| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,672.59 |
$11,981 |
3.4× |
| Abdomen 2 views (74019) |
$164.58 |
$422 |
1.6× |
| Acute gastrointestinal blood loss imaging (78278) |
$860.34 |
$2,206 |
2.1× |
| Acute venous thrombus image (78456) |
$492.57 |
$1,263 |
0.4× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,600.91 |
$6,669 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,554.50 |
$6,550 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$1,971.06 |
$5,054 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$2,137.59 |
$5,481 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$2,944.11 |
$7,549 |
0.5× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,392.61 |
$8,699 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,921.88 |
$7,492 |
0.9× |
| Angiography Spinal Selective Rs&I (75705) |
$2,944.11 |
$7,549 |
0.5× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$2,944.11 |
$7,549 |
0.5× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$2,542.41 |
$6,519 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,138.37 |
$5,483 |
0.7× |
| Ankle 2 views (73600) |
$111.54 |
$286 |
1.3× |
| Antegrade urography radiological supvj & interpj (74425) |
$489.45 |
$1,255 |
1.4× |
| Aortogram thoracic (75605) |
$2,944.11 |
$7,549 |
0.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,637.18 |
$6,762 |
0.8× |
| Aortography abdominal serialography rs&i (75625) |
$2,496 |
$6,400 |
0.8× |
| Aortography thoracic w/o serialography rs&i (75600) |
$2,142.66 |
$5,494 |
0.7× |
| Artery X-Rays Adrenal Gland (75731) |
$2,464.41 |
$6,319 |
0.8× |
| Arthrogram elbow (73085) |
$261.88 |
$671.50 |
0.7× |
| Arthrogram hip (73525) |
$371.28 |
$952 |
1.1× |
| Arthrogram shoulder (73040) |
$327.40 |
$839.50 |
0.9× |
| Arthrogram wrist (73115) |
$203.38 |
$521.50 |
0.6× |
| Arthrography knee lt (73580) |
$220.35 |
$565 |
0.6× |
| Basic radiation dosimetry calculation (77300) |
$397.02 |
$1,018 |
2.9× |
| Bone &/Joint Imaging Limited Area (78300) |
$453.76 |
$1,163.50 |
1.1× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$542.49 |
$1,391 |
1.3× |
| Bone &/joint imaging whole body (78306) |
$631.41 |
$1,619 |
1.6× |
| Bone age studies (77072) |
$121.88 |
$312.50 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$637.26 |
$1,634 |
1.6× |
| Bone Marrow Imaging Limited Area (78102) |
$591.63 |
$1,517 |
1.5× |
| Bone survey complete (77075) |
$424.12 |
$1,087.50 |
4.0× |
| Brachytx isodose complex (77318) |
$1,884.87 |
$4,833 |
5.0× |
| Brachytx isodose intermed (77317) |
$829.14 |
$2,126 |
2.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$1,324.83 |
$3,397 |
3.5× |
| Brain image w/flow 4 + views (78606) |
$1,186.77 |
$3,043 |
2.2× |
| Brain imaging < 4 static views (78600) |
$262.08 |
$672 |
0.7× |
| Brain imaging < 4 static views w vascular flow (78601) |
$714.87 |
$1,833 |
1.8× |
| Brain Imaging Minimum 4 Static Views (78605) |
$1,061.19 |
$2,721 |
1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,087.08 |
$5,351.50 |
1.5× |
| Brain Imaging Vascular Flow Only (78610) |
$187.20 |
$480 |
0.3× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$257.01 |
$659 |
23.2× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$497.25 |
$1,275 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,011.86 |
$2,594.50 |
2.9× |
| Cardiac shunt detection (78428) |
$696.15 |
$1,785 |
1.7× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$333.84 |
$856 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$175.70 |
$450.50 |
2.0× |
| Chest 1 view (71045) |
$139.04 |
$356.50 |
1.6× |
| Chest 3 views (71047) |
