Imaging prices at Washington County Hospital and Nursing Home

Chatom, AL · every code in this section with a posted price and a Medicare benchmark.

552 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $54.17 — 0.0×
Abdomen 2 views (74019) $54.17 $343.38 0.6×
Acute gastrointestinal blood loss imaging (78278) $54.17 — 0.2×
Acute venous thrombus image (78456) $54.17 — 0.0×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $54.17 — 0.0×
Angiography extremity bilateral rs&i (75716) $54.17 — 0.0×
Angiography extremity unilateral rs&i (75710) $54.17 — 0.0×
Angiography internal mammary rs&i (75756) $54.17 — 0.0×
Angiography pelvic slctv/supraslctv rs&i (75736) $54.17 — 0.0×
Angiography pulmonary bilateral slctv rs&i (75743) $54.17 — 0.0×
Angiography pulmonary unilateral slctv rs&i (75741) $54.17 — 0.0×
Angiography Spinal Selective Rs&I (75705) $54.17 — 0.0×
Angiography visceral slctv/supraslctv rs&i (75726) $54.17 — 0.0×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $54.17 — 0.0×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $54.17 — 0.0×
Ankle 2 views (73600) $54.17 — 0.7×
Antegrade urography radiological supvj & interpj (74425) $54.17 — 0.2×
Aortogram thoracic (75605) $54.17 — 0.0×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $54.17 — 0.0×
Aortography abdominal serialography rs&i (75625) $54.17 — 0.0×
Aortography thoracic w/o serialography rs&i (75600) $54.17 — 0.0×
Artery X-Rays Adrenal Gland (75731) $54.17 — 0.0×
Arthrogram elbow (73085) $54.17 — 0.2×
Arthrogram hip (73525) $54.17 — 0.2×
Arthrogram shoulder (73040) $54.17 — 0.2×
Arthrogram wrist (73115) $54.17 — 0.2×
Arthrography knee lt (73580) $54.17 — 0.2×
Basic radiation dosimetry calculation (77300) $54.17 — 0.5×
Bone &/Joint Imaging Limited Area (78300) $54.17 — 0.2×
Bone &/Joint Imaging Multiple Areas (78305) $54.17 — 0.2×
Bone &/joint imaging whole body (78306) $54.17 — 0.2×
Bone age studies (77072) $54.17 $343.38 0.6×
Bone Imaging 3 Phase (78315) $54.17 — 0.2×
Bone Marrow Imaging Limited Area (78102) $54.17 — 0.2×
Bone survey complete (77075) $54.17 $480 0.6×
Brachytx isodose complex (77318) $54.17 — 0.2×
Brachytx isodose intermed (77317) $54.17 — 0.2×
Brachytx isodose pln smpl w/dosimetry cal (77316) $54.17 — 0.2×
Brain image w/flow 4 + views (78606) $54.17 — 0.1×
Brain imaging < 4 static views (78600) $54.17 — 0.2×
Brain imaging < 4 static views w vascular flow (78601) $54.17 — 0.2×
Brain Imaging Minimum 4 Static Views (78605) $54.17 — 0.1×
Brain Imaging Pet Metabolic Evaluation (78608) $54.17 — 0.0×
Brain Imaging Vascular Flow Only (78610) $54.17 — 0.1×
Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) $54.17 — 4.9×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $54.17 — 0.2×
Cardiac MRI w/w/o contrast & further seq (75561) $54.17 — 0.2×
Cardiac shunt detection (78428) $54.17 — 0.2×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $54.17 — 0.1×
Cervical spine 2 or 3 views (72040) $54.17 $186.36 0.7×
Chest 1 view (71045) $54.17 $186.36 0.7×
Chest 3 views (71047) $54.17 $186.36 0.7×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $54.17 — 0.4×
Cineradiography/videoradiography (76120) $54.17 — 0.6×
Cisternography Positive Contrast Rs&I (70015) $54.17 — 0.1×
Clavicle complete (73000) $54.17 — 0.7×
Complete single session course of cranial lesion surgery using radiation (77371)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $54.17 — 0.6×
Continuing medical physics consltj pr wk (77336) $54.17 — 0.5×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $54.17 — 0.4×
Corpora cavernosography (74445) $54.17 — 0.6×
CT abdomen and pelvis without and with contrast (74178) $54.17 $1,447.74 0.2×
CT abdomen and pelvis without contrast (74176) $54.17 $918.15 0.3×
CT abdomen w contrast (74160) $54.17 $891.45 0.4×
CT abdomen w wo contrast (74170) $54.17 $988.02 0.4×
CT abdomen w/o contrast (74150) $54.17 $520.74 0.6×
CT angio hrt w/3d image (75574) $54.17 — 0.2×
CT angiography upper extremity lt (73206) $54.17 — 0.4×
CT c-spine w/o contrast (72125) $54.17 $520.74 0.6×
