| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,753.64 |
$3,442.05 |
1.9× |
| Abdomen 2 views (74019) |
$236.24 |
$295.30 |
2.2× |
| Acute gi blood loss imaging (78278) |
$1,038.64 |
$1,298.30 |
2.5× |
| Angiography extremity bilateral rs&i (75716) |
$5,512.64 |
$6,890.80 |
1.7× |
| Angiography extremity unilateral rs&i (75710) |
$5,389.28 |
$6,736.60 |
1.6× |
| Angiography Spinal Selective Rs&I (75705) |
$5,307.60 |
$6,634.50 |
0.9× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$8,406.16 |
$10,507.70 |
1.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$4,901.36 |
$6,126.70 |
1.5× |
| Ankle 2 views (73600) |
$171.92 |
$214.90 |
1.9× |
| Aortogram thoracic (75605) |
$8,711.60 |
$10,889.50 |
1.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,024.64 |
$2,530.80 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$5,141.76 |
$6,427.20 |
1.6× |
| Arthrogram ankle (73615) |
$367.52 |
$459.40 |
1.0× |
| Arthrogram elbow (73085) |
$850.48 |
$1,063.10 |
2.4× |
| Arthrogram knee (73580) |
$550.72 |
$688.40 |
1.5× |
| Basic dosimetry (77300) |
$235.27 |
$294.09 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$668.50 |
$835.63 |
1.6× |
| Bone &/joint imaging whole body (78306) |
$1,999.49 |
$2,499.36 |
4.8× |
| Bone age studies (77072) |
$252.88 |
$316.10 |
2.3× |
| Bone Imaging 3 Phase (78315) |
$981.84 |
$1,227.30 |
2.4× |
| Bone Marrow Imaging Limited Area (78102) |
$742.88 |
$928.60 |
1.8× |
| Bone survey complete (77075) |
$688.88 |
$861.10 |
6.4× |
| Bone survey infant (77076) |
$161.16 |
$201.45 |
1.5× |
| Bowel imaging (78290) |
$1,075.44 |
$1,344.30 |
2.6× |
| Brachytx isodose complex (77318) |
$2,314.40 |
$2,893 |
6.0× |
| Brachytx isodose intermed (77317) |
$1,268.16 |
$1,585.20 |
3.3× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$689.65 |
$862.06 |
1.8× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$909.26 |
$1,136.58 |
1.6× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$5,304.48 |
$6,630.60 |
3.6× |
| Card Bpi Gtd =Brm Plnr 1 Std Rest/Strs (78472) |
$1,137.68 |
$1,422.10 |
2.8× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,966.44 |
$2,458.05 |
5.4× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$1,236.16 |
$1,545.20 |
2.2× |
| Cervical spine 2 or 3 views (72040) |
$280.36 |
$350.45 |
3.1× |
| Chest 1 view (71045) |
$109.92 |
$137.40 |
1.2× |
| Chest xray 3 views (71047) |
$154.40 |
$193 |
1.7× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$369.78 |
$462.22 |
2.0× |
| Clavicle complete (73000) |
$284.04 |
$355.05 |
3.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$1,249.60 |
$1,562 |
11.6× |
| Continuing medical physics consltj pr wk (77336) |
$224.40 |
$280.50 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,416.32 |
$4,270.40 |
9.5× |
| CT abdomen and pelvis without contrast (74176) |
$1,721.68 |
$2,152.10 |
7.0× |
| CT abdomen w contrast (74160) |
$1,891.92 |
$2,364.90 |
10.4× |
| CT abdomen w wo contrast (74170) |
$1,980.72 |
$2,475.90 |
10.9× |
| CT abdomen w/o contrast (74150) |
$1,249.60 |
$1,562 |
11.6× |
| CT angio hrt w/3d image (75574) |
$1,249.60 |
$1,562 |
3.5× |
| CT angio lwr extr w/o&w/dye (73706) |
$1,249.60 |
$1,562 |
6.9× |
| CT angiography upper extremity lt (73206) |
$1,249.60 |
$1,562 |
6.9× |
| CT c-spine w/contrast (72126) |
$1,967.68 |
$2,459.60 |
5.5× |
| CT c-spine w/o contrast (72125) |
$1,816.80 |
$2,271 |
16.8× |
| CT cervical spine w&w/o contrast (72127) |
$1,827.82 |
$2,284.78 |
10.1× |
