| 3-D radiotherapy plan dose-volume histograms (77295) |
$7,459.60 |
$8,776 |
5.1× |
| Abdomen 2 views (74019) |
$248.20 |
$292 |
2.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,737.85 |
$3,221 |
6.5× |
| Angiography extremity bilateral rs&i (75716) |
$4,562.80 |
$5,368 |
1.4× |
| Angiography extremity unilateral rs&i (75710) |
$4,515.20 |
$5,312 |
1.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,683.50 |
$5,510 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$5,506.30 |
$6,478 |
1.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$8,664.05 |
$10,193 |
2.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$18,401.65 |
$21,649 |
3.1× |
| Ankle 2 views (73600) |
$231.20 |
$272 |
2.5× |
| Antegrade urography radiological supvj & interpj (74425) |
$1,319.20 |
$1,552 |
3.6× |
| Aortogram thoracic (75605) |
$4,794.85 |
$5,641 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$8,455.38 |
$9,947.50 |
2.5× |
| Aortography abdominal serialography rs&i (75625) |
$4,625.28 |
$5,441.50 |
1.4× |
| Aortography thoracic w/o serialography rs&i (75600) |
$8,770.30 |
$10,318 |
2.6× |
| Arthrogram hip (73525) |
$1,319.20 |
$1,552 |
3.6× |
| Arthrogram shoulder (73040) |
$1,319.20 |
$1,552 |
3.6× |
| Arthrogram wrist (73115) |
$1,319.20 |
$1,552 |
3.6× |
| Basic radiation dosimetry calculation (77300) |
$1,615 |
$1,900 |
11.4× |
| Bone &/Joint Imaging Limited Area (78300) |
$2,622.25 |
$3,085 |
6.2× |
| Bone &/joint imaging whole body (78306) |
$3,176.45 |
$3,737 |
7.5× |
| Bone age studies (77072) |
$226.52 |
$266.50 |
2.1× |
| Bone Imaging 3 Phase (78315) |
$3,834.35 |
$4,511 |
9.1× |
| Bone survey complete (77075) |
$360.82 |
$424.50 |
3.3× |
| Brachytx isodose complex (77318) |
$2,181.52 |
$2,566.50 |
5.5× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$853.40 |
$1,004 |
2.2× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,247.05 |
$6,173 |
3.5× |
| Cervical spine 2 or 3 views (72040) |
$201.02 |
$236.50 |
2.2× |
| Chest 1 view (71045) |
$226.10 |
$266 |
2.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$606.48 |
$713.50 |
3.3× |
| Clavicle complete (73000) |
$238 |
$280 |
2.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$249.90 |
$294 |
2.3× |
| Continuing medical physics consltj pr wk (77336) |
$822.80 |
$968 |
5.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$752.25 |
$885 |
2.0× |
| CT abdomen and pelvis without contrast (74176) |
$752.25 |
$885 |
3.0× |
| CT abdomen w contrast (74160) |
$752.25 |
$885 |
4.1× |
| CT abdomen w wo contrast (74170) |
$752.25 |
$885 |
4.1× |
| CT abdomen w/o contrast (74150) |
$752.25 |
$885 |
6.8× |
| CT angio hrt w/3d image (75574) |
$752.25 |
$885 |
2.0× |
| CT angiography upper extremity lt (73206) |
$752.25 |
$885 |
4.1× |
| CT c-spine w/o contrast (72125) |
$752.25 |
$885 |
6.8× |
| CT cervical spine w&w/o contrast (72127) |
$404.60 |
$476 |
2.2× |
| CT cervical spine with contrast (72126) |
$752.25 |
$885 |
2.0× |
| CT chest w/wo contrast (71270) |
$752.25 |
$885 |
4.1× |
| CT chest with contrast (71260) |
$752.25 |
$885 |
4.1× |
| CT colonography w/o cntrst (74261) |
$752.25 |
$885 |
6.8× |
| CT head/brain with contrast (70460) |
$752.25 |
$885 |
4.1× |
| CT head/brain without and with contrast (70470) |
$752.25 |
$885 |
4.1× |
| CT heart contrast eval cardiac structure&morph (75572) |
$752.25 |
$885 |
2.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$101.15 |
$119 |
1.1× |
| CT iac w contrast (70481) |
$752.25 |
$885 |
4.1× |
| CT lower ext w/o (73700) |
$752.25 |
$885 |
6.8× |
| CT lower extremity w wo contrast (73702) |
$752.25 |
$885 |
4.1× |
| CT lower extremity with contrast (73701) |
$752.25 |
$885 |
4.1× |
| CT lumbar spine w & w/o contrast (72133) |
$404.60 |