CT cervical spine w&w/o contrast (72127) $54.17 $988.02 0.4×
CT cervical spine with contrast (72126) $54.17 $1,369.11 0.2×
CT chest w/wo contrast (71270) $54.17 $988.02 0.4×
CT chest with contrast (71260) $54.17 $891.45 0.4×
CT colonography screening (74263) $54.17 — 0.3×
CT colonography w/dye (74262) $54.17 — 0.4×
CT colonography w/o cntrst (74261) $54.17 — 0.6×
CT head/brain with contrast (70460) $54.17 $891.45 0.4×
CT head/brain without and with contrast (70470) $54.17 $988.02 0.4×
CT heart contrast eval cardiac structure&morph (75572) $54.17 — 0.2×
CT heart no contrast quant eval coronry calcium (75571) $54.17 — 0.7×
CT hrt w/3d image congen (75573) $54.17 — 0.2×
CT iac w contrast (70481) $54.17 — 0.4×
CT limited/localized follow up study (76380) $54.17 — 0.7×
CT lower ext w/o (73700) $54.17 $520.74 0.6×
CT lower extremity w wo contrast (73702) $54.17 $1,002 0.4×
CT lower extremity with contrast (73701) $54.17 $901 0.4×
CT lumbar spine w & w/o contrast (72133) $54.17 $809 0.4×
CT lumbar spine w/o contrast (72131) $54.17 $520.74 0.6×
CT lumbar spine with contrast (72132) $54.17 $1,369.11 0.2×
CT maxillofacial w contrast (70487) $54.17 $891.45 0.4×
CT maxillofacial w/o contrast (70486) $54.17 $520.74 0.6×
CT maxillofacial w/wo contrast (70488) $54.17 $988.02 0.4×
CT neck soft tissue w contrast (70491) $54.17 $891.45 0.4×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $54.17 — 0.4×
CT orbits w/o contrast (70480) $54.17 $520.74 0.6×
CT pelvis w & w/o contrast (72194) $54.17 $988.02 0.4×
CT pelvis w/o contrast (72192) $54.17 $520.74 0.6×
CT scan for measuring calcium and other minerals in bone (77078) $54.17 $307 0.7×
CT soft tissue neck w/o & w/contrast material (70492) $54.17 $988.02 0.4×
CT soft tissue neck w/o contrast (70490) $54.17 $520.74 0.6×
CT thoracic spine w/contrast (72129) $54.17 — 0.4×
CT thoracic spine w/o contrast (72128) $54.17 $520.74 0.6×
CT thoracic spine w/wo contrast (72130) $54.17 — 0.4×
CT thorax w/o contrast (71250) $54.17 $520.74 0.6×
CT unlisted procedure (76497) $54.17 — 0.7×
CT upper extremity w/o & w/contrast material (73202) $54.17 $809 0.4×
CT upper extremity w/o contrast rt (73200) $54.17 $520.74 0.6×
CT upper extremity with contrast (73201) $54.17 $758.22 0.2×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $54.17 — 0.4×
Cta Abdomen (74175) $54.17 — 0.4×
CTA abdomen pelvis (74174) $54.17 — 0.2×
CTA chest (71275) $54.17 — 0.4×
Cta Head (70496) $54.17 — 0.4×
CTA lwr ext w&w/o contrast (73706) $54.17 — 0.4×
Cta Neck (70498) $54.17 — 0.4×
Cta Pelvis (72191) $54.17 — 0.4×
Cystography minimum 3 views rs&i (74430) $54.17 — 0.2×
Dacryocystography (70170) $54.17 — 0.3×
Diskogram cervical (72285) $54.17 — 0.0×
Diskography lumbar (72295) $54.17 — 0.0×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $54.17 — 0.6×
Doppler Echo Fetal Spectral Display Complete (76827) $54.17 — 0.6×
Doppler Fetal Mid Cerebral Artery (76821) $54.17 — 0.6×
Dx ophthalmic us ant segment immersion uni/bi (76513) $54.17 — 0.6×
Dxa bone density study 1/> sites axial skel (77080) $54.17 $343.38 0.6×
Dxa bone density study 1/>sites appendiclr skel (77081) $54.17 $186.36 0.7×
Dxa bone density study axial skeleton (77085) $54.17 — 0.6×
Echo exam of eye (76529) $54.17 — 0.7×
Echo exam of fetal heart (76825) $54.17 — 0.1×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $54.17 — 0.3×
Echoencephalography real time imaging (76506) $54.17 — 0.6×
Esophageal motility (78258) $54.17 — 0.2×
Esophagus (74220) $54.17 — 0.4×
Fetal biophysical profile non-stress testing (76818) $54.17 — 0.6×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $54.17 $404 0.6×
Fluoroscopy up to 1 hr (76000) $54.17 — 0.3×
Foot 2 views (73620) $54.17 — 0.7×
Forearm 2 views (73090) $54.17 — 0.7×
Full Mouth X-Ray Of Teeth - Xr Teeth Full Mouth (70320) $54.17 — 0.3×
Functional MRI brain by phys/psych (70555) $54.17 — 0.3×
Functional MRI brain by tech (70554) $54.17 — 0.3×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $54.17 — 0.1×
Gastric mucosa imaging (78261) $54.17 — 0.2×
Gastrointestinal Protein Loss (78282) $54.17 — 0.2×