$171.02 |
$438.50 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$733.20 |
$1,880 |
4.2× |
| Cineradiography/videoradiography (76120) |
$136.50 |
$350 |
1.3× |
| Cisternography Positive Contrast Rs&I (70015) |
$390.78 |
$1,002 |
0.5× |
| Clavicle complete (73000) |
$133.58 |
$342.50 |
1.5× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$35,608.36 |
$91,303.50 |
4.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$292.50 |
$750 |
2.8× |
| Continuing medical physics consltj pr wk (77336) |
$489.84 |
$1,256 |
3.6× |
| Corpora cavernosography (74445) |
$171.99 |
$441 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,749.74 |
$4,486.50 |
5.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,192.62 |
$3,058 |
5.0× |
| CT abdomen w contrast (74160) |
$910.06 |
$2,333.50 |
5.2× |
| CT abdomen w wo contrast (74170) |
$1,066.26 |
$2,734 |
6.0× |
| CT abdomen w/o contrast (74150) |
$733 |
$1,879.50 |
7.0× |
| CT angio hrt w/3d image (75574) |
$823.68 |
$2,112 |
2.3× |
| CT angiography upper extremity lt (73206) |
$778.05 |
$1,995 |
4.4× |
| CT c-spine w/o contrast (72125) |
$852.74 |
$2,186.50 |
8.1× |
| CT cervical spine w&w/o contrast (72127) |
$986.12 |
$2,528.50 |
5.6× |
| CT cervical spine with contrast (72126) |
$911.04 |
$2,336 |
2.6× |
| CT chest w/wo contrast (71270) |
$1,080.88 |
$2,771.50 |
6.1× |
| CT chest with contrast (71260) |
$849.42 |
$2,178 |
4.8× |
| CT head/brain with contrast (70460) |
$862.10 |
$2,210.50 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,062.56 |
$2,724.50 |
6.0× |
| CT heart contrast eval cardiac structure&morph (75572) |
$1,159.66 |
$2,973.50 |
3.3× |
| CT heart no contrast quant eval coronry calcium (75571) |
$253.30 |
$649.50 |
2.9× |
| CT hrt w/3d image congen (75573) |
$972.46 |
$2,493.50 |
2.8× |
| CT iac w contrast (70481) |
$843.96 |
$2,164 |
4.8× |
| CT limited/localized follow up study (76380) |
$469.56 |
$1,204 |
5.4× |
| CT lower ext w/o (73700) |
$637.26 |
$1,634 |
6.1× |
| CT lower extremity w wo contrast (73702) |
$831.48 |
$2,132 |
4.7× |
| CT lower extremity with contrast (73701) |
$702.98 |
$1,802.50 |
4.0× |
| CT lumbar spine w & w/o contrast (72133) |
$1,100.97 |
$2,823 |
6.2× |
| CT lumbar spine w/o contrast (72131) |
$858.98 |
$2,202.50 |
8.2× |
| CT lumbar spine with contrast (72132) |
$920.79 |
$2,361 |
2.6× |
| CT maxillofacial w contrast (70487) |
$804.76 |
$2,063.50 |
4.6× |
| CT maxillofacial w/o contrast (70486) |
$713.31 |
$1,829 |
6.8× |
| CT maxillofacial w/wo contrast (70488) |
$927.22 |
$2,377.50 |
5.3× |
| CT neck soft tissue w contrast (70491) |
$906.94 |
$2,325.50 |
5.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$965.25 |
$2,475 |
5.5× |
| CT orbits w/o contrast (70480) |
$746.26 |
$1,913.50 |
7.1× |
| CT pelvis w & w/o contrast (72194) |
$1,057.88 |
$2,712.50 |
6.0× |
| CT pelvis w/o contrast (72192) |
$708.82 |
$1,817.50 |
6.7× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,101.75 |
$2,825 |
6.2× |
| CT soft tissue neck w/o contrast (70490) |
$780.20 |
$2,000.50 |
7.4× |
| CT thoracic spine w/contrast (72129) |
$942.44 |
$2,416.50 |
5.3× |
| CT thoracic spine w/o contrast (72128) |
$842.20 |
$2,159.50 |
8.0× |
| CT thoracic spine w/wo contrast (72130) |
$1,138.60 |
$2,919.50 |
6.4× |
| CT thorax w/o contrast (71250) |
$823.88 |
$2,112.50 |
7.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$812.96 |
$2,084.50 |
4.6× |
| CT upper extremity w/o contrast rt (73200) |
$628.68 |
$1,612 |
6.0× |
| CT upper extremity with contrast (73201) |
$702.39 |
$1,801 |
2.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,905.34 |