| CT chest w contrast (71260) |
$1,916.08 |
$2,395.10 |
10.6× |
| CT chest w/wo contrast (71270) |
$1,967.68 |
$2,459.60 |
10.8× |
| CT colonography screening (74263) |
$1,249.60 |
$1,562 |
5.1× |
| CT colonography w/o cntrst (74261) |
$1,249.60 |
$1,562 |
11.6× |
| CT head/brain with contrast (70460) |
$1,624.40 |
$2,030.50 |
9.0× |
| CT head/brain without and with contrast (70470) |
$2,062 |
$2,577.50 |
11.4× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,249.60 |
$1,562 |
3.5× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$280 |
$350 |
3.1× |
| CT iac w contrast (70481) |
$2,151.36 |
$2,689.20 |
11.9× |
| CT limited/localized follow up study (76380) |
$1,249.60 |
$1,562 |
13.9× |
| CT lower ext w/o (73700) |
$1,738.16 |
$2,172.70 |
16.1× |
| CT lower extremity w wo contrast (73702) |
$1,610.72 |
$2,013.40 |
8.9× |
| CT lower extremity w/contrast material (73701) |
$1,802.16 |
$2,252.70 |
9.9× |
| CT lumbar spine w/contrast (72132) |
$1,916.08 |
$2,395.10 |
5.3× |
| CT lumbar spine w/o contrast (72131) |
$1,696.08 |
$2,120.10 |
15.7× |
| CT maxillofacial w contrast (70487) |
$1,479.04 |
$1,848.80 |
8.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,413.98 |
$1,767.48 |
7.8× |
| CT maxillofacial wo contrast (70486) |
$1,301.80 |
$1,627.25 |
12.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,735.92 |
$3,419.90 |
15.1× |
| CT orbits w/o contrast (70480) |
$1,480 |
$1,850 |
13.7× |
| CT pelvis w/o contrast (72192) |
$1,249.60 |
$1,562 |
11.6× |
| CT pelvis w/wo contrast (72194) |
$2,331.04 |
$2,913.80 |
12.8× |
| CT scan of arm combo (73202) |
$1,789.92 |
$2,237.40 |
9.9× |
| CT soft tissue neck w contrast (70491) |
$1,624.40 |
$2,030.50 |
9.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,719.76 |
$2,149.70 |
9.5× |
| CT soft tissue neck w/o contrast (70490) |
$1,397.52 |
$1,746.90 |
12.9× |
| CT thoracic spine w/contrast (72129) |
$1,916.08 |
$2,395.10 |
10.6× |
| CT thoracic spine w/o contrast (72128) |
$1,249.60 |
$1,562 |
11.6× |
| CT thorax w/o contrast (71250) |
$1,394.56 |
$1,743.20 |
12.9× |
| CT unlisted procedure (76497) |
$1,249.60 |
$1,562 |
13.9× |
| CT upper ext wo (73200) |
$1,540.48 |
$1,925.60 |
14.2× |
| CT upper extremity with contrast (73201) |
$1,742.16 |
$2,177.70 |
4.8× |
| Cta Aa&Bi Iliofem Lxtr Rs&I C-/C+ Post-Pxessing (75635) |
$2,071.60 |
$2,589.50 |
11.4× |
| Cta Abdomen (74175) |
$1,249.60 |
$1,562 |
6.9× |
| CTA abdomen pelvis (74174) |
$2,049.76 |
$2,562.20 |
5.7× |
| CTA chest (71275) |
$1,249.60 |
$1,562 |
6.9× |
| Cta Head (70496) |
$1,249.60 |
$1,562 |
6.9× |
| Cta Neck (70498) |
$1,249.60 |
$1,562 |
6.9× |
| Cta Pelvis (72191) |
$1,249.60 |
$1,562 |
6.9× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$130.80 |
$163.50 |
1.2× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$228.96 |
$286.20 |
2.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$133.04 |
$166.30 |
1.2× |
| Dxa bone density study 1/> sites axial skel (77080) |
$199.60 |
$249.50 |
1.8× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$73.44 |
$91.80 |
0.8× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$764 |
$955 |
3.1× |
| Esophagus (74220) |
$412.72 |
$515.90 |
2.3× |
| Facial bones min 3 views (70150) |
$392.40 |
$490.50 |
3.6× |
| Fetal biophysical profile non-stress testing (76818) |
$495.60 |
$619.50 |
4.6× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$173.38 |
$216.72 |
1.6× |
| Fetal Echo (76825) |
$793.41 |
$991.76 |
1.4× |