Gated Heart Planar Single (78472) $54.17 — 0.2×
Hand 2 views (73120) $54.17 — 0.6×
Hand 3 views (73130) $54.17 — 0.7×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $54.17 — 0.1×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $54.17 — 0.1×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $54.17 — 0.1×
Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) $54.17 — 0.2×
Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) $54.17 — 0.2×
Heart Infarct Image (78466) $54.17 — 0.2×
Heart infarct image w ef (78468) $54.17 — 0.1×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $54.17 — 0.0×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $54.17 — 0.1×
Hepatobiliary syst imaging including gallbladder (78226) $54.17 — 0.2×
High energy neutron radj tx dlvr 1/> isocenter (77423) $54.17 — 0.1×
Ht muscle image spect sing (78451) $54.17 — 0.0×
Humerus Min 2 Views Left (73060) $54.17 — 0.7×
Hyperthermia ntrstl prb 5/< (77610) $54.17 — 0.1×
Hysterosalpingogram (74740) $54.17 — 0.3×
Image fusion (77399) $54.17 — 0.5×
Interstitial radiation source applic complex (77778) $54.17 — 0.1×
Intracavitary Radiation Source Applic Complex (77763) $54.17 — 0.1×
Intracavitary Radiation Source Applic Intermed (77762) $54.17 — 0.1×
Intracavitary radiation source applic simple (77761) $54.17 — 0.1×
Intraop radiaj tx deliver xray single tx session (77424)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Io rad tx deliver by elctrns (77425)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $54.17 — 0.6×
Kidney funcj study non-img radioisotopic study (78725) $54.17 — 0.2×
Kidney imaging morphology (78700) $54.17 — 0.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $54.17 — 0.1×
Kidney img morphology vascular flow 1 w/rx (78708) $54.17 — 0.1×
Kidney Img Morphology Vascular Flow Multiple (78709) $54.17 — 0.1×
Knee 3 views (73562) $54.17 — 0.7×
Liver & spleen imaging static only (78215) $54.17 — 0.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $54.17 — 0.2×
Liver imaging static only (78201) $54.17 — 0.1×
Liver imaging w/vascular flow (78202) $54.17 — 0.1×
Lung perf&ventilat diferentl (78598) $54.17 — 0.1×
Lung perfusion differential (78597) $54.17 — 0.2×
Lung Ventilation Imaging (78579) $54.17 — 0.2×
Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) $54.17 — 0.0×
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $54.17 — 0.1×
Lymphangiography extremity only bilateral rs&i (75803) $54.17 — 0.0×
Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) $54.17 — 0.0×
Lymphoscintigraphy (78195) $54.17 — 0.1×
Mammary ductogram or galactogram multiple (77054) $54.17 — 0.3×
Mammary ductogram or galactogram single (77053) $54.17 — 0.3×
Manual appl stress pfrmd phys/qhp joint films (77071) $54.17 — 0.7×
Meckels Diverticulum (78290) $54.17 — 0.2×
Medical physics dose eval radiation expos w/rprt (76145) $54.17 — 0.2×
Mlc imrt design & construction per imrt plan (77338) $54.17 — 0.2×
Mr elastography (76391) $54.17 — 0.3×
Mr safety determination physician/other qhp (76016) $54.17 — 0.7×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $54.17 — 1.1×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $54.17 — 2.2×
Mr safety implt electronics prepj supvj phys/qhp (76018) $54.17 — 0.7×
Mr safety med physics xm customization plng&mntr (76017) $54.17 — 0.3×
MRA head w & w/o contrast (70546) $54.17 — 0.2×
MRA head w/o contrast (70544) $54.17 — 0.3×
MRA head with contrast (70545) $54.17 — 0.2×
MRA neck w contrast (70548) $54.17 — 0.2×
Mra Neck W/O &W/Contrast Material (70549) $54.17 — 0.2×
MRA neck w/o contrast (70547) $54.17 — 0.3×
MRI abdomen w contrast (74182) $54.17 — 0.2×
MRI abdomen w/o & w/contrast material (74183) $54.17 — 0.2×
MRI abdomen w/o contrast (74181) $54.17 — 0.3×
MRI any jnt lwr ext with con lt (73722) $54.17 — 0.1×
MRI any jt upper extremity w/contrast matrl (73222) $54.17 — 0.1×
MRI bone marrow blood supply (77084) $54.17 — 0.3×
MRI breast w/o contrast bilateral (77047) $54.17 — 0.3×
MRI breast w/o contrast unilat (77046) $54.17 — 0.3×
MRI c-spine with contrast (72142) $54.17 — 0.2×