$4,885.50 |
10.8× |
| Cta Abdomen (74175) |
$1,112.86 |
$2,853.50 |
6.3× |
| CTA abdomen pelvis (74174) |
$1,568.19 |
$4,021 |
4.5× |
| CTA chest (71275) |
$761.67 |
$1,953 |
4.3× |
| Cta Head (70496) |
$1,155.96 |
$2,964 |
6.5× |
| CTA lwr ext w&w/o contrast (73706) |
$967.98 |
$2,482 |
5.5× |
| Cta Neck (70498) |
$972.46 |
$2,493.50 |
5.5× |
| Cta Pelvis (72191) |
$975.39 |
$2,501 |
5.5× |
| Cystography minimum 3 views rs&i (74430) |
$210.21 |
$539 |
0.6× |
| Dacryocystography (70170) |
$572.91 |
$1,469 |
2.4× |
| Diskogram cervical (72285) |
$1,921.92 |
$4,928 |
1.0× |
| Diskography lumbar (72295) |
$667.29 |
$1,711 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$297.57 |
$763 |
2.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$175.50 |
$450 |
1.7× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$257.01 |
$659 |
2.4× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$251.94 |
$646 |
2.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$233.22 |
$598 |
2.2× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$195.58 |
$501.50 |
2.2× |
| Dxa bone density study axial skeleton (77085) |
$295.42 |
$757.50 |
2.8× |
| Echo exam of eye (76529) |
$107.64 |
$276 |
1.2× |
| Echo exam of fetal heart (76825) |
$175.50 |
$450 |
0.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$216.64 |
$555.50 |
0.9× |
| Echoencephalography real time imaging (76506) |
$395.26 |
$1,013.50 |
3.8× |
| Esophageal motility (78258) |
$517.92 |
$1,328 |
1.3× |
| Esophagus (74220) |
$277.88 |
$712.50 |
1.6× |
| Fetal biophysical profile non-stress testing (76818) |
$311.42 |
$798.50 |
3.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$301.47 |
$773 |
2.9× |
| Fluoroscopy up to 1 hr (76000) |
$401.12 |
$1,028.50 |
1.7× |
| Foot 2 views (73620) |
$105.50 |
$270.50 |
1.2× |
| Forearm 2 views (73090) |
$132.02 |
$338.50 |
1.5× |
| Functional MRI brain by phys/psych (70555) |
$414.18 |
$1,062 |
1.7× |
| Functional MRI brain by tech (70554) |
$953.36 |
$2,444.50 |
4.0× |
| Gastric mucosa imaging (78261) |
$497.25 |
$1,275 |
1.2× |
| Gated Heart Planar Single (78472) |
$1,006.20 |
$2,580 |
2.5× |
| Hand 2 views (73120) |
$131.62 |
$337.50 |
1.3× |
| Hand 3 views (73130) |
$144.88 |
$371.50 |
1.7× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,781.83 |
$9,697 |
5.4× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,046.25 |
$10,375 |
5.8× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,184.70 |
$10,730 |
6.0× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,264.34 |
$5,806 |
5.8× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$1,545.18 |
$3,962 |
4.0× |
| Heart infarct image w ef (78468) |
$714.87 |
$1,833 |
1.3× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,405.91 |
$6,169 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$627.12 |
$1,608 |
1.1× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$627.12 |
$1,608 |
1.6× |
| Ht muscle image spect sing (78451) |
$2,603.25 |
$6,675 |
2.0× |
| Humerus Min 2 Views Left (73060) |
$130.26 |
$334 |
1.5× |
| Hysterosalpingogram (74740) |
$242.58 |
$622 |
1.0× |
| Interstitial radiation source applic complex (77778) |
$3,117.46 |
$7,993.50 |
4.4× |
| Intracavitary Radiation Source Applic Complex (77763) |
$1,815.45 |
$4,655 |
2.6× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,338.48 |
$3,432 |
2.4× |
| Intracavitary radiation source applic simple (77761) |
$1,338.48 |
$3,432 |
2.4× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$11,887.20 |
$30,480 |
1.6× |
| Io rad tx deliver by elctrns (77425) |
$9,332.31 |
$23,929 |