| Fluoroscopy up to 1 hr (76000) |
$325.88 |
$407.35 |
1.3× |
| Foot 2 views (73620) |
$197.87 |
$247.34 |
2.2× |
| Forearm 2 views (73090) |
$273.52 |
$341.90 |
3.0× |
| Hand 2 views (73120) |
$112.90 |
$141.12 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,429.21 |
$1,786.51 |
2.0× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,595.12 |
$1,993.90 |
2.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,595.12 |
$1,993.90 |
2.2× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,307.68 |
$6,634.60 |
1.6× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,600.80 |
$2,001 |
2.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,600.80 |
$2,001 |
3.9× |
| Hysterosalpingogram (74740) |
$470 |
$587.50 |
1.9× |
| Image fusion (77399) |
$224.11 |
$280.14 |
1.6× |
| Interstitial radiation source applic complex (77778) |
$1,829.54 |
$2,286.93 |
2.5× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$14,636.80 |
$18,296 |
1.9× |
| Kidney function study, non-imaging radioisotopic study Non-Facility (78725) |
$839.91 |
$1,049.89 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$1,020.46 |
$1,275.57 |
1.8× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$1,878.08 |
$2,347.60 |
3.3× |
| Knee 3 views (73562) |
$191.31 |
$239.14 |
2.1× |
| Liver & spleen imaging static only (78215) |
$1,277.44 |
$1,596.80 |
3.1× |
| Liver imaging static only (78201) |
$2,712.64 |
$3,390.80 |
4.8× |
| Lung perf&ventilat diferentl (78598) |
$1,543.04 |
$1,928.80 |
2.7× |
| Lung perfusion differential (78597) |
$943.28 |
$1,179.10 |
2.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$4,462.48 |
$5,578.10 |
1.4× |
| Lymphoscintigraphy (78195) |
$1,115.12 |
$1,393.90 |
2.0× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,942.88 |
$2,428.60 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$1,619.84 |
$2,024.80 |
4.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,915.36 |
$2,394.20 |
5.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,618.82 |
$2,023.53 |
4.2× |
| Mr safety determination physician/other qhp (76016) |
$141.84 |
$177.30 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$39.44 |
$49.30 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$147.84 |
$184.80 |
1.5× |
| Mr safety implt pos&/immoblj (76019) |
$95.68 |
$119.60 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$389.44 |
$486.80 |
1.6× |
| MRA head w & w/o contrast (70546) |
$3,218 |
$4,022.50 |
8.9× |
| MRA head w/o contrast (70544) |
$1,849.52 |
$2,311.90 |
7.5× |
| MRA neck w contrast (70548) |
$1,910.42 |
$2,388.02 |
5.3× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,789.20 |
$3,486.50 |
7.7× |
| MRA neck w/o contrast (70547) |
$1,923.52 |
$2,404.40 |
7.8× |
| MRI abdomen w contrast (74182) |
$2,242.16 |
$2,802.70 |
6.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$4,385.74 |
$5,482.18 |
12.2× |
| MRI abdomen w/o contrast (74181) |
$2,413.82 |
$3,017.28 |
9.8× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,234.08 |
$2,792.60 |
2.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,595.76 |
$4,494.70 |
10.0× |
| MRI breast w/o contrast bilateral (77047) |
$1,947.68 |
$2,434.60 |
7.9× |
| MRI breast wo contrast unilateral (77046) |
$1,947.68 |
$2,434.60 |
7.9× |
| MRI c-spine with contrast (72142) |
$2,592.48 |
$3,240.60 |
7.2× |
| MRI cardiac w/o contrast (75557) |
$1,947.68 |
$2,434.60 |
7.9× |
| MRI cervical spine w/o contrast (72141) |
$2,012.16 |
$2,515.20 |
8.2× |