MRI cardiac w/o cont stress (75559) $54.17 — 0.1×
MRI cardiac w/o contrast (75557) $54.17 — 0.3×
MRI cervical spine w/o contrast (72141) $54.17 — 0.3×
MRI chest w/o & w/contrast material (71552) $54.17 — 0.2×
MRI chest w/o contrast (71550) $54.17 — 0.3×
MRI chest with contrast (71551) $54.17 — 0.1×
MRI fetal sngl/1st gestation (74712) $54.17 — 0.3×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $54.17 — 0.2×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $54.17 — 0.2×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $54.17 — 0.3×
MRI orbit face &/neck w/o contrast (70540) $54.17 — 0.3×
MRI orbit/face/neck w&w/o cont (70543) $54.17 — 0.2×
MRI orbit/face/neck w/contrast (70542) $54.17 — 0.2×
MRI pelvis w contrast (72196) $54.17 — 0.2×
MRI pelvis w/o & w/contrast material (72197) $54.17 — 0.2×
MRI pelvis w/o contrast (72195) $54.17 — 0.3×
MRI scan of arm joint before and after contrast (73223) $54.17 — 0.2×
MRI scan of heart before and after contrast with stress imaging (75563) $54.17 — 0.1×
MRI scan of leg joint before and after contrast (73723) $54.17 — 0.2×
MRI spectroscopy (76390) $54.17 — 0.7×
MRI spinal canal cervical w/o & w/contr matrl (72156) $54.17 — 0.2×
MRI spinal canal lumbar w/contrast material (72149) $54.17 — 0.2×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $54.17 — 0.2×
MRI spinal canal thoracic w/contrast matrl (72147) $54.17 — 0.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $54.17 — 0.2×
MRI thoracic spine w/o contrast (72146) $54.17 — 0.3×
MRI tmj (70336) $54.17 — 0.3×
MRI upper ext joint w/o contrast (73221) $54.17 — 0.3×
MRI upper extrem other than jt w/o & w/contras (73220) $54.17 — 0.2×
MRI upper extremity oth than jt w/o contr matrl (73218) $54.17 — 0.3×
Myelogram Cervical (72240) $54.17 — 0.1×
Myelogram Lumbar (72265) $54.17 — 0.1×
Myelogram thoracic (72255) $54.17 — 0.1×
Myelography 2 or more regions (72270) $54.17 — 0.1×
Myocardial Imaging Pet Metabolic Evaluation (78459) $54.17 — 0.0×
Myocardial infarct spect (78469) $54.17 — 0.1×
Myocardial Spect Multiple Studies (78452) $54.17 — 0.0×
Myocrd img PET metab eval single study cncrnt CT (78429) $54.17 — 0.0×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $54.17 — 0.0×
Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) $54.17 — 0.0×
Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) $54.17 — 0.0×
Myocrd img PET prfuj w/metab dual radiotracer (78432) $54.17 — 0.0×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $54.17 — 0.1×
Neck soft tissue (70360) $54.17 $186.36 0.7×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $54.17 — 0.2×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $54.17 — 0.2×
Nm adrenal scan (78075) $54.17 — 0.0×
Nm bone marrow multiple (78103) $54.17 — 0.2×
Nm bone marrow wb (78104) $54.17 — 0.2×
Nm cisternogram (78630) $54.17 — 0.1×
Nm csf leak detection (78650) $54.17 — 0.0×
Nm gastric emptying study (78264) $54.17 — 0.2×
Nm gastroesophageal reflux study (78262) $54.17 — 0.2×
Nm peritoneal-venous shunt patency (78291) $54.17 — 0.2×
Nm red cell sequestration (78140) $54.17 — 0.2×
Nm whole blood volume (78122) $54.17 — 0.1×
Ntsty modul radthx pln dose-vol histos (77301) $54.17 — 0.0×
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $54.17 — 0.0×
Nuclear medicine of heart muscle at rest with stress (78454) $54.17 — 0.0×
Nuclear medicine of heart pumping function (78473) $54.17 — 0.2×
Nuclear medicine of heart pumping function by first pass technique (78483) $54.17 — 0.1×
Nuclear medicine study from skull base to mid-thigh (78812) $54.17 — 0.0×
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $54.17 — 0.0×
Nuclear medicine study of digestive tracts (78299) $54.17 — 0.2×
Nuclear medicine study of endocrine organs (78099) $54.17 — 0.2×
Nuclear medicine study of heart muscle at rest with stress (78453) $54.17 — 0.0×
Nuclear medicine study of kidney and blood flow (78701) $54.17 — 0.2×
Nuclear medicine study of limited area for thyroid cancer (78015) $54.17 — 0.2×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $54.17 — 0.2×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $54.17 — 0.2×
