6× |
| Radex foot complete minimum 3 views (73630) |
$335.40 |
$559 |
4.1× |
| Radex Hand Minimum 3 Views (73130) |
$334.20 |
$557 |
4.0× |
| Radex lower extremity infant minimum 2 views (73592) |
$274.80 |
$458 |
3.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$260.40 |
$434 |
2.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$315.60 |
$526 |
3.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$248.40 |
$414 |
3.0× |
| Radex shoulder complete minimum 2 views (73030) |
$340.20 |
$567 |
4.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$76.20 |
$127 |
0.9× |
| Radex Sternum Minimum 2 Views (71120) |
$251.40 |
$419 |
3.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$256.80 |
$428 |
3.1× |
| Radex Toe Minimum 2 Views (73660) |
$201 |
$335 |
2.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$300.60 |
$501 |
3.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$328.20 |
$547 |
4.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$481.80 |
$803 |
4.9× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$22,229.40 |
$37,049 |
3.2× |
| Radiation treatment delivery level 1 (77402) |
$496.20 |
$827 |
5.1× |
| Radiation treatment delivery level 3 (77412) |
$1,110.60 |
$1,851 |
2.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$390.60 |
$651 |
3.9× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$379.20 |
$632 |
3.8× |
| Radiologic exam colon double contrast study (74280) |
$717 |
$1,195 |
4.3× |
| Radiologic exam colon single contrast study (74270) |
$517.80 |
$863 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$364.80 |
$608 |
2.2× |
| Radiologic exam knee complete 4/more views (73564) |
$340.80 |
$568 |
3.4× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$424.80 |
$708 |
4.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$507.60 |
$846 |
3.0× |
| Radiologic exam swallow function contrast study (74230) |
$464.40 |
$774 |
2.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$540 |
$900 |
3.2× |
| Radiologic examination femur 1 view (73551) |
$214.20 |
$357 |
2.6× |
| Radiologic examination femur minimum 2 views (73552) |
$297 |
$495 |
3.6× |
| Radiologic examination knee 1/2 views (73560) |
$264 |
$440 |
3.2× |
| Radiologic examination tibia & fibula 2 views (73590) |
$273 |
$455 |
3.3× |
| Ribs bilateral 3 views (71110) |
$420 |
$700 |
4.2× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$1,216.20 |
$2,027 |
3.2× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,583.40 |
$2,639 |
4.2× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,610 |
$4,350 |
5.1× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,571 |
$4,285 |
5.0× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,470.80 |
$4,118 |
4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,687.40 |
$4,479 |
2.2× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,839.80 |
$4,733 |
2.1× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,763.60 |
$4,606 |
2.2× |
| Rp Therapy Intravenous Administration (79101) |
$892.80 |
$1,488 |
4.0× |
| Scapula (73010) |
$250.20 |
$417 |
2.5× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$54.60 |
$91 |
2.3× |
| Shoulder 1 view (73020) |
$231.60 |
$386 |
2.8× |
| Shoulder Arthrography (73040) |
$1,047.60 |
$1,746 |
3.2× |
| Skull less than 4 views (70250) |
$321.60 |
$536 |
3.2× |
| Special dosimetry (77331) |
$827.40 |
$1,379 |
6.5× |
| Special Physics Consult (77370) |
$856.20 |
$1,427 |
6.7× |
| Special teletherapy port plan (77321) |
$1,901.40 |
$3,169 |
5.3× |
| Special treatment procedure (77470) |
$3,141 |
$5,235 |
6.0× |
| Stereotactic Body Radiation Delivery (77373) |
$9,426.60 |
$15,711 |
5.5× |
| Sternoclavicular joints (71130) |
$288.60 |
$481 |
3.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,325.60 |
$3,876 |
6.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$943.80 |
$1,573 |
2.7× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$2,304.60 |
$3,841 |
6.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,410 |
$2,350 |
4.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$632.40 |
$1,054 |
5.0× |
| Thoracic spine 3 views (72072) |
$348.60 |
$581 |
3.5× |
| Thoracolumbar 2 views (72080) |
$300.60 |
$501 |
3.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$575.40 |
$959 |
1.5× |
| Thyroid Met Imaging Body (78018) |
$2,053.80 |
$3,423 |
4.0× |
| Thyroid Uptake Measurement (78012) |
$672 |
$1,120 |
1.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,053 |
$1,755 |
2.8× |
| Tx Devices Design & Construction Complex (77334) |
$1,256.40 |
$2,094 |
3.5× |
| Tx devices design & construction intermediate (77333) |
$892.80 |
$1,488 |
7.0× |
| Tx devices design & construction simple (77332) |
$620.40 |
$1,034 |
4.9× |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
$326.40–$531.60 |
$544–$886 |
varies |
| Ultrasound Elastography Parenchyma (76981) |
$658.80 |
$1,098 |
6.6× |
| Ultrasound Exam Aaa Screen (76706) |
$286.20 |
$477 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$567 |
$945 |
5.7× |