| MRI chest w/o & w/contrast material (71552) |
$5,298.16 |
$6,622.70 |
14.7× |
| MRI chest w/o contrast (71550) |
$2,945.68 |
$3,682.10 |
11.9× |
| MRI chest with contrast (71551) |
$1,510.34 |
$1,887.93 |
1.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,942.88 |
$2,428.60 |
5.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,330.54 |
$2,913.18 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,970.85 |
$2,463.56 |
8.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,260.24 |
$2,825.30 |
9.2× |
| MRI orbit face neck w contrast (70542) |
$2,801.68 |
$3,502.10 |
7.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$4,065.68 |
$5,082.10 |
11.3× |
| MRI pelvis w/contrast (72196) |
$2,507.52 |
$3,134.40 |
6.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$3,794 |
$4,742.50 |
10.5× |
| MRI pelvis w/o contrast (72195) |
$2,431.12 |
$3,038.90 |
9.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,763.38 |
$4,704.23 |
10.4× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,592.48 |
$3,240.60 |
7.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,618.64 |
$4,523.30 |
10.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$2,592.48 |
$3,240.60 |
7.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,763.38 |
$4,704.23 |
10.4× |
| MRI temporomandibular joint (70336) |
$2,260.24 |
$2,825.30 |
9.2× |
| MRI thoracic spine w/o contrast (72146) |
$2,112.77 |
$2,640.96 |
8.6× |
| MRI up ext w/o contrast (73218) |
$1,919.28 |
$2,399.10 |
7.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,488.28 |
$3,110.36 |
10.1× |
| MRI, joint upper extrem combo (73223) |
$3,595.76 |
$4,494.70 |
10.0× |
| Myelogram Cervical (72240) |
$1,304.08 |
$1,630.10 |
1.6× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$5,304.48 |
$6,630.60 |
4.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,890.44 |
$3,613.05 |
2.2× |
| Myocardial spect single study at rest or stress (78451) |
$3,000.20 |
$3,750.25 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$1,639.04 |
$2,048.80 |
1.8× |
| Neck soft tissue (70360) |
$217.32 |
$271.65 |
2.4× |
| Nm cisternogram (78630) |
$1,112.40 |
$1,390.50 |
2.0× |
| Nm gastric emptying study (78264) |
$1,560.72 |
$1,950.90 |
3.8× |
| Nm peritoneal-venous shunt patency (78291) |
$1,210.88 |
$1,513.60 |
2.9× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,409.71 |
$3,012.14 |
1.7× |
| Nuclear Rx Oral Admin (79005) |
$728.72 |
$910.90 |
3.0× |
| Ob us nuchal meas 1 gest (76813) |
$246.04 |
$307.55 |
2.3× |
| Parathyrd planar w/spect&CT (78072) |
$1,396.48 |
$1,745.60 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$267.98 |
$334.97 |
2.5× |
| Perineogram (74775) |
$416.08 |
$520.10 |
1.7× |
| PET image w/CT, skull-thigh (78815) |
$4,109.78 |
$5,137.22 |
2.8× |
| PET imaging CT for attenuation limited area (78814) |
$3,211.68 |
$4,014.60 |
2.2× |
| PET imaging for CT attenuation whole body (78816) |
$5,136.88 |
$6,421.10 |
3.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,309.76 |
$6,637.20 |
1.6× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,822.56 |
$2,278.20 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$889.82 |
$1,112.27 |
2.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,636.96 |
$2,046.20 |
2.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$676.80 |
$846 |
1.2× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$295.47 |
$369.34 |
3.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$219.60 |
$274.50 |