Nuclear medicine study to assess blood clot in vein of side (78457) $54.17 — 0.1×
Nuclear Rx Oral Admin (79005) $54.17 — 0.3×
Nuclr Rx Interstit Colloid (79300) $54.17 — 0.3×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $54.17 — 0.6×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $54.17 — 0.5×
Ophthalmic biometry us echograpy a-scan (76516) $54.17 — 0.6×
Ophthalmic us dx quantitative a-scan only (76511) $54.17 — 0.6×
Orthopantogram (70355) $54.17 — 0.7×
Osseous survey infant (77076) $54.17 — 0.6×
Osseous survey limited (77074) $54.17 — 0.6×
Parathyrd planar w/spect&CT (78072) $54.17 — 0.1×
Parathyrd planar w/wo subtrj (78071) $54.17 — 0.2×
Parathyroid imaging (78070) $54.17 — 0.2×
Pelvis 1 or 2 views (72170) $54.17 $343.38 0.6×
Perineogram (74775) $54.17 — 0.3×
Peritoneogram rs&i (74190) $54.17 — 0.1×
PET image w/CT, skull-thigh (78815) $54.17 — 0.0×
PET imaging CT for attenuation limited area (78814) $54.17 — 0.0×
PET imaging for CT attenuation whole body (78816) $54.17 — 0.0×
PET imaging limited area chest head/neck (78811) $54.17 — 0.0×
PET whole body (78813) $54.17 — 0.0×
Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) $54.17 — 0.0×
Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) $54.17 — 0.0×
Platelet survival study (78191) $54.17 — 0.2×
Pr csf ventriculography (78635) $54.17 — 0.1×
Pr gi endoscopic ultrasound (76975) $54.17 — 0.3×
Pr heart first pass single,planar (78481) $54.17 — 0.1×
Pr MRI brain w/ dye (70558) $54.17 — 0.4×
Pr MRI brain w/o & w/ dye (70559) $54.17 — 0.4×
Pr MRI brain w/o dye (70557) $54.17 — 0.1×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $54.17 — 0.2×
Pr non-imaging heart function (78414) $54.17 — 0.1×
Pr red cell survival study (78130) $54.17 — 0.2×
Pr sono bone density measure,peripheral (76977) $54.17 — 0.6×
Proton trmt simple w/comp (77522) $54.17 — 0.1×
Proton tx delivery complex (77525) $54.17 — 0.1×
Proton tx delivery intermediate (77523) $54.17 — 0.1×
Proton tx delivery simple w/o compensation (77520) $54.17 — 0.1×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $54.17 — 0.0×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $54.17 — 0.0×
Pulmonary Perfusion Imaging Particulate (78580) $54.17 — 0.2×
Pulmonary Ventilation & Perfusion Imaging (78582) $54.17 — 0.1×
Radex abscess/fistula/sinus tract rs&i (76080) $54.17 — 0.1×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $54.17 $221.07 0.7×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $54.17 — 0.6×
Radex hips bilateral with pelvis 2 views (73521) $54.17 — 0.6×
Radex mastoids compl minimum 3 views pr side (70130) $54.17 — 0.6×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $54.17 — 0.6×
Radiation Delivery Stereotactic Cranial Linear (77372)
likely a partial charge, not the full procedure		 $54.17 — 0.0×
Radiation treatment delivery 1 mev >= complex (77412) $54.17 — 0.1×
Radiation treatment delivery 1 mev >= simple (77402) $54.17 — 0.6×
Radiation tx delivery 1 mev >= intermediate (77407) $54.17 — 0.2×
Radiolog exam mandible compl minimum 4 views (70110) $54.17 $343.38 0.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $54.17 $186.36 0.7×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $54.17 — 0.6×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $54.17 $113.18 0.7×
Radiologic exam colon single contrast study (74270) $54.17 — 0.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $54.17 — 0.4×
Radiologic exam teeth prtl exam < full mouth (70310) $54.17 — 0.3×
Radiologic exam upr gi trc double contrast study (74246) $54.17 $758.22 0.4×
Radiologic exam upr gi trc single contrast study (74240) $54.17 $758.22 0.4×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $54.17 — 0.7×
Radiologic Examination Salivary Gland Calculus (70380) $54.17 — 0.7×
Radiological examination surgical specimen (76098) $54.17 — 0.1×
Radiopharm Dacryocystography (78660) $54.17 — 0.2×
Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) $54.17 — 0.3×
Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) $54.17 — 0.3×
Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) $54.17 — 0.3×
Red Cell Volume Determination Spx 1 Sampling (78120) $54.17 — 0.2×
Red Cell Volume Determination Spx Mult Samplings (78121) $54.17 — 0.1×
Review by radiologist of adrenal gland vein image (75840) $54.17 — 0.0×
Review by radiologist of liver vein image with assessment of blood flow (75889) $54.17 — 0.0×
Ribs bilateral 3 views (71110) $54.17 — 0.6×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $54.17 — 0.2×
Rp loclzj tum plnr whole body single day imaging (78802) $54.17 — 0.1×
Rp loclzj tum spect 1 area single day imaging (78803) $54.17 — 0.1×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $54.17 — 0.0×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $54.17 — 0.0×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $54.17 — 0.0×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $54.17 — 0.3×
Rp therapy intra-arterial particulate admn (79445) $54.17 — 0.3×
Rp Therapy Intravenous Administration (79101) $54.17 — 0.3×
Sacroiliac Joints < 3 Views (72200) $54.17 — 0.6×
Saline Infus Sonohysterography W/Color Doppler (76831) $54.17 — 0.3×
Salivary gland function study (78232) $54.17 — 0.2×
Salivary gland imaging (78230) $54.17 — 0.2×
Salivary gland imaging serial images (78231) $54.17 — 0.2×
Scanogram (77073) $54.17 — 0.6×
Scapula complete (73010) $54.17 — 0.6×
Screening digital breast tomosynthesis (77063) $54.17 — 2.3×
Sella turcica (70240) $54.17 — 0.7×
Shuntogram indwelling nonvascular shunt rs&i (75809) $54.17 — 0.6×
Sialogram (70390) $54.17 — 0.3×
Simulation intermediate (77285) $54.17 — 0.2×
Small bowel series (74250) $54.17 $343.38 0.4×
Spec medical radj physics consltj (77370) $54.17 — 0.5×
Spec telethx port pln parts hemibdy tot bdy (77321) $54.17 — 0.2×
Special dosimetry (77331) $54.17 — 0.5×
Special treatment procedure (77470) $54.17 — 0.1×
Speech evaluation complex (70371) $54.17 — 0.3×
Spine thoracic 3 views (72072) $54.17 $343.38 0.6×
Spleen imaging only (78185) $54.17 — 0.2×
Splenoportograpy rs&i (75810) $54.17 — 0.0×
Stereotactic body radiation delivery (77373) $54.17 — 0.0×
Superior sagittal sinus venogram (75870) $54.17 — 0.0×
Surface Applic Low Dose Rate Radionuclide Source (77789) $54.17 — 0.6×
Tbs Technical Calculation Only (77091) $54.17 — 0.7×
Telethx isodose pln cplx w/basic dosimetry (77307) $54.17 — 0.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $54.17 — 0.2×
Temporomandble Jt Arthrography Rs&I (70332) $54.17 — 0.3×
Testicular Imaging With Vascular Flow (78761) $54.17 — 0.2×
Ther rad simulaj-aided field setting complex (77290) $54.17 — 0.2×
Ther rad simulaj-aided field setting simple (77280) $54.17 — 0.5×
Therapeutic Enema (74283) $54.17 — 0.4×
Thoracolumbar 2 views (72080) $54.17 $186.36 0.7×
Thyroid carcinoma metastases img addl study (78016) $54.17 — 0.2×
Thyroid carcinoma metastases img whole body (78018) $54.17 — 0.1×
Thyroid Imaging With Vascular Flow (78013) $54.17 — 0.2×
Thyroid uptake measurement (78012) $54.17 — 0.2×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $54.17 — 0.2×
Tmj unilateral (70328) $54.17 $186.36 0.7×
Tomogram (76100) $54.17 — 0.6×
Trabecular bone score (TBS), structural condition of the bone microarchitecture; technical preparation and transmission… (77090) $54.17 — 0.7×
Treatment device intermediate (77333) $54.17 — 0.5×
Treatment devices simple (77332) $54.17 — 0.5×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $54.17 — 0.1×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $54.17 — 0.2×
Tx devices design & construction complex (77334) $54.17 — 0.2×
Ultrasound elastography first target lesion (76982) $54.17 $281.28 0.6×
Ultrasound scan of cornea to determine thickness (76514) $54.17 — 2.2×
Ultrasound scan to determine eye length and lens power (76519) $54.17 — 0.6×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $54.17 — 0.2×
Ultrasound, abdomen limited (76705) $54.17 $343.38 0.6×
Umbilical-artery Doppler (OB) (76820) $54.17 — 0.6×
Unlisted cardiovascular procedure, diagnostic nuclear medicine UNSCHEDULED (78499) $54.17 — 0.2×