| Unlisted Dx Radiographic Procedure (76499) |
$336.60 |
$561 |
4.1× |
| Unlisted genitourinary px dx nuclear medicine (78799) |
$495 |
$825 |
1.3× |
| Unlisted magnetic resonance procedure (76498) |
$387.60 |
$646 |
4.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$575.40 |
$959 |
1.5× |
| Upper gi w/o kub (74240) |
$544.80 |
$908 |
3.3× |
| Urethrocystogram voiding (74455) |
$552.60 |
$921 |
2.4× |
| Urethrocystography retrograde (74450) |
$552.60 |
$921 |
2.4× |
| Us breast unilateral complete (76641) |
$338.40 |
$564 |
3.4× |
| Us chest (76604) |
$562.20 |
$937 |
5.7× |
| Us complete joint (76881) |
$634.80 |
$1,058 |
6.4× |
| Us exam, pelvic, limited (76857) |
$375 |
$625 |
3.8× |
| Us head (76506) |
$349.20 |
$582 |
3.5× |
| Us kidney transplant (76776) |
$567 |
$945 |
5.7× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$543.60 |
$906 |
5.5× |
| Us ob detailed single fetus (76811) |
$573 |
$955 |
2.5× |
| Us ob limited 1 or more fetuses (76815) |
$413.40 |
$689 |
4.2× |
| Us ob transvaginal (76817) |
$408 |
$680 |
4.1× |
| Us pelvic non ob complete (76856) |
$666.60 |
$1,111 |
6.7× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$528.60 |
$881 |
5.3× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$267 |
$445 |
2.7× |
| Us retroperitoneal complete (76770) |
$806.40 |
$1,344 |
8.1× |
| Us retroperitoneal limited (76775) |
$696.60 |
$1,161 |
7.0× |
| Us scrotum and contents (76870) |
$624 |
$1,040 |
6.3× |
| Us thyroid (76536) |
$531.60 |
$886 |
5.4× |
| Us transrectal (76872) |
$664.80 |
$1,108 |
6.7× |
| Vascular Flow Imaging (78445) |
$575.40 |
$959 |
1.5× |
| Vein X-Ray Chest (75827) |
$2,016.60 |
$3,361 |
1.3× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$3,082.80 |
$5,138 |
1.0× |
| Venogram Sinus/Jugular (75860) |
$4,507.20 |
$7,512 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$4,507.20 |
$7,512 |
1.5× |
| Venography extremity bilateral rs&i (75822) |
$2,696.40 |
$4,494 |
1.8× |
| Venography extremity unilateral rs&i (75820) |
$1,778.40 |
$2,964 |
1.2× |
| Venography Renal Bilateral (75833) |
$4,507.20 |
$7,512 |
1.5× |
| Venography Renal Unilateral (75831) |
$4,507.20 |
$7,512 |
1.5× |
| Venous sampling by catheter (75893) |
$7,690.80 |
$12,818 |
1.5× |
| Vertebral fracture assessment via dxa (77086) |
$313.20 |
$522 |
3.8× |
| Wrist 2 views (73100) |
$277.80 |
$463 |
3.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$474 |
$790 |
5.7× |
| X-ray antegrade pyelogram tube (74425) |
$597.60 |
$996 |
1.8× |
| X-Ray Aorta Leg Arteries (75630) |
$4,507.20 |
$7,512 |
1.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$322.20 |
$537 |
3.9× |
| X-Ray Exam Breast Specimen (76098) |
$785.40 |
$1,309 |
1.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$204 |
$340 |
2.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$322.20 |
$537 |
3.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$474.60 |
$791 |
4.8× |
| X-Ray Exam Hip Uni 1 View (73501) |
$223.20 |
$372 |
2.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$316.80 |
$528 |
3.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$548.40 |
$914 |
5.5× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$354 |
$590 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$388.20 |
$647 |
3.9× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$576 |
$960 |
5.8× |
| X-Ray Exam L-S Spine Bending (72114) |
$599.40 |
$999 |
6.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$336 |
$560 |
4.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$454.20 |
$757 |
4.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$337.80 |
$563 |
3.4× |
| X-ray eye for foreign body (70030) |
$219.60 |
$366 |
2.7× |
| X-ray humerus (73060) |
$324 |
$540 |
3.9× |
| X-ray IV pyelogram (ivp) (74400) |
$616.20 |
$1,027 |
3.7× |
| X-ray IV pyelogram+tomography (74415) |
$676.80 |
$1,128 |
4.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$382.20 |
$637 |
4.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$273.60 |
$456 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$357 |
$595 |
3.6× |
| X-ray nose-rectum child f.b. (76010) |
$228 |
$380 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$428.40 |
$714 |
4.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$341.40 |
$569 |
3.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$247.20 |
$412 |
2.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$303.60 |
$506 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$316.80 |
$528 |
3.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$414.60 |
$691 |
4.2× |
| X-Ray Tmj Unilat (70328) |
$154.20 |
$257 |
1.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$1,007.40 |
$1,679 |
3.0× |
| X-Rays Bone Survey Complete (77075) |
$610.20 |
$1,017 |
6.1× |
| Xr c-spine 4 or 5 views (72050) |
$415.20 |
$692 |
4.2× |
| Xr facial bones less than 3 views (70140) |
$361.80 |
$603 |
4.4× |
| Xr orbits complete 4 views (70200) |
$261.60 |
$436 |
2.6× |
| Xr Tomogram Single Plane (76100) |
$552.60 |
$921 |
5.6× |