| 3-D radiotherapy plan dose-volume histograms (77295) |
$6,975.75 |
$9,301 |
4.8× |
| Abdomen 2 views (74019) |
$301.50 |
$402 |
2.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,534.50 |
$2,046 |
3.6× |
| Ankle 2 views (73600) |
$306.75 |
$409 |
3.3× |
| Arthrogram elbow (73085) |
$785.25 |
$1,047 |
2.1× |
| Arthrogram hip (73525) |
$744.75 |
$993 |
2.0× |
| Arthrogram shoulder (73040) |
$922.50 |
$1,230 |
2.5× |
| Arthrogram wrist (73115) |
$754.50 |
$1,006 |
2.1× |
| Arthrography knee lt (73580) |
$1,074.75 |
$1,433 |
2.9× |
| Basic radiation dosimetry calculation (77300) |
$470.25 |
$627 |
3.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$1,149 |
$1,532 |
2.7× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$1,350 |
$1,800 |
3.2× |
| Bone &/joint imaging whole body (78306) |
$1,580.25 |
$2,107 |
3.7× |
| Bone age studies (77072) |
$266.25 |
$355 |
2.4× |
| Bone Imaging 3 Phase (78315) |
$1,762.50 |
$2,350 |
4.2× |
| Bone survey complete (77075) |
$582 |
$776 |
5.3× |
| Brachytx isodose complex (77318) |
$2,100.75 |
$2,801 |
5.3× |
| Brachytx isodose intermed (77317) |
$885 |
$1,180 |
2.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$319.50 |
$426 |
0.8× |
| Brain imaging < 4 static views w vascular flow (78601) |
$1,905 |
$2,540 |
4.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,239 |
$5,652 |
2.8× |
| Cardiac shunt detection (78428) |
$684 |
$912 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$286.50 |
$382 |
3.1× |
| Chest 1 view (71045) |
$162.75 |
$217 |
1.8× |
| Chest 3 views (71047) |
$308.25 |
$411 |
3.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$477 |
$636 |
2.6× |
| Clavicle complete (73000) |
$243.75 |
$325 |
2.7× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$224.25 |
$299 |
2.0× |
| Continuing medical physics consltj pr wk (77336) |
$850.50 |
$1,134 |
6.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,206.75 |
$5,609 |
11.4× |
| CT abdomen and pelvis without contrast (74176) |
$3,003.75 |
$4,005 |
11.9× |
| CT abdomen w contrast (74160) |
$1,699.50 |
$2,266 |
9.2× |
| CT abdomen w wo contrast (74170) |
$2,106.75 |
$2,809 |
11.4× |
| CT abdomen w/o contrast (74150) |
$1,404.75 |
$1,873 |
12.7× |
| CT angio hrt w/3d image (75574) |
$2,207.25 |
$2,943 |
6.0× |
| CT angiography upper extremity lt (73206) |
$3,272.25 |
$4,363 |
17.7× |
| CT c-spine w/o contrast (72125) |
$1,842 |
$2,456 |
16.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,613 |
$3,484 |
14.1× |
| CT cervical spine with contrast (72126) |
$2,154 |
$2,872 |
5.9× |
| CT chest w/wo contrast (71270) |
$2,037.75 |
$2,717 |
11.0× |
| CT chest with contrast (71260) |
$1,665 |
$2,220 |
9.0× |
| CT colonography screening (74263) |
$1,101.75 |
$1,469 |
4.4× |
| CT colonography w/o cntrst (74261) |
$891 |
$1,188 |
8.1× |
| CT head/brain with contrast (70460) |
$1,803.75 |
$2,405 |
9.7× |
| CT head/brain without and with contrast (70470) |
$2,204.25 |
$2,939 |
11.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,306.50 |
$1,742 |
3.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$212.25 |
$283 |
2.3× |
| CT hrt w/3d image congen (75573) |
$1,538.25 |
$2,051 |
4.2× |
| CT iac w contrast (70481) |
$1,860 |
$2,480 |
10.1× |
| CT lower ext w/o (73700) |
$917.88 |
$1,223.84 |
8.3× |
| CT lower extremity with contrast (73701) |
$1,230.75 |
$1,641 |
6.7× |
| CT lumbar spine w & w/o contrast (72133) |
$2,618.25 |
$3,491 |
14.2× |
| CT lumbar spine w/o contrast (72131) |
$1,842 |
$2,456 |
16.7× |
| CT lumbar spine with contrast (72132) |
$2,157.75 |
$2,877 |
5.9× |
| CT maxillofacial w contrast (70487) |
$1,833.75 |
$2,445 |
9.9× |
| CT maxillofacial w/o contrast (70486) |
$964.12 |
$1,285.50 |
8.7× |
| CT maxillofacial w/wo contrast (70488) |
$2,212.50 |
$2,950 |
12.0× |
| CT neck soft tissue w contrast (70491) |
$1,557 |
$2,076 |
8.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,232 |
$2,976 |
12.1× |
| CT orbits w/o contrast (70480) |
$1,590.75 |
$2,121 |
14.4× |
| CT pelvis w & w/o contrast (72194) |
$2,154.75 |
$2,873 |
11.6× |
| CT pelvis w/o contrast (72192) |
$2,094.75 |
$2,793 |
19.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,868.25 |
$2,491 |
10.1× |
| CT soft tissue neck w/o contrast (70490) |
$1,370.25 |
$1,827 |
12.4× |