1.3× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$187.20 |
$480 |
1.8× |
| Kidney imaging morphology (78700) |
$553.80 |
$1,420 |
1.4× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$824.46 |
$2,114 |
1.5× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$870.48 |
$2,232 |
1.6× |
| Knee 3 views (73562) |
$147.62 |
$378.50 |
1.7× |
| Liver & spleen imaging static only (78215) |
$406.96 |
$1,043.50 |
1.0× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$451.42 |
$1,157.50 |
1.1× |
| Liver imaging static only (78201) |
$453.96 |
$1,164 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$904.41 |
$2,319 |
1.7× |
| Lung perf&ventilat diferentl (78598) |
$640.38 |
$1,642 |
1.2× |
| Lung perfusion differential (78597) |
$1,503.06 |
$3,854 |
3.7× |
| Lung Ventilation Imaging (78579) |
$1,333.80 |
$3,420 |
3.3× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$1,775.28 |
$4,552 |
0.6× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$687.96 |
$1,764 |
1.1× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$1,229.28 |
$3,152 |
0.8× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$2,542.41 |
$6,519 |
0.8× |
| Lymphoscintigraphy (78195) |
$920.79 |
$2,361 |
1.7× |
| Mammary ductogram or galactogram multiple (77054) |
$504.27 |
$1,293 |
2.1× |
| Mammary ductogram or galactogram single (77053) |
$450.06 |
$1,154 |
1.9× |
| Meckels Diverticulum (78290) |
$745.29 |
$1,911 |
1.9× |
| Mlc imrt design & construction per imrt plan (77338) |
$4,659.72 |
$11,948 |
12.4× |
| Mr elastography (76391) |
$684.06 |
$1,754 |
2.8× |
| MRA head w & w/o contrast (70546) |
$1,166.88 |
$2,992 |
3.3× |
| MRA head w/o contrast (70544) |
$924.30 |
$2,370 |
3.8× |
| MRA head with contrast (70545) |
$1,045.59 |
$2,681 |
3.0× |
| MRA neck w contrast (70548) |
$1,739.40 |
$4,460 |
5.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,159.86 |
$2,974 |
3.3× |
| MRA neck w/o contrast (70547) |
$897 |
$2,300 |
3.7× |
| MRI abdomen w contrast (74182) |
$1,248.20 |
$3,200.50 |
3.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,349.20 |
$3,459.50 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$1,043.25 |
$2,675 |
4.3× |
| MRI any jnt lwr ext with con lt (73722) |
$1,160.06 |
$2,974.50 |
1.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,081.28 |
$2,772.50 |
1.4× |
| MRI bone marrow blood supply (77084) |
$333.06 |
$854 |
1.4× |
| MRI breast w/o contrast bilateral (77047) |
$1,121.06 |
$2,874.50 |
4.7× |
| MRI breast w/o contrast unilat (77046) |
$856.64 |
$2,196.50 |
3.6× |
| MRI c-spine with contrast (72142) |
$1,126.32 |
$2,888 |
3.2× |
| MRI cardiac w/o cont stress (75559) |
$1,474.98 |
$3,782 |
2.7× |
| MRI cardiac w/o contrast (75557) |
$841.23 |
$2,157 |
3.5× |
| MRI cervical spine w/o contrast (72141) |
$981.63 |
$2,517 |
4.1× |
| MRI chest w/o & w/contrast material (71552) |
$1,274.32 |
$3,267.50 |
3.6× |
| MRI chest w/o contrast (71550) |
$1,006.59 |
$2,581 |
4.2× |
| MRI fetal sngl/1st gestation (74712) |
$132.21 |
$339 |
0.6× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,162.20 |
$2,980 |
3.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,079.32 |
$2,767.50 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$959.60 |
$2,460.50 |
4.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$992.74 |
$2,545.50 |
4.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,301.62 |
$3,337.50 |
3.7× |
| MRI orbit/face/neck w/contrast (70542) |
$1,275.69 |
$3,271 |
3.6× |
| MRI pelvis w contrast (72196) |
$1,136.66 |
$2,914.50 |
3.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,255.02 |
$3,218 |