2.4× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$301.84 |
$377.30 |
3.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$118.64 |
$148.30 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$236.32 |
$295.40 |
2.2× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 4/5 Vw (72083) |
$378.34 |
$472.92 |
3.5× |
| Radex fingr minimum 2 views (73140) |
$136.52 |
$170.65 |
1.5× |
| Radex Foot Compl Minimum 3 Views (73630) |
$346.88 |
$433.60 |
3.9× |
| Radex Hand Minimum 3 Views (73130) |
$245.67 |
$307.09 |
2.7× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$142.64 |
$178.30 |
1.6× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$196.80 |
$246 |
1.8× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$212.68 |
$265.85 |
2.0× |
| Radex Hips Bilateral With Pelvis Minimum 5 Views (73523) |
$374.72 |
$468.40 |
3.5× |
| Radex Humerus Minimum 2 Views (73060) |
$239.68 |
$299.60 |
2.7× |
| Radex Kne 1/2 Views (73560) |
$185.76 |
$232.20 |
2.1× |
| Radex Kne Compl 4/More Views (73564) |
$323.28 |
$404.10 |
3.0× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$384.32 |
$480.40 |
3.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$284.04 |
$355.05 |
3.2× |
| Radex Sho Compl Minimum 2 Views (73030) |
$383.60 |
$479.50 |
4.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$288.16 |
$360.20 |
3.2× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$485.76 |
$607.20 |
4.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$83.42 |
$104.27 |
0.9× |
| Radex Toe Minimum 2 Views (73660) |
$118.88 |
$148.60 |
1.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$260.48 |
$325.60 |
2.4× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$242.56 |
$303.20 |
2.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$450.40 |
$563 |
4.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$19,156.80 |
$23,946 |
2.5× |
| Radiation treatment delivery level 1 (77402) |
$251.34 |
$314.17 |
2.4× |
| Radiation treatment delivery level 2 (77407) |
$245.06 |
$306.32 |
0.6× |
| Radiation treatment delivery level 3 (77412) |
$363.68 |
$454.60 |
0.6× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$109.92 |
$137.40 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$218.40 |
$273 |
2.0× |
| Radiologic exam chest 2 views (71046) |
$154.40 |
$193 |
1.7× |
| Radiologic exam colon single contrast study (74270) |
$563.68 |
$704.60 |
3.1× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$313.84 |
$392.30 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$623.11 |
$778.89 |
3.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$773.04 |
$966.30 |
4.3× |
| Radiologic examination femur 1 view (73551) |
$118.64 |
$148.30 |
1.3× |
| Radiologic examination tibia & fibula 2 views (73590) |
$257.76 |
$322.20 |
2.9× |
| Radiologic examination, mastoids; less than 3 views per side Non-Facility (70120) |
$207.52 |
$259.40 |
1.9× |
| Radiological examination surgical specimen (76098) |
$717.32 |
$896.66 |
1.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$445.44 |
$556.80 |
1.1× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$445.44 |
$556.80 |
1.1× |
| Ribs bilateral 3 views (71110) |
$271.72 |
$339.65 |
2.5× |
| Rp Loclzj Tum Plnr 1 Area Single Day Imaging (78800) |
$943.28 |
$1,179.10 |
2.3× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$943.28 |
$1,179.10 |
2.3× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,944.88 |
$3,681.10 |
5.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,812.40 |
$2,265.50 |