| CT thoracic spine w/contrast (72129) |
$2,220 |
$2,960 |
12.0× |
| CT thoracic spine w/o contrast (72128) |
$1,842 |
$2,456 |
16.7× |
| CT thoracic spine w/wo contrast (72130) |
$2,611.50 |
$3,482 |
14.1× |
| CT thorax w/o contrast (71250) |
$799.50 |
$1,066 |
7.2× |
| CT upper extremity w/o contrast rt (73200) |
$253.25 |
$337.67 |
2.3× |
| CT upper extremity with contrast (73201) |
$1,722.75 |
$2,297 |
4.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,516 |
$4,688 |
19.0× |
| Cta Abdomen (74175) |
$2,920.50 |
$3,894 |
15.8× |
| CTA abdomen pelvis (74174) |
$1,122.75 |
$1,497 |
3.1× |
| CTA chest (71275) |
$2,798.25 |
$3,731 |
15.1× |
| Cta Head (70496) |
$2,691.75 |
$3,589 |
14.5× |
| CTA lwr ext w&w/o contrast (73706) |
$3,297 |
$4,396 |
17.8× |
| Cta Neck (70498) |
$2,514.75 |
$3,353 |
13.6× |
| Cta Pelvis (72191) |
$3,027 |
$4,036 |
16.4× |
| Cystography minimum 3 views rs&i (74430) |
$549.75 |
$733 |
1.5× |
| Diskogram cervical (72285) |
$2,933.25 |
$3,911 |
1.4× |
| Diskography lumbar (72295) |
$2,933.25 |
$3,911 |
1.4× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$377.25 |
$503 |
3.4× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$624.75 |
$833 |
5.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$391.50 |
$522 |
3.6× |
| Dxa bone density study 1/> sites axial skel (77080) |
$469.50 |
$626 |
4.3× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$135 |
$180 |
1.5× |
| Dxa bone density study axial skeleton (77085) |
$296.25 |
$395 |
2.7× |
| Echo exam of fetal heart (76825) |
$807 |
$1,076 |
1.4× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$562.50 |
$750 |
2.2× |
| Echoencephalography real time imaging (76506) |
$264 |
$352 |
2.4× |
| Esophagus (74220) |
$430.50 |
$574 |
2.3× |
| Fetal biophysical profile non-stress testing (76818) |
$531 |
$708 |
4.8× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$487.50 |
$650 |
4.4× |
| Fluoroscopy up to 1 hr (76000) |
$528 |
$704 |
2.1× |
| Foot 2 views (73620) |
$465.75 |
$621 |
5.1× |
| Forearm 2 views (73090) |
$272.25 |
$363 |
3.0× |
| Gated Heart Planar Single (78472) |
$1,645.50 |
$2,194 |
3.9× |
| Hand 2 views (73120) |
$222.75 |
$297 |
2.0× |
| Hand 3 views (73130) |
$255.75 |
$341 |
2.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$4,458.75 |
$5,945 |
6.1× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,557 |
$6,076 |
6.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,816.50 |
$6,422 |
6.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,545 |
$2,060 |
2.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,112.25 |
$1,483 |
2.6× |
| Humerus Min 2 Views Left (73060) |
$279.75 |
$373 |
3.0× |
| Hysterosalpingogram (74740) |
$645.75 |
$861 |
2.6× |
| Image fusion (77399) |
$404.62 |
$539.50 |
2.9× |
| Interstitial radiation source applic complex (77778) |
$1,688.25 |
$2,251 |
2.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$222 |
$296 |
2.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,271.25 |
$1,695 |
2.2× |
| Knee 3 views (73562) |
$541.50 |
$722 |
5.9× |
| Liver & spleen imaging static only (78215) |
$1,157.25 |
$1,543 |
2.7× |
| Lung perf&ventilat diferentl (78598) |
$758.25 |
$1,011 |
1.3× |
| Lung perfusion differential (78597) |
$469.50 |
$626 |
1.1× |
| Lung Ventilation Imaging (78579) |
$437.25 |
$583 |
1.0× |
| Lymphoscintigraphy (78195) |
$1,878 |
$2,504 |
3.3× |
| Mammary ductogram or galactogram multiple (77054) |
$612 |
$816 |
2.4× |
| Mammary ductogram or galactogram single (77053) |
$738.75 |
$985 |
2.9× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$138.75 |
$185 |
1.5× |
| Meckels Diverticulum (78290) |
$1,100.25 |
$1,467 |
2.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,004.25 |
$1,339 |
2.5× |
| MRA head w & w/o contrast (70546) |
$1,195.50 |
$1,594 |
3.2× |
| MRA head w/o contrast (70544) |
$1,217.25 |
$1,623 |
4.8× |
| MRA head with contrast (70545) |
$1,012.50 |
$1,350 |
2.8× |
| MRA neck w contrast (70548) |
$998.25 |
$1,331 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,628.25 |
$2,171 |
4.4× |
| MRA neck w/o contrast (70547) |
$934.50 |
$1,246 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,503.75 |
$2,005 |
4.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,730.25 |
$2,307 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,281 |
