| Abdomen 2 views (74019) |
$97.80 |
$978 |
0.9× |
| Acute gastrointestinal blood loss imaging (78278) |
$387.50 |
$3,875 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,659.50 |
$16,595 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,249.70 |
$12,497 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
likely a partial charge, not the full procedure |
$1,562.12 |
$15,621.25 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$1,562.12 |
$15,621.25 |
0.5× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,249.70 |
$12,497 |
0.4× |
Angiography Spinal Selective Rs&I (75705)
likely a partial charge, not the full procedure |
$1,249.70 |
$12,497 |
0.2× |
Angiography visceral slctv/supraslctv rs&i (75726)
likely a partial charge, not the full procedure |
$1,249.70 |
$12,497 |
0.2× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$463.80 |
$4,638 |
0.1× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,001 |
$10,010 |
0.3× |
| Ankle 2 views (73600) |
$122.88 |
$1,228.75 |
1.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$183.10 |
$1,831 |
0.5× |
Aortogram thoracic (75605)
likely a partial charge, not the full procedure |
$1,659.50 |
$16,595 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,814.80 |
$18,148 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$1,659.50 |
$16,595 |
0.5× |
| Arthrogram elbow (73085) |
$208.30 |
$2,083 |
0.6× |
| Arthrogram hip (73525) |
$208.30 |
$2,083 |
0.6× |
| Arthrogram shoulder (73040) |
$208.30 |
$2,083 |
0.6× |
| Arthrogram wrist (73115) |
$156.80 |
$1,568 |
0.4× |
| Arthrography knee lt (73580) |
$261.40 |
$2,614 |
0.7× |
| Basic radiation dosimetry calculation (77300) |
$39.20 |
$392 |
0.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$130.20 |
$1,302 |
0.3× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$294.90 |
$2,949 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$315.70 |
$3,157 |
0.8× |
| Bone age studies (77072) |
$75.90 |
$759 |
0.7× |
| Bone Imaging 3 Phase (78315) |
$336.20 |
$3,362 |
0.8× |
| Bone survey complete (77075) |
$210.70 |
$2,107 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,227.50 |
$12,275 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$315.70 |
$3,157 |
0.6× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$588.70 |
$5,887 |
1.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$307.60 |
$3,076 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$98.30 |
$983 |
1.1× |
| Chest 1 view (71045) |
$112.70 |
$1,127 |
1.3× |
| Chest 3 views (71047) |
$136.40 |
$1,364 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$133.60 |
$1,336 |
0.8× |
| Cisternography Positive Contrast Rs&I (70015) |
$96.90 |
$969 |
0.1× |
| Clavicle complete (73000) |
$122.88 |
$1,228.75 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$114 |
$1,140 |
1.1× |
| Continuing medical physics consltj pr wk (77336) |
$86.30 |
$863 |
0.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,808.40 |
$18,084 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,220.60 |
$12,206 |
5.1× |
| CT abdomen w contrast (74160) |
$797.30 |
$7,973 |
4.5× |
| CT abdomen w wo contrast (74170) |
$904.20 |
$9,042 |
5.1× |
| CT abdomen w/o contrast (74150) |
$610.30 |
$6,103 |
5.8× |
| CT angio hrt w/3d image (75574) |
$663.90 |
$6,639 |
1.9× |
| CT angiography upper extremity lt (73206) |
$1,011.10 |
$10,111 |
5.7× |
| CT c-spine w/o contrast (72125) |
$588.50 |
$5,885 |
5.6× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$57 |
$570 |
0.3× |
| CT cervical spine w&w/o contrast (72127) |
$871.70 |
$8,717 |
4.9× |
| CT cervical spine with contrast (72126) |
$768.80 |
$7,688 |
2.2× |
| CT chest w/wo contrast (71270) |
$904.20 |
$9,042 |
5.1× |
| CT chest with contrast (71260) |
$797.30 |
$7,973 |
4.5× |
| CT head/brain with contrast (70460) |
$768.80 |
$7,688 |
4.4× |
| CT head/brain without and with contrast (70470) |
$871.70 |
$8,717 |
4.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$663.90 |
$6,639 |
1.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$27.20 |
$272 |
0.3× |
| CT hrt w/3d image congen (75573) |
$58 |
$580 |
0.2× |
| CT iac w contrast (70481) |
$768.80 |
$7,688 |
4.4× |
| CT limited/localized follow up study (76380) |
$26.80 |
$268 |
0.3× |
| CT lower ext w/o (73700) |
$762.88 |
$7,628.75 |
7.3× |
| CT lower extremity w wo contrast (73702) |
$904.20 |
$9,042 |
5.1× |
| CT lower extremity with contrast (73701) |
$996.62 |
$9,966.25 |