3.2× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,275.12 |
$2,843.90 |
4.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,247.60 |
$4,059.50 |
2.4× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,285.74 |
$4,107.18 |
2.2× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$2,843.77 |
$3,554.71 |
2.1× |
| Rp therapy intra-arterial particulate admn (79445) |
$568.96 |
$711.20 |
2.4× |
| Rp Therapy Intravenous Administration (79101) |
$729.50 |
$911.87 |
3.0× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$714.56 |
$893.20 |
2.9× |
| Scapula (73010) |
$247.60 |
$309.50 |
2.3× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$120.02 |
$150.02 |
5.1× |
| Shoulder 1 view (73020) |
$119.06 |
$148.82 |
1.3× |
| Sialogram (70390) |
$374.72 |
$468.40 |
1.5× |
| Simulation intermediate (77285) |
$570.32 |
$712.90 |
1.5× |
| Small bowel series (74250) |
$532.80 |
$666 |
2.9× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$535.27 |
$669.09 |
1.4× |
| Special dosimetry (77331) |
$168.45 |
$210.56 |
1.2× |
| Special Physics Consult (77370) |
$425.87 |
$532.34 |
3.1× |
| Special treatment procedure (77470) |
$1,045.52 |
$1,306.90 |
1.8× |
| Spine thoracic 3 views (72072) |
$375.12 |
$468.90 |
3.5× |
| Stereotactic Body Radiation Delivery (77373) |
$3,948.34 |
$4,935.42 |
2.1× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,268.16 |
$1,585.20 |
3.3× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$769.68 |
$962.10 |
2.0× |
| Ther rad simulaj-aided field setting complex (77290) |
$772.56 |
$965.70 |
2.0× |
| Ther rad simulaj-aided field setting simple (77280) |
$271.96 |
$339.95 |
2.0× |
| Thoracolumbar 2 views (72080) |
$137.42 |
$171.78 |
1.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,109.78 |
$1,387.23 |
2.0× |
| Thyroid imaging w/blood flow (78013) |
$367.52 |
$459.40 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$943.28 |
$1,179.10 |
2.3× |
| Treatment device complex (77334) |
$569.02 |
$711.27 |
1.5× |
| Treatment device intermediate (77333) |
$381.64 |
$477.05 |
2.7× |
| Treatment devices simple (77332) |
$417.97 |
$522.46 |
3.0× |
| Ultrasound breast complete (76641) |
$314.41 |
$393.01 |
2.9× |
| Ultrasound elastography first target lesion (76982) |
$180.52 |
$225.65 |
1.7× |
| Ultrasound Exam Aaa Screen (76706) |
$224 |
$280 |
2.1× |
| Ultrasound, abdomen limited (76705) |
$569.95 |
$712.44 |
5.3× |
| Umbilical-artery Doppler (OB) (76820) |
$133.04 |
$166.30 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$1,639.68 |
$2,049.60 |
18.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$583.28 |
$729.10 |
5.5× |
| Unlisted ultrasound procedure (76999) |
$437.12 |
$546.40 |
4.9× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$66.80 |
$83.50 |
6.0× |
| Urea breath test, C-14 (isotopic); analysis Facility (78268) |
$578.72 |
$723.40 |
6.1× |
| Urethrocystogram voiding (74455) |
$360.44 |
$450.55 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$532.56 |
$665.70 |
2.2× |
| Us breast unilateral limited (76642) |
$166.99 |
$208.74 |
1.9× |
| Us chest (76604) |
$253.44 |
$316.80 |
2.3× |
| Us elastography parenchyma (76981) |
$214.88 |
$268.60 |
2.0× |
| Us encephalogram (76506) |
$357.04 |
$446.30 |
3.3× |
| Us hips infant static (76886) |
$383.84 |
$479.80 |
4.3× |
| Us infant hips w manipulation (76885) |
$577.68 |
$722.10 |
6.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$199.92 |
$249.90 |
1.8× |
| Us ob detailed single fetus (76811) |