$1,708 |
5.1× |
| MRI any jnt lwr ext with con lt (73722) |
$1,216.88 |
$1,622.50 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,248 |
$1,664 |
1.5× |
| MRI breast w/o contrast bilateral (77047) |
$1,179 |
$1,572 |
4.7× |
| MRI c-spine with contrast (72142) |
$1,407 |
$1,876 |
3.8× |
| MRI cervical spine w/o contrast (72141) |
$1,248.75 |
$1,665 |
5.0× |
| MRI chest w/o & w/contrast material (71552) |
$1,710.75 |
$2,281 |
4.6× |
| MRI chest w/o contrast (71550) |
$1,161.75 |
$1,549 |
4.6× |
| MRI chest with contrast (71551) |
$954 |
$1,272 |
1.2× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$978.75 |
$1,305 |
2.7× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,282.12 |
$1,709.50 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,199.25 |
$1,599 |
4.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$926.25 |
$1,235 |
3.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,678.50 |
$2,238 |
4.6× |
| MRI orbit/face/neck w/contrast (70542) |
$1,074 |
$1,432 |
2.9× |
| MRI pelvis w contrast (72196) |
$1,079.25 |
$1,439 |
2.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,708.50 |
$2,278 |
4.6× |
| MRI pelvis w/o contrast (72195) |
$1,233.75 |
$1,645 |
4.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,396.12 |
$1,861.50 |
3.8× |
| MRI scan of leg joint before and after contrast (73723) |
$1,431.75 |
$1,909 |
3.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,493.25 |
$1,991 |
4.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,347.75 |
$1,797 |
3.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,767.75 |
$2,357 |
4.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,485 |
$1,980 |
4.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,779.75 |
$2,373 |
4.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,265.25 |
$1,687 |
5.0× |
| MRI tmj (70336) |
$1,098 |
$1,464 |
4.4× |
| MRI upper ext joint w/o contrast (73221) |
$1,203.75 |
$1,605 |
4.8× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,390.88 |
$1,854.50 |
3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,068 |
$1,424 |
4.2× |
| Myelogram Cervical (72240) |
$1,488.75 |
$1,985 |
1.8× |
| Myelogram Lumbar (72265) |
$1,215 |
$1,620 |
1.5× |
| Myelogram thoracic (72255) |
$1,408.50 |
$1,878 |
1.7× |
| Myelography 2 or more regions (72270) |
$2,117.25 |
$2,823 |
2.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$4,013.25 |
$5,351 |
2.9× |
| Myocardial Spect Multiple Studies (78452) |
$3,077.25 |
$4,103 |
2.3× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$2,850.75 |
$3,801 |
3.1× |
| Neck soft tissue (70360) |
$222 |
$296 |
2.4× |
| Nm gastric emptying study (78264) |
$1,271.25 |
$1,695 |
3.0× |
| Nm red cell sequestration (78140) |
$822 |
$1,096 |
1.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$6,842.25 |
$9,123 |
4.7× |
| Nuclear medicine study of kidney and blood flow (78701) |
$1,062.75 |
$1,417 |
2.5× |
| Nuclear Rx Oral Admin (79005) |
$1,043.62 |
$1,391.50 |
4.2× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$484.50 |
$646 |
4.4× |
| Osseous survey limited (77074) |
$282.75 |
$377 |
2.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,389.75 |
$1,853 |
2.4× |
| Parathyroid imaging (78070) |
$1,221 |
$1,628 |
2.9× |
| Pelvis 1 or 2 views (72170) |
$257.25 |
$343 |
2.3× |
| PET image w/CT, skull-thigh (78815) |
$5,739 |
$7,652 |
3.8× |
| PET imaging CT for attenuation limited area (78814) |
$4,013.25 |
$5,351 |
2.7× |
| PET imaging for CT attenuation whole body (78816) |
$5,939.25 |
$7,919 |
3.9× |
| PET whole body (78813) |
$11,042.25 |
$14,723 |
7.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,411.12 |
$1,881.50 |
3.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$686.25 |
$915 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$783.75 |
$1,045 |
1.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$540.75 |
$721 |
0.9× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$336.75 |
$449 |
3.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$354.75 |
$473 |
3.2× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$228.75 |
$305 |
2.1× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$588.75 |
$785 |
5.3× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$3,826.51 |
$5,102.01 |
6.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$393.75 |