5.7× |
| CT lumbar spine w & w/o contrast (72133) |
$904.20 |
$9,042 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$610.30 |
$6,103 |
5.8× |
| CT lumbar spine with contrast (72132) |
$797.30 |
$7,973 |
2.3× |
| CT maxillofacial w contrast (70487) |
$768.80 |
$7,688 |
4.4× |
| CT maxillofacial w/o contrast (70486) |
$588.50 |
$5,885 |
5.6× |
| CT maxillofacial w/wo contrast (70488) |
$871.70 |
$8,717 |
4.9× |
| CT neck soft tissue w contrast (70491) |
$768.80 |
$7,688 |
4.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$871.70 |
$8,717 |
4.9× |
| CT orbits w/o contrast (70480) |
$588.50 |
$5,885 |
5.6× |
| CT pelvis w & w/o contrast (72194) |
$904.20 |
$9,042 |
5.1× |
| CT pelvis w/o contrast (72192) |
$610.30 |
$6,103 |
5.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$871.70 |
$8,717 |
4.9× |
| CT soft tissue neck w/o contrast (70490) |
$588.50 |
$5,885 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$797.30 |
$7,973 |
4.5× |
| CT thoracic spine w/o contrast (72128) |
$610.30 |
$6,103 |
5.8× |
| CT thoracic spine w/wo contrast (72130) |
$904.20 |
$9,042 |
5.1× |
| CT thorax w/o contrast (71250) |
$610.30 |
$6,103 |
5.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$904.20 |
$9,042 |
5.1× |
| CT upper extremity w/o contrast rt (73200) |
$762.88 |
$7,628.75 |
7.3× |
| CT upper extremity with contrast (73201) |
$797.30 |
$7,973 |
2.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,011.10 |
$10,111 |
5.7× |
| Cta Abdomen (74175) |
$1,011.10 |
$10,111 |
5.7× |
| CTA abdomen pelvis (74174) |
$359.60 |
$3,596 |
1.0× |
| CTA chest (71275) |
$1,011.10 |
$10,111 |
5.7× |
| Cta Head (70496) |
$974.80 |
$9,748 |
5.5× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$974.80 |
$9,748 |
2.8× |
| CTA lwr ext w&w/o contrast (73706) |
$1,263.88 |
$12,638.75 |
7.2× |
| Cta Neck (70498) |
$974.80 |
$9,748 |
5.5× |
| Cta Pelvis (72191) |
$1,011.10 |
$10,111 |
5.7× |
| Cystography minimum 3 views rs&i (74430) |
$130.40 |
$1,304 |
0.4× |
| Diskogram cervical (72285) |
$936 |
$9,360 |
0.5× |
| Diskography lumbar (72295) |
$838.70 |
$8,387 |
0.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$83.70 |
$837 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$232.60 |
$2,326 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$65.20 |
$652 |
0.7× |
| Dxa bone density study axial skeleton (77085) |
$37.70 |
$377 |
0.4× |
| Echoencephalography real time imaging (76506) |
$119.10 |
$1,191 |
1.1× |
| Esophagus (74220) |
$100.80 |
$1,008 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$157.10 |
$1,571 |
1.5× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$118.50 |
$1,185 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$157.90 |
$1,579 |
0.7× |
| Foot 2 views (73620) |
$147.45 |
$1,474.50 |
1.7× |
| Forearm 2 views (73090) |
$147.45 |
$1,474.50 |
1.7× |
| Gated Heart Planar Single (78472) |
$514.10 |
$5,141 |
1.3× |
| Hand 2 views (73120) |
$122.88 |
$1,228.75 |
1.2× |
| Hand 3 views (73130) |
$163.20 |
$1,632 |
1.9× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,887.40 |
$18,874 |
0.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$330 |
$3,300 |
0.6× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$330 |
$3,300 |
0.8× |
| Ht muscle image spect sing (78451) |
$566.80 |
$5,668 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$98.30 |
$983 |
1.1× |
| Hysterosalpingogram (74740) |
$79.40 |
$794 |
0.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$37.70 |
$377 |
0.4× |
| Kidney funcj study non-img radioisotopic study (78725) |
$122.30 |
$1,223 |
0.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$347.40 |
$3,474 |
0.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$401.60 |
$4,016 |
0.7× |
| Knee 3 views (73562) |
$136 |
$1,360 |
1.6× |
| Liver & spleen imaging static only (78215) |
$351.70 |
$3,517 |
0.9× |
| Liver imaging static only (78201) |
$171.20 |
$1,712 |
0.3× |
| Lung perf&ventilat diferentl (78598) |
$194.40 |
$1,944 |
0.4× |
| Lung perfusion differential (78597) |
$130.20 |
$1,302 |
0.3× |
| Lymphoscintigraphy (78195) |
$341.40 |
$3,414 |
0.6× |
| Mammary ductogram or galactogram multiple (77054) |
$95.30 |
$953 |
0.4× |
| Mammary ductogram or galactogram single (77053) |
$211 |
$2,110 |
0.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$25.80 |
$258 |
0.3× |
| Meckels Diverticulum (78290) |
$294.40 |
$2,944 |
0.7× |
| Mlc imrt design & construction per imrt plan (77338) |