$505.01 |
$631.26 |
2.0× |
| Us ob limited (76815) |
$201.92 |
$252.40 |
1.9× |
| Us ob transvaginal (76817) |
$192.36 |
$240.45 |
1.8× |
| Us pelvic non ob complete (76856) |
$194.19 |
$242.74 |
1.8× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$260.84 |
$326.06 |
2.4× |
| Us pg uter r-t img f-up tabdl appr pr fetus (76816) |
$257.88 |
$322.35 |
2.4× |
| Us retroperitoneal complete (76770) |
$509.38 |
$636.72 |
4.7× |
| Us retroperitoneal limited (76775) |
$322.08 |
$402.60 |
3.0× |
| Us scrotum and contents (76870) |
$538 |
$672.50 |
5.0× |
| Us soft tissue head/neck (76536) |
$462.35 |
$577.94 |
4.3× |
| Us spinal canal and contents (76800) |
$550.80 |
$688.50 |
5.1× |
| Us,transplanted kidney, real time/ doppler (76776) |
$189.42 |
$236.78 |
1.8× |
| Venogram extremity bilateral (75822) |
$1,930.40 |
$2,413 |
1.2× |
| Venogram Extremity Unilateral (75820) |
$1,094.40 |
$1,368 |
0.7× |
| Venography caval inferior serialography rs&i (75825) |
$4,772.24 |
$5,965.30 |
1.5× |
| Venography caval superior serialography rs&i (75827) |
$1,085.76 |
$1,357.20 |
0.7× |
| Venography Renal Bilateral (75833) |
$5,307.68 |
$6,634.60 |
1.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$4,662.64 |
$5,828.30 |
1.4× |
| Wrist 2 views (73100) |
$205.04 |
$256.30 |
2.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$549.84 |
$687.30 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$307.76 |
$384.70 |
3.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$746.40 |
$933 |
4.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$107 |
$133.75 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$114.08 |
$142.60 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$236.32 |
$295.40 |
2.2× |
| X-ray exam of femur 2/> (73552) |
$119.78 |
$149.73 |
1.3× |
| X-ray eye for foreign body (70030) |
$135.28 |
$169.10 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$223.92 |
$279.90 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$174.88 |
$218.60 |
1.9× |
| X-ray leg, infant (73592) |
$200.80 |
$251 |
2.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$306.68 |
$383.35 |
2.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$582.96 |
$728.70 |
5.4× |
| X-ray nose-rectum child f.b. (76010) |
$167.68 |
$209.60 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$318.68 |
$398.35 |
3.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$413.48 |
$516.85 |
3.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$451.16 |
$563.95 |
4.2× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$221.60 |
$277 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$280.36 |
$350.45 |
3.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$479.60 |
$599.50 |
5.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$485.76 |
$607.20 |
4.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$323.28 |
$404.10 |
3.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$164.96 |
$206.20 |
1.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$265.76 |
$332.20 |
3.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$269.92 |
$337.40 |
3.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$317.08 |
$396.35 |
2.9× |
| Xr bone length studies (77073) |
$190.80 |
$238.50 |
1.8× |
| Xr c-spine 4 or 5 views (72050) |
$482 |
$602.50 |
4.5× |
| Xr c-spine 6 or more views (72052) |
$625.12 |
$781.40 |
5.8× |
| Xr chest 4+ views (71048) |
$242.66 |
$303.32 |
2.2× |
| Xr urogram antegrade (74425) |
$686.64 |
$858.30 |
1.9× |