$525 |
3.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$213 |
$284 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$298.50 |
$398 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$248.25 |
$331 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$382.50 |
$510 |
2.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$579.75 |
$773 |
3.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$565.50 |
$754 |
3.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$257.25 |
$343 |
2.8× |
| Radiological examination surgical specimen (76098) |
$450.75 |
$601 |
0.8× |
| Ribs bilateral 3 views (71110) |
$401.25 |
$535 |
3.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,347.75 |
$1,797 |
3.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,687.50 |
$2,250 |
2.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,176.50 |
$2,902 |
3.8× |
| Rp Therapy Intravenous Administration (79101) |
$13,734.38 |
$18,312.50 |
55.8× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$435.75 |
$581 |
1.7× |
| Scanogram (77073) |
$240.75 |
$321 |
2.2× |
| Scapula complete (73010) |
$315 |
$420 |
2.9× |
| Screening digital breast tomosynthesis (77063) |
$42 |
$56 |
1.8× |
| Sella turcica (70240) |
$126 |
$168 |
1.4× |
| Sialogram (70390) |
$426.75 |
$569 |
1.7× |
| Small bowel series (74250) |
$446.25 |
$595 |
2.4× |
| Spec medical radj physics consltj (77370) |
$996 |
$1,328 |
7.0× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$830.25 |
$1,107 |
2.1× |
| Special dosimetry (77331) |
$336.75 |
$449 |
2.4× |
| Special treatment procedure (77470) |
$4,079.25 |
$5,439 |
7.0× |
| Spine thoracic 3 views (72072) |
$291 |
$388 |
2.6× |
| Stereotactic body radiation delivery (77373) |
$6,594.75 |
$8,793 |
3.5× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$348.75 |
$465 |
3.2× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,423.50 |
$1,898 |
3.6× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$967.50 |
$1,290 |
2.4× |
| Testicular Imaging With Vascular Flow (78761) |
$423 |
$564 |
1.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,370 |
$3,160 |
6.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$1,320 |
$1,760 |
9.3× |
| Therapeutic Enema (74283) |
$570 |
$760 |
3.1× |
| Thoracolumbar 2 views (72080) |
$300.75 |
$401 |
3.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,022.75 |
$2,697 |
3.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,685.25 |
$2,247 |
4.0× |
| Treatment device intermediate (77333) |
$564 |
$752 |
4.0× |
| Treatment devices simple (77332) |
$484.50 |
$646 |
3.4× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$3,396 |
$4,528 |
5.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$1,034.25 |
$1,379 |
2.5× |
| Tx devices design & construction complex (77334) |
$1,079.25 |
$1,439 |
2.7× |
| Ultrasound elastography first target lesion (76982) |
$282 |
$376 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$442.50 |
$590 |
4.0× |
| Umbilical-artery Doppler (OB) (76820) |
$463.50 |
$618 |
4.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$965.25 |
$1,287 |
9.0× |
| Upper Extremity Infant (73092) |
$195.75 |
$261 |
1.8× |
| Urethrocystography retrograde rs&i (74450) |
$314.25 |
$419 |
1.2× |
| Urethrocystography voiding (74455) |
$361.50 |
$482 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$368.25 |
$491 |
2.0× |
| Us breast unilateral complete (76641) |
$370.88 |
$494.50 |
3.4× |
| Us breast unilateral limited (76642) |
$377.62 |
$503.50 |
4.1× |
| Us chest (76604) |
$427.50 |
$570 |
3.9× |
| Us compl joint r-t w/image documentation (76881) |
$329.62 |
$439.50 |
3.0× |
| Us elastography parenchyma (76981) |
$282 |
$376 |
2.6× |
| Us fetal nuchal translucency 1st gestation (76813) |
$391.50 |
$522 |
3.6× |
| Us infant hips dynamic (76885) |
$449.25 |
$599 |
4.9× |
| Us kidney transplant (76776) |
$501 |
$668 |
4.5× |
| Us ob detailed single fetus (76811) |
$735 |
$980 |
2.9× |
| Us ob transvaginal (76817) |
$477 |
$636 |
4.3× |
| Us pelvic non ob complete (76856) |
$494.25 |
$659 |
4.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$374.25 |
$499 |
3.4× |
| Us pregnancy ltd (76815) |
$402.75 |
$537 |
3.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$726.75 |
$969 |
6.6× |
| Us retroperitoneal complete (76770) |