$118.60 |
$1,186 |
0.3× |
| MRA head w & w/o contrast (70546) |
$873.90 |
$8,739 |
2.5× |
| MRA head w/o contrast (70544) |
$645.90 |
$6,459 |
2.7× |
| MRA head with contrast (70545) |
$768.60 |
$7,686 |
2.2× |
| MRA neck w contrast (70548) |
$768.60 |
$7,686 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$873.90 |
$8,739 |
2.5× |
| MRA neck w/o contrast (70547) |
$645.90 |
$6,459 |
2.7× |
| MRI abdomen w contrast (74182) |
$1,083.40 |
$10,834 |
3.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,231.70 |
$12,317 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$910.50 |
$9,105 |
3.8× |
| MRI any jnt lwr ext with con lt (73722) |
$1,083.40 |
$10,834 |
1.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,083.40 |
$10,834 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,129.70 |
$11,297 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$1,129.70 |
$11,297 |
4.7× |
| MRI c-spine with contrast (72142) |
$768.60 |
$7,686 |
2.2× |
| MRI cardiac w/o contrast (75557) |
$75.90 |
$759 |
0.3× |
| MRI cervical spine w/o contrast (72141) |
$645.90 |
$6,459 |
2.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,231.70 |
$12,317 |
3.5× |
| MRI chest w/o contrast (71550) |
$910.50 |
$9,105 |
3.8× |
| MRI chest with contrast (71551) |
$1,083.40 |
$10,834 |
1.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,083.40 |
$10,834 |
3.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,083.40 |
$10,834 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,138.12 |
$11,381.25 |
4.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$645.90 |
$6,459 |
2.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$873.90 |
$8,739 |
2.5× |
| MRI orbit/face/neck w/contrast (70542) |
$768.60 |
$7,686 |
2.2× |
| MRI pelvis w contrast (72196) |
$1,083.40 |
$10,834 |
3.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,231.70 |
$12,317 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$910.50 |
$9,105 |
3.8× |
| MRI scan of arm joint before and after contrast (73223) |
$1,231.70 |
$12,317 |
3.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$638.30 |
$6,383 |
0.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,231.70 |
$12,317 |
3.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$873.90 |
$8,739 |
2.5× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,083.40 |
$10,834 |
3.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,231.70 |
$12,317 |
3.5× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,083.40 |
$10,834 |
3.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,231.70 |
$12,317 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$910.50 |
$9,105 |
3.8× |
| MRI tmj (70336) |
$910.50 |
$9,105 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$1,138.12 |
$11,381.25 |
4.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,231.70 |
$12,317 |
3.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,138.12 |
$11,381.25 |
4.7× |
| Myocardial Spect Multiple Studies (78452) |
$869.10 |
$8,691 |
0.7× |
| Neck soft tissue (70360) |
$76.50 |
$765 |
0.9× |
| Nm cisternogram (78630) |
$390.90 |
$3,909 |
0.7× |
| Nm gastric emptying study (78264) |
$341.40 |
$3,414 |
0.9× |
| Nm gastroesophageal reflux study (78262) |
$122.30 |
$1,223 |
0.3× |
| Nuclear Rx Oral Admin (79005) |
$147.30 |
$1,473 |
0.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$83.70 |
$837 |
0.8× |
| Orthopantogram (70355) |
$86.10 |
$861 |
1.0× |
| Osseous survey infant (77076) |
$147.10 |
$1,471 |
1.4× |
| Osseous survey limited (77074) |
$144.10 |
$1,441 |
1.4× |
| Parathyrd planar w/spect&CT (78072) |
$123.30 |
$1,233 |
0.2× |
| Parathyrd planar w/wo subtrj (78071) |
$124.10 |
$1,241 |
0.3× |
| Parathyroid imaging (78070) |
$130.20 |
$1,302 |
0.3× |
| Pelvis 1 or 2 views (72170) |
$98.30 |
$983 |
0.9× |
| PET image w/CT, skull-thigh (78815) |
$1,294.70 |
$12,947 |
0.9× |
| PET imaging CT for attenuation limited area (78814) |
$959.30 |
$9,593 |
0.7× |
| PET imaging for CT attenuation whole body (78816) |
$1,294.70 |
$12,947 |
0.9× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,231.70 |
$12,317 |
3.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$309.90 |
$3,099 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$479.30 |
$4,793 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$155.20 |
$1,552 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$28.60 |
$286 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$19.30 |