$476 |
2.2× |
| CT lumbar spine w/o contrast (72131) |
$752.25 |
$885 |
6.8× |
| CT lumbar spine with contrast (72132) |
$752.25 |
$885 |
2.0× |
| CT maxillofacial w contrast (70487) |
$752.25 |
$885 |
4.1× |
| CT maxillofacial w/o contrast (70486) |
$752.25 |
$885 |
6.8× |
| CT maxillofacial w/wo contrast (70488) |
$752.25 |
$885 |
4.1× |
| CT neck soft tissue w contrast (70491) |
$752.25 |
$885 |
4.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$752.25 |
$885 |
4.1× |
| CT orbits w/o contrast (70480) |
$752.25 |
$885 |
6.8× |
| CT pelvis w & w/o contrast (72194) |
$752.25 |
$885 |
4.1× |
| CT pelvis w/o contrast (72192) |
$752.25 |
$885 |
6.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$752.25 |
$885 |
4.1× |
| CT soft tissue neck w/o contrast (70490) |
$752.25 |
$885 |
6.8× |
| CT thoracic spine w/contrast (72129) |
$752.25 |
$885 |
4.1× |
| CT thoracic spine w/o contrast (72128) |
$752.25 |
$885 |
6.8× |
| CT thoracic spine w/wo contrast (72130) |
$752.25 |
$885 |
4.1× |
| CT thorax w/o contrast (71250) |
$752.25 |
$885 |
6.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$413.95 |
$487 |
2.2× |
| CT upper extremity w/o contrast rt (73200) |
$752.25 |
$885 |
6.8× |
| CT upper extremity with contrast (73201) |
$752.25 |
$885 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$752.25 |
$885 |
4.1× |
| Cta Abdomen (74175) |
$752.25 |
$885 |
4.1× |
| CTA abdomen pelvis (74174) |
$752.25 |
$885 |
2.0× |
| CTA chest (71275) |
$752.25 |
$885 |
4.1× |
| Cta Head (70496) |
$752.25 |
$885 |
4.1× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$837.25 |
$985 |
2.3× |
| CTA lwr ext w&w/o contrast (73706) |
$752.25 |
$885 |
4.1× |
| Cta Neck (70498) |
$752.25 |
$885 |
4.1× |
| Cta Pelvis (72191) |
$752.25 |
$885 |
4.1× |
| Cystography minimum 3 views rs&i (74430) |
$1,272.02 |
$1,496.50 |
3.5× |
| Diskography lumbar (72295) |
$5,936.40 |
$6,984 |
2.9× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$311.10 |
$366 |
2.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$306 |
$360 |
2.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$164.90 |
$194 |
1.8× |
| Dxa bone density study axial skeleton (77085) |
$329.80 |
$388 |
3.0× |
| Echoencephalography real time imaging (76506) |
$358.70 |
$422 |
3.3× |
| Esophagus (74220) |
$606.48 |
$713.50 |
3.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$358.70 |
$422 |
3.3× |
| Fluoroscopy up to 1 hr (76000) |
$783.70 |
$922 |
3.1× |
| Foot 2 views (73620) |
$233.75 |
$275 |
2.5× |
| Forearm 2 views (73090) |
$217.60 |
$256 |
2.4× |
| Gated Heart Planar Single (78472) |
$4,162.02 |
$4,896.50 |
9.9× |
| Hand 2 views (73120) |
$220.58 |
$259.50 |
2.0× |
| Hand 3 views (73130) |
$260.10 |
$306 |
2.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$5,362.65 |
$6,309 |
7.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$5,170.12 |
$6,082.50 |
7.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$5,170.12 |
$6,082.50 |
7.0× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$1,430.98 |
$1,683.50 |
3.5× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,430.98 |
$1,683.50 |
3.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,703.42 |
$3,180.50 |
4.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,703.42 |
$3,180.50 |
6.4× |
| Ht muscle image spect sing (78451) |
$2,744.65 |
$3,229 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$238 |
$280 |
2.6× |
| Hysterosalpingogram (74740) |
$775.20 |
$912 |
3.1× |
| Image fusion (77399) |
$853.40 |
$1,004 |
6.0× |
| Interstitial radiation source applic complex (77778) |
$5,170.12 |
$6,082.50 |
7.0× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$174.25 |
$205 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,066.78 |
$2,431.50 |