Unlisted Diagnostic Radiographic Procedure (76499) $54.17 — 0.7×
Unlisted fluoroscopic procedure (76496) $54.17 — 0.7×
Unlisted genitourinary procedure, diagnostic nuclear medicine UNSCHEDULED (78799) $54.17 — 0.2×
Unlisted hematopoietic, reticuloendothelial and lymphatic procedure, diagnostic nuclear medicine UNSCHEDULED (78199) $54.17 — 0.2×
Unlisted magnetic resonance procedure (76498) $54.17 — 0.7×
Unlisted miscellaneous px dx nuclear medicine (78999) $54.17 — 0.2×
Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) $54.17 — 0.2×
Unlisted nervous system procedure, diagnostic nuclear medicine UNSCHEDULED (78699) $54.17 — 0.2×
Unlisted Procedure Clinical Brachytherapy (77799) $54.17 — 0.6×
Unlisted procedure, therapeutic radiology clinical treatment planning 2nd-5th Sessions (77299) $54.17 — 0.5×
Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) $54.17 — 0.2×
Unlisted Ultrasound Procedure (76999) $54.17 — 0.7×
Upper Extremity Infant (73092) $54.17 $343.38 0.6×
Urea breath test, C-14 (isotopic); analysis (78268) $54.17 — 0.6×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $54.17 — 0.2×
Urethrocystography retrograde rs&i (74450) $54.17 — 0.3×
Urethrocystography voiding (74455) $54.17 — 0.3×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $54.17 $758.22 0.4×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $54.17 — 0.4×
Us abdl aorta screen aaa (76706) $54.17 — 0.6×
Us breast unilateral complete (76641) $54.17 $290.07 0.6×
Us breast unilateral limited (76642) $54.17 — 0.7×
Us chest (76604) $54.17 — 0.6×
Us compl joint r-t w/image documentation (76881) $54.17 $343.38 0.6×
Us elastography parenchyma (76981) $54.17 $312.51 0.6×
Us fetal nuchal translucency 1st gestation (76813) $54.17 — 0.6×
Us guided compression repair (76936) $54.17 — 0.3×
Us infant hips dynamic (76885) $54.17 — 0.7×
Us infant hips limited static (76886) $54.17 — 0.7×
Us kidney transplant (76776) $54.17 $343.38 0.6×
Us nrv&acc strux 1 xtr compre w/img pr extremity (76883) $54.17 — 0.6×
Us ob detailed single fetus (76811) $54.17 — 0.3×
Us ob transvaginal (76817) $54.17 — 0.6×
Us pelvic non ob complete (76856) $54.17 $343.38 0.6×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $54.17 $343.38 0.6×
Us pregnancy ltd (76815) $54.17 $404 0.6×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $54.17 $404 0.6×
Us retroperitoneal complete (76770) $54.17 — 0.6×
Us retroperitoneal limited (76775) $54.17 $343.38 0.6×
Us scrotum and contents (76870) $54.17 $343.38 0.6×
Us soft tissue head/neck (76536) $54.17 $449.50 0.6×
Us spinal canal and contents (76800) $54.17 $685.68 0.6×
Us transrectal (76872) $54.17 — 0.6×
Us transrectal prostate volume (76873) $54.17 $464.22 0.6×
Us xtr non-vasc lmtd (76882) $54.17 — 0.6×
Us, eye b-scan (76512) $54.17 — 0.6×
Use of body cavity probe generated heat to increase temperature of cancer cell (77620) $54.17 — 0.1×
Use of externally generated heat to increase temperature of cancer cell, heating to depths 4.0 cm or less (77600) $54.17 — 0.2×
Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) $54.17 — 0.1×
Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) $54.17 — 0.1×
Vascular flow imaging (78445) $54.17 — 0.2×
Vasogram (74440) $54.17 — 0.3×
Venogram extremity bilateral (75822) $54.17 — 0.0×
Venogram orbital (75880) $54.17 — 0.1×
Venography caval inferior serialography rs&i (75825) $54.17 — 0.0×
Venography caval superior serialography rs&i (75827) $54.17 — 0.0×
Venography epidural rs&i (75872) $54.17 — 0.1×
Venography extremity unilateral rs&i (75820) $54.17 — 0.0×
Venography Renal Bilateral (75833) $54.17 — 0.0×
Venography renal unilateral selective rs&i (75831) $54.17 — 0.0×
Venography venous sinus/jugular cath rs&i (75860) $54.17 — 0.0×
Venous sampling thru cath w/wo angiography rs& (75893) $54.17 — 0.0×
Vertebral fracture assessment via dxa (77086) $54.17 — 0.7×