$193 |
0.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$38.70 |
$387 |
0.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$98.30 |
$983 |
0.9× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$36.70 |
$367 |
0.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$108.80 |
$1,088 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$88.80 |
$888 |
1.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$107.60 |
$1,076 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$124 |
$1,240 |
1.4× |
| Radiologic exam colon single contrast study (74270) |
$145.50 |
$1,455 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$143.90 |
$1,439 |
0.8× |
| Radiologic exam upr gi trc single contrast study (74240) |
$126.70 |
$1,267 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$42.90 |
$429 |
0.5× |
| Radiological examination surgical specimen (76098) |
$232.80 |
$2,328 |
0.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$1,887.40 |
$18,874 |
0.6× |
| Ribs bilateral 3 views (71110) |
$37.70 |
$377 |
0.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$366.90 |
$3,669 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$403.60 |
$4,036 |
0.7× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$527.50 |
$5,275 |
1.0× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$638.10 |
$6,381 |
0.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$488.70 |
$4,887 |
0.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$580.10 |
$5,801 |
0.4× |
| Rp therapy intra-arterial particulate admn (79445) |
$109.20 |
$1,092 |
0.5× |
| Sacroiliac Joints < 3 Views (72200) |
$38.70 |
$387 |
0.4× |
| Salivary gland function study (78232) |
$135.60 |
$1,356 |
0.3× |
| Scanogram (77073) |
$98.30 |
$983 |
0.9× |
| Scapula complete (73010) |
$98.30 |
$983 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$18.60 |
$186 |
0.8× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$125 |
$1,250 |
1.2× |
| Small bowel series (74250) |
$111 |
$1,110 |
0.6× |
| Speech evaluation complex (70371) |
$79.40 |
$794 |
0.3× |
| Spine thoracic 3 views (72072) |
$108.80 |
$1,088 |
1.0× |
| Superior sagittal sinus venogram (75870) |
$1,249.70 |
$12,497 |
0.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$315.80 |
$3,158 |
0.8× |
| Therapeutic Enema (74283) |
$224.90 |
$2,249 |
1.3× |
| Thoracolumbar 2 views (72080) |
$98.30 |
$983 |
1.1× |
| Thyroid carcinoma metastases img whole body (78018) |
$301.70 |
$3,017 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$231.60 |
$2,316 |
0.6× |
| Tmj unilateral (70328) |
$26.80 |
$268 |
0.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$444 |
$4,440 |
0.8× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$333.60 |
$3,336 |
0.8× |
| Tx devices design & construction complex (77334) |
$94 |
$940 |
0.2× |
| Ultrasound, abdomen limited (76705) |
$97.10 |
$971 |
0.9× |
| Umbilical-artery Doppler (OB) (76820) |
$35.40 |
$354 |
0.3× |
| Upper Extremity Infant (73092) |
$22.80 |
$228 |
0.2× |
| Urethrocystography retrograde rs&i (74450) |
$165 |
$1,650 |
0.7× |
| Urethrocystography voiding (74455) |
$134.40 |
$1,344 |
0.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$143.90 |
$1,439 |
0.8× |
| Us abdl aorta screen aaa (76706) |
$32.30 |
$323 |
0.3× |
| Us breast unilateral complete (76641) |
$99.12 |
$991.25 |
0.9× |
| Us breast unilateral limited (76642) |
$90.12 |
$901.25 |
1.0× |
| Us chest (76604) |
$131.30 |
$1,313 |
1.3× |
| Us compl joint r-t w/image documentation (76881) |
$110.10 |
$1,101 |
1.0× |
| Us elastography parenchyma (76981) |
$41.90 |
$419 |
0.4× |
| Us guided compression repair (76936) |
$974 |
$9,740 |
4.5× |
| Us infant hips dynamic (76885) |
$62 |
$620 |
0.7× |
| Us infant hips limited static (76886) |
$26.80 |
$268 |
0.3× |
| Us kidney transplant (76776) |
$152.20 |
$1,522 |
1.4× |
| Us ob detailed single fetus (76811) |
$79.40 |
$794 |
0.3× |
| Us ob transvaginal (76817) |
$65.80 |
$658 |
0.6× |
| Us pelvic non ob complete (76856) |
$128.40 |
$1,284 |
1.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$117.60 |
$1,176 |
1.1× |
| Us pregnancy ltd (76815) |
$96.10 |
$961 |
0.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$116.90 |
$1,169 |
1.1× |
| Us retroperitoneal complete (76770) |
$154.20 |
$1,542 |
1.5× |
| Us retroperitoneal limited (76775) |
$140.10 |
$1,401 |
1.3× |
| Us scrotum and contents (76870) |
$110.10 |
$1,101 |
1.0× |