3.6× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,374.90 |
$2,794 |
4.1× |
| Knee 3 views (73562) |
$269.02 |
$316.50 |
2.9× |
| Liver & spleen imaging static only (78215) |
$2,411.45 |
$2,837 |
5.7× |
| Liver imaging static only (78201) |
$2,119.05 |
$2,493 |
3.7× |
| Lung Ventilation Imaging (78579) |
$3,029.40 |
$3,564 |
7.2× |
| Lymphoscintigraphy (78195) |
$2,368.95 |
$2,787 |
4.1× |
| Meckels Diverticulum (78290) |
$2,791.40 |
$3,284 |
6.6× |
| Mlc imrt design & construction per imrt plan (77338) |
$2,181.52 |
$2,566.50 |
5.5× |
| MRA head w & w/o contrast (70546) |
$752.25 |
$885 |
2.0× |
| MRA head w/o contrast (70544) |
$752.25 |
$885 |
3.0× |
| MRA head with contrast (70545) |
$752.25 |
$885 |
2.0× |
| MRA neck w contrast (70548) |
$752.25 |
$885 |
2.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$752.25 |
$885 |
2.0× |
| MRA neck w/o contrast (70547) |
$752.25 |
$885 |
3.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$752.25 |
$885 |
2.0× |
| MRI abdomen w/o contrast (74181) |
$752.25 |
$885 |
3.0× |
| MRI any jnt lwr ext with con lt (73722) |
$752.25 |
$885 |
0.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$752.25 |
$885 |
0.9× |
| MRI breast w/o contrast bilateral (77047) |
$752.25 |
$885 |
3.0× |
| MRI breast w/o contrast unilat (77046) |
$752.25 |
$885 |
3.0× |
| MRI cervical spine w/o contrast (72141) |
$752.25 |
$885 |
3.0× |
| MRI chest w/o & w/contrast material (71552) |
$752.25 |
$885 |
2.0× |
| MRI chest w/o contrast (71550) |
$752.25 |
$885 |
3.0× |
| MRI chest with contrast (71551) |
$752.25 |
$885 |
0.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$752.25 |
$885 |
2.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$752.25 |
$885 |
2.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$752.25 |
$885 |
3.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$752.25 |
$885 |
3.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$752.25 |
$885 |
2.0× |
| MRI orbit/face/neck w/contrast (70542) |
$752.25 |
$885 |
2.0× |
| MRI pelvis w contrast (72196) |
$752.25 |
$885 |
2.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$752.25 |
$885 |
2.0× |
| MRI pelvis w/o contrast (72195) |
$752.25 |
$885 |
3.0× |
| MRI scan of arm joint before and after contrast (73223) |
$752.25 |
$885 |
2.0× |
| MRI scan of leg joint before and after contrast (73723) |
$752.25 |
$885 |
2.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$752.25 |
$885 |
2.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$752.25 |
$885 |
2.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$752.25 |
$885 |
2.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$752.25 |
$885 |
2.0× |
| MRI thoracic spine w/o contrast (72146) |
$752.25 |
$885 |
3.0× |
| MRI tmj (70336) |
$752.25 |
$885 |
3.0× |
| MRI upper ext joint w/o contrast (73221) |
$752.25 |
$885 |
3.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$752.25 |
$885 |
2.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$752.25 |
$885 |
3.0× |
| Myelogram Cervical (72240) |
$2,351.10 |
$2,766 |
2.8× |
| Myelogram thoracic (72255) |
$2,351.10 |
$2,766 |
2.8× |
| Myelography 2 or more regions (72270) |
$2,351.10 |
$2,766 |
2.8× |
| Myocardial infarct spect (78469) |
$1,802.85 |
$2,121 |
3.1× |
| Myocardial Spect Multiple Studies (78452) |
$5,286.58 |
$6,219.50 |
3.9× |
| Neck soft tissue (70360) |
$186.15 |
$219 |
2.0× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,484.10 |
$1,746 |
3.6× |
| Nm csf leak detection (78650) |
$2,202.35 |
$2,591 |
1.6× |
| Nm gastric emptying study (78264) |
$2,703.42 |
$3,180.50 |
6.4× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$7,459.60 |
$8,776 |
5.1× |
| Nuclear Rx Oral Admin (79005) |
$2,380.42 |
$2,800.50 |