Wrist 2 views (73100) $54.17 — 0.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $54.17 $343.38 0.6×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $54.17 $186.36 0.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $54.17 — 0.7×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $54.17 — 0.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $54.17 — 0.7×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $54.17 — 0.7×
X-ray exam entire spi 4/5 vw (72083) $54.17 — 0.6×
X-ray exam hip uni 1 view (73501) $54.17 — 0.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $54.17 $186.36 0.7×
X-ray exam hip uni 4/> views (73503) $54.17 — 0.6×
X-Ray Exam Hips Bi 3-4 Views (73522) $54.17 $343.38 0.6×
X-Ray Exam Hips Bi 5/> Views (73523) $54.17 — 0.6×
X-ray exam of femur 1 (73551) $54.17 — 0.7×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $54.17 — 0.4×
X-ray eye for foreign body (70030) $54.17 $186.36 0.7×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $54.17 $343.38 0.6×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $54.17 $186.36 0.7×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $54.17 — 0.7×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $54.17 — 0.0×
X-ray head for orthodontia (70350) $54.17 — 0.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $54.17 — 0.7×
X-ray IV pyelogram+drip infusn (74410) $54.17 — 0.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $54.17 $186.36 0.7×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $54.17 — 0.6×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $54.17 $186.36 0.7×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $54.17 $186.36 0.7×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $54.17 $343.38 0.6×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $54.17 $343.38 0.6×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $54.17 — 0.6×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $54.17 $186.36 0.7×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $54.17 $186.36 0.7×
X-ray of voice box or throat (70370) $54.17 — 0.7×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $54.17 $212.52 0.6×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $54.17 — 0.6×
X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) $54.17 — 0.1×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $54.17 — 0.2×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $54.17 — 0.7×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $54.17 — 0.6×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $54.17 $343.38 0.6×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $54.17 $343.38 0.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $54.17 $343.38 0.7×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $54.17 — 0.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $54.17 $212.52 0.7×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $54.17 $186.36 0.7×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $54.17 $343.38 0.6×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $54.17 $343.38 0.6×
X-Ray Spine One View - Xr Spine (72020) $54.17 $186.36 0.7×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $54.17 $186.36 0.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $54.17 $186.36 0.7×
X-Ray Teeth Single - Xr Teeth 1 View (70300) $54.17 — 0.7×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $54.17 — 0.6×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $54.17 — 0.6×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $54.17 — 0.7×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $54.17 — 0.7×
Xr arthrogram ankle (73615) $54.17 — 0.2×
Xr c-spine 6 or more views (72052) $54.17 $343.38 0.6×
Xr chest 4+ views (71048) $54.17 $343.38 0.6×
Xr Cholecystography Oral Contrast (74290) $54.17 — 0.4×
Xr finger(s) 2+ views (73140) $54.17 — 0.7×
Xr internal auditory meati complete (70134) $54.17 — 0.1×
XR Mastoids < 3 Views Bilateral (70120) $54.17 — 0.6×
Xr myelogram posterior fossa (70010) $54.17 — 0.2×
Xr optic foramina (70190) $54.17 $186.36 0.7×
Xr shoulder 1 view (73020) $54.17 — 0.7×
Xr spine cervical 4 or 5 views (72050) $54.17 — 0.6×
Xr tibia/fibula 2 views (73590) $54.17 — 0.7×
Xr tmj bilateral (70330) $54.17 $186.36 0.7×
Xray knee 1 or 2 views rt (73560) $54.17 — 0.7×