| Us soft tissue head/neck (76536) |
$108.90 |
$1,089 |
1.0× |
| Us spinal canal and contents (76800) |
$67.60 |
$676 |
0.6× |
| Us transrectal (76872) |
$154.40 |
$1,544 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$117.75 |
$1,177.50 |
1.1× |
| Us, eye b-scan (76512) |
$35.20 |
$352 |
0.3× |
| Venogram extremity bilateral (75822) |
$525.20 |
$5,252 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,249.70 |
$12,497 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$1,249.70 |
$12,497 |
0.8× |
| Venography extremity unilateral rs&i (75820) |
$384.90 |
$3,849 |
0.2× |
| Venography Renal Bilateral (75833) |
$1,249.70 |
$12,497 |
0.4× |
| Venography renal unilateral selective rs&i (75831) |
$1,249.70 |
$12,497 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$465.80 |
$4,658 |
0.1× |
| Wrist 2 views (73100) |
$94.12 |
$941.25 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$118.40 |
$1,184 |
1.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$163.20 |
$1,632 |
1.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$190.40 |
$1,904 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$147.45 |
$1,474.50 |
1.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$135.12 |
$1,351.25 |
1.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$36.70 |
$367 |
0.3× |
| X-ray exam hip uni 1 view (73501) |
$11.70 |
$117 |
0.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$28.60 |
$286 |
0.3× |
| X-ray exam hip uni 4/> views (73503) |
$37.70 |
$377 |
0.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$39.80 |
$398 |
0.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$36.70 |
$367 |
0.3× |
| X-ray exam of femur 1 (73551) |
$29.20 |
$292 |
0.3× |
| X-ray eye for foreign body (70030) |
$76.50 |
$765 |
0.9× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$108.80 |
$1,088 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$98.30 |
$983 |
1.1× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$163.20 |
$1,632 |
1.9× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$122.88 |
$1,228.75 |
1.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98.30 |
$983 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$119.50 |
$1,195 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$98.30 |
$983 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$118.90 |
$1,189 |
1.1× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$86 |
$860 |
0.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$106.10 |
$1,061 |
1.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$119.50 |
$1,195 |
1.1× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$119.50 |
$1,195 |
1.1× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$166.50 |
$1,665 |
0.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$224.20 |
$2,242 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$28.10 |
$281 |
0.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$108.80 |
$1,088 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$86 |
$860 |
0.8× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$108.80 |
$1,088 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$98.30 |
$983 |
1.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$147.45 |
$1,474.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$98.30 |
$983 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$119.70 |
$1,197 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$108.80 |
$1,088 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$86.10 |
$861 |
1.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$108.80 |
$1,088 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$98.30 |
$983 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$98.30 |
$983 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$117.10 |
$1,171 |
1.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$122.88 |
$1,228.75 |
1.4× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$163.20 |
$1,632 |
1.9× |
| Xr c-spine 6 or more views (72052) |
$118.90 |
$1,189 |
1.1× |
| Xr chest 4+ views (71048) |
$150.20 |
$1,502 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$98.30 |
$983 |
1.1× |
| Xr shoulder 1 view (73020) |
$107.62 |
$1,076.25 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$108.10 |
$1,081 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$122.88 |
$1,228.75 |
1.4× |
| Xr tmj bilateral (70330) |
$119.50 |
$1,195 |
1.4× |
| Xray knee 1 or 2 views rt (73560) |
$129.15 |
$1,291.50 |
1.5× |