$641.25 |
$855 |
5.8× |
| Us retroperitoneal limited (76775) |
$428.25 |
$571 |
3.9× |
| Us scrotum and contents (76870) |
$459.75 |
$613 |
4.2× |
| Us soft tissue head/neck (76536) |
$423 |
$564 |
3.8× |
| Us spinal canal and contents (76800) |
$375.75 |
$501 |
3.4× |
| Us xtr non-vasc lmtd (76882) |
$373.50 |
$498 |
3.4× |
| Us, eye b-scan (76512) |
$285.75 |
$381 |
2.6× |
| Venography extremity unilateral rs&i (75820) |
$1,312.50 |
$1,750 |
0.8× |
| Vertebral fracture assessment via dxa (77086) |
$132 |
$176 |
1.4× |
| Wrist 2 views (73100) |
$242.25 |
$323 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$399 |
$532 |
3.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$312.75 |
$417 |
3.4× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$247.50 |
$330 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$528.75 |
$705 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$396 |
$528 |
4.3× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$259.50 |
$346 |
2.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$554.25 |
$739 |
5.0× |
| X-ray exam hip uni 1 view (73501) |
$169.50 |
$226 |
1.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$278.25 |
$371 |
3.0× |
| X-ray exam hip uni 4/> views (73503) |
$460.50 |
$614 |
4.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$354.75 |
$473 |
3.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$672.75 |
$897 |
6.1× |
| X-ray exam of femur 1 (73551) |
$257.25 |
$343 |
2.8× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$523.50 |
$698 |
2.8× |
| X-ray eye for foreign body (70030) |
$162.75 |
$217 |
1.8× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$378 |
$504 |
3.4× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$258 |
$344 |
2.8× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$216.75 |
$289 |
2.4× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$147 |
$196 |
1.6× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$322.50 |
$430 |
2.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$152.25 |
$203 |
1.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$303.75 |
$405 |
3.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$330 |
$440 |
3.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$696.75 |
$929 |
6.3× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$758.25 |
$1,011 |
6.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$313.50 |
$418 |
3.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$198 |
$264 |
2.2× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$271.50 |
$362 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$283.50 |
$378 |
2.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$351.75 |
$469 |
3.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$342.75 |
$457 |
3.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$595.50 |
$794 |
5.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$345 |
$460 |
3.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$266.25 |
$355 |
2.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$287.25 |
$383 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$210 |
$280 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$161.25 |
$215 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$475.50 |
$634 |
4.3× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$282.75 |
$377 |
2.6× |
| X-Ray Spine One View - Xr Spine (72020) |
$262.50 |
$350 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$279.75 |
$373 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$312.75 |
$417 |
3.4× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$309.75 |
$413 |
2.8× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$196.50 |
$262 |
2.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$248.25 |
$331 |
2.7× |
| Xr arthrogram ankle (73615) |
$917.25 |
$1,223 |
2.5× |
| Xr c-spine 6 or more views (72052) |
$480 |
$640 |
4.4× |
| Xr chest 4+ views (71048) |
$346.50 |
$462 |
3.1× |
| Xr finger(s) 2+ views (73140) |
$193.50 |
$258 |
2.1× |
| Xr shoulder 1 view (73020) |
$192 |
$256 |
2.1× |
| Xr spine cervical 4 or 5 views (72050) |
$501.75 |
$669 |
4.5× |
| Xr tibia/fibula 2 views (73590) |
$275.25 |
$367 |
3.0× |
| Xr tmj bilateral (70330) |
$321.75 |
$429 |
3.5× |
| Xray knee 1 or 2 views rt (73560) |
$206.25 |
$275 |
2.2× |