9.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$358.70 |
$422 |
3.3× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$402.90 |
$474 |
3.7× |
| Osseous survey infant (77076) |
$372.72 |
$438.50 |
3.4× |
| Parathyrd planar w/spect&CT (78072) |
$1,413.55 |
$1,663 |
2.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,067.60 |
$1,256 |
2.5× |
| Parathyroid imaging (78070) |
$2,169.20 |
$2,552 |
5.1× |
| Pelvis 1 or 2 views (72170) |
$233.75 |
$275 |
2.1× |
| PET image w/CT, skull-thigh (78815) |
$10,171.52 |
$11,966.50 |
6.7× |
| PET imaging CT for attenuation limited area (78814) |
$7,864.20 |
$9,252 |
5.2× |
| PET imaging for CT attenuation whole body (78816) |
$10,115 |
$11,900 |
6.7× |
| PET imaging limited area chest head/neck (78811) |
$5,099.15 |
$5,999 |
3.7× |
| PET whole body (78813) |
$4,236.40 |
$4,984 |
2.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$752.25 |
$885 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$2,028.10 |
$2,386 |
4.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$5,060.48 |
$5,953.50 |
8.8× |
| Quan&charac c atherosclerotc plaq asses sev c ds (75577) |
$2,020.45 |
$2,377 |
2.1× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$149.18 |
$175.50 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$308.12 |
$362.50 |
2.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$255 |
$300 |
2.3× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,322.18 |
$21,555.50 |
2.4× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$1,430.98 |
$1,683.50 |
2.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$828.75 |
$975 |
7.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$828.75 |
$975 |
2.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$260.10 |
$306 |
2.4× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$245.65 |
$289 |
2.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$226.10 |
$266 |
2.5× |
| Radiologic exam colon single contrast study (74270) |
$606.48 |
$713.50 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$606.48 |
$713.50 |
3.3× |
| Radiologic exam upr gi trc single contrast study (74240) |
$606.48 |
$713.50 |
3.3× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$244.38 |
$287.50 |
2.7× |
| Radiological examination surgical specimen (76098) |
$1,144.95 |
$1,347 |
2.0× |
| Ribs bilateral 3 views (71110) |
$260.95 |
$307 |
2.4× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$2,603.55 |
$3,063 |
6.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,603.55 |
$3,063 |
4.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$3,323.08 |
$3,909.50 |
5.8× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,586.15 |
$4,219 |
2.6× |
| Rp Therapy Intravenous Administration (79101) |
$518.08 |
$609.50 |
2.1× |
| Sacroiliac Joints < 3 Views (72200) |
$240.55 |
$283 |
2.2× |
| Scanogram (77073) |
$263.08 |
$309.50 |
2.4× |
| Scapula complete (73010) |
$198.90 |
$234 |
1.8× |
| Screening digital breast tomosynthesis (77063) |
$68.85 |
$81 |
2.9× |
| Simulation intermediate (77285) |
$2,262.70 |
$2,662 |
5.7× |
| Small bowel series (74250) |
$606.48 |
$713.50 |
3.3× |
| Spec medical radj physics consltj (77370) |
$822.80 |
$968 |
5.8× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$2,262.70 |
$2,662 |
5.7× |
| Special dosimetry (77331) |
$853.40 |
$1,004 |
6.0× |
| Special treatment procedure (77470) |
$3,462.48 |
$4,073.50 |
5.9× |
| Spleen imaging only (78185) |
$2,270.35 |
$2,671 |
5.4× |
| Stereotactic body radiation delivery (77373) |
$6,496.98 |
$7,643.50 |
3.4× |
| Surface radiation therapy; orthovoltage, delivery, >150-500 kV, per fraction 2nd-5th Sessions (77438) |
$769.25 |
$905 |
7.1× |
| Surface radiation therapy; superficial or orthovoltage, treatment planning and simulation-aided field setting 2nd-5th… (77436) |
$769.25 |
$905 |
19.5× |
| Surface radiation therapy; superficial, delivery, </=150 kV, per fraction (eg, electronic brachytherapy) 2nd-5th… (77437) |
$769.25 |
$905 |
7.1× |
| Tbs Technical Calculation Only (77091) |
$233.75 |
$275 |
2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$2,181.52 |
$2,566.50 |
5.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$939.25 |
$1,105 |
2.4× |
| Ther rad simulaj-aided field setting complex (77290) |
$2,181.52 |
$2,566.50 |
5.5× |
| Ther rad simulaj-aided field setting simple (77280) |
$822.80 |
$968 |
5.8× |
| Therapeutic Enema (74283) |
$629 |
$740 |
3.4× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,445.45 |
$2,877 |
4.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,174.70 |
$1,382 |
2.8× |
| Thyroid uptake measurement (78012) |
$733.55 |
$863 |
1.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,823.25 |
$2,145 |
4.3× |
| Tmj unilateral (70328) |
$193.80 |
$228 |
2.1× |
| Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) |
$242.25 |
$285 |
2.6× |
| Treatment device intermediate (77333) |
$822.80 |
$968 |
5.8× |
| Treatment devices simple (77332) |
$822.80 |
$968 |
5.8× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$9,014.25 |
$10,605 |
15.7× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$3,100.80 |
$3,648 |
7.4× |
| Tx devices design & construction complex (77334) |
$3,231.70 |
$3,802 |
8.2× |
| Ultrasound elastography first target lesion (76982) |
$255 |
$300 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$358.70 |
$422 |
3.3× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$52.28 |
$61.50 |
0.6× |
| Unlisted magnetic resonance procedure (76498) |
$335.75 |
$395 |
3.7× |
| Unlisted Ultrasound Procedure (76999) |
$225.25 |
$265 |
2.5× |
| Upper Extremity Infant (73092) |
$236.30 |
$278 |
2.1× |
| Urethrocystography retrograde rs&i (74450) |
$804.10 |
$946 |
3.2× |
| Urethrocystography voiding (74455) |
$804.10 |
$946 |
3.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$629 |
$740 |
3.4× |
| Us abdl aorta screen aaa (76706) |
$315.78 |
$371.50 |
2.9× |
| Us breast unilateral complete (76641) |
$370.60 |
$436 |
3.4× |
| Us breast unilateral limited (76642) |
$303.02 |
$356.50 |
3.3× |
| Us chest (76604) |
$502.35 |
$591 |
4.6× |
| Us compl joint r-t w/image documentation (76881) |
$358.70 |
$422 |
3.3× |
| Us elastography parenchyma (76981) |
$255 |
$300 |
2.3× |
| Us guided compression repair (76936) |
$774.35 |
$911 |
3.4× |
| Us infant hips dynamic (76885) |
$190.40 |
$224 |
2.1× |
| Us ob transvaginal (76817) |
$358.70 |
$422 |
3.3× |
| Us pelvic non ob complete (76856) |
$358.70 |
$422 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$358.70 |
$422 |
3.3× |
| Us pregnancy ltd (76815) |
$642.60 |
$756 |
5.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$358.70 |
$422 |
3.3× |
| Us retroperitoneal complete (76770) |
$358.70 |
$422 |
3.3× |
| Us retroperitoneal limited (76775) |
$358.70 |
$422 |
3.3× |
| Us scrotum and contents (76870) |
$358.70 |
$422 |
3.3× |
| Us soft tissue head/neck (76536) |
$358.70 |
$422 |
3.3× |
| Us spinal canal and contents (76800) |
$190.40 |
$224 |
1.7× |
| Us transrectal (76872) |
$317.90 |
$374 |
2.9× |
| Us transrectal prostate volume (76873) |
$765.42 |
$900.50 |
6.9× |
| Us xtr non-vasc lmtd (76882) |
$234.60 |
$276 |
2.1× |
| Us, eye b-scan (76512) |
$363.80 |
$428 |
3.3× |
| Venogram extremity bilateral (75822) |
$1,597.15 |
$1,879 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$4,718.35 |
$5,551 |
1.4× |
| Venography caval superior serialography rs&i (75827) |
$2,222.75 |
$2,615 |
1.3× |
| Venography extremity unilateral rs&i (75820) |
$3,045.12 |
$3,582.50 |
1.8× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,211.70 |
$2,602 |
0.7× |
| Vertebral fracture assessment via dxa (77086) |
$209.10 |
$246 |
2.3× |
| Wrist 2 views (73100) |
$239.28 |
$281.50 |
2.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$270.72 |
$318.50 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$188.28 |
$221.50 |
2.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$245.22 |
$288.50 |
2.7× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$629 |
$740 |
3.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$203.58 |
$239.50 |
2.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$234.60 |
$276 |
2.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$372.72 |
$438.50 |
3.4× |
| X-ray exam hip uni 1 view (73501) |
$266.48 |
$313.50 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$214.62 |
$252.50 |
2.3× |
| X-ray exam of femur 1 (73551) |
$209.10 |
$246 |
2.3× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$629 |
$740 |
3.4× |
| X-ray eye for foreign body (70030) |
$373.15 |
$439 |
4.1× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$266.48 |
$313.50 |
2.4× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$187 |
$220 |
2.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$248.20 |
$292 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$214.20 |
$252 |
2.3× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$131.32 |
$154.50 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$313.22 |
$368.50 |
2.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$266.48 |
$313.50 |
2.9× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$228.65 |
$269 |
2.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$252.02 |
$296.50 |
2.3× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$197.62 |
$232.50 |
2.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$183.18 |
$215.50 |
2.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$268.18 |
$315.50 |
2.4× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$277.10 |
$326 |
2.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$3,025.58 |
$3,559.50 |
8.2× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$196.78 |
$231.50 |
2.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$256.70 |
$302 |
2.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$386.75 |
$455 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$188.28 |
$221.50 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$251.60 |
$296 |
2.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$198.05 |
$233 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$116.45 |
$137 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$263.08 |
$309.50 |
2.4× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$247.78 |
$291.50 |
2.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$174.25 |
$205 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$204 |
$240 |
2.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$190.82 |
$224.50 |
2.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$240.12 |
$282.50 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$161.08 |
$189.50 |
1.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$266.48 |
$313.50 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$291.98 |
$343.50 |
2.6× |
| Xr chest 4+ views (71048) |
$224.82 |
$264.50 |
2.0× |
| Xr Cholecystography Oral Contrast (74290) |
$629 |
$740 |
3.4× |
| Xr finger(s) 2+ views (73140) |
$239.70 |
$282 |
2.6× |
| Xr shoulder 1 view (73020) |
$162.35 |
$191 |
1.8× |
| Xr spine cervical 4 or 5 views (72050) |
$275.82 |
$324.50 |
2.5× |
| Xr tibia/fibula 2 views (73590) |
$230.78 |
$271.50 |
2.5× |
| Xr tmj bilateral (70330) |
$226.95 |
$267 |
2.5× |
| Xray knee 1 or 2 views rt (73560) |
$255.85 |
$301 |
2.8× |