3.6× |
| MRI pelvis w/o contrast (72195) |
$1,006.59 |
$2,581 |
4.2× |
| MRI scan of arm joint before and after contrast (73223) |
$1,240.40 |
$3,180.50 |
3.5× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$1,927.38 |
$4,942 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$1,245.86 |
$3,194.50 |
3.5× |
| MRI spectroscopy (76390) |
$871.26 |
$2,234 |
9.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,400.88 |
$3,592 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,232.40 |
$3,160 |
3.5× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,394.64 |
$3,576 |
4.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,210.56 |
$3,104 |
3.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,424.28 |
$3,652 |
4.1× |
| MRI thoracic spine w/o contrast (72146) |
$982.60 |
$2,519.50 |
4.1× |
| MRI tmj (70336) |
$739.44 |
$1,896 |
3.1× |
| MRI upper ext joint w/o contrast (73221) |
$875.94 |
$2,246 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,267.30 |
$3,249.50 |
3.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$972.27 |
$2,493 |
4.0× |
| Myelogram Cervical (72240) |
$1,103.70 |
$2,830 |
1.4× |
| Myelogram Lumbar (72265) |
$1,103.70 |
$2,830 |
1.4× |
| Myelogram thoracic (72255) |
$1,103.70 |
$2,830 |
1.4× |
| Myelography 2 or more regions (72270) |
$883.35 |
$2,265 |
1.1× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,460.12 |
$6,308 |
1.9× |
| Myocardial infarct spect (78469) |
$834.21 |
$2,139 |
1.5× |
| Myocardial Spect Multiple Studies (78452) |
$2,962.05 |
$7,595 |
2.3× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,135.64 |
$5,476 |
1.5× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$2,543.19 |
$6,521 |
1.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$1,740.18 |
$4,462 |
2.0× |
| Neck soft tissue (70360) |
$113.68 |
$291.50 |
1.3× |
| Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) |
$1,240.98 |
$3,182 |
3.2× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$281.19 |
$721 |
0.7× |
| Nm adrenal scan (78075) |
$710.19 |
$1,821 |
0.5× |
| Nm bone marrow multiple (78103) |
$610.74 |
$1,566 |
1.5× |
| Nm bone marrow wb (78104) |
$641.94 |
$1,646 |
1.6× |
| Nm cisternogram (78630) |
$450.84 |
$1,156 |
0.8× |
| Nm csf leak detection (78650) |
$238.68 |
$612 |
0.2× |
| Nm gastric emptying study (78264) |
$579.15 |
$1,485 |
1.4× |
| Nm gastroesophageal reflux study (78262) |
$452.79 |
$1,161 |
1.1× |
| Nm peritoneal-venous shunt patency (78291) |
$580.71 |
$1,489 |
1.4× |
| Nm red cell sequestration (78140) |
$1,057.68 |
$2,712 |
2.6× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,087.94 |
$13,046 |
3.7× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,629.03 |
$4,177 |
1.1× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$3,563.04 |
$9,136 |
2.7× |
| Nuclear medicine of heart pumping function (78473) |
$1,157.91 |
$2,969 |
2.9× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,464.84 |
$3,756 |
1.0× |
| Nuclear medicine study of endocrine organs (78099) |
$346.71 |
$889 |
0.9× |
| Nuclear medicine study of kidney and blood flow (78701) |
$755.43 |
$1,937 |
1.9× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$498.03 |
$1,277 |
1.2× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$989.82 |
$2,538 |
2.5× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$458.25 |
$1,175 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$370.89 |
$951 |
0.7× |
| Nuclear Rx Oral Admin (79005) |
$702.39 |
$1,801 |
3.0× |
| Nuclr Rx Interstit Colloid (79300) |
$372.06 |
$954 |
1.6× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$323.70 |
$830 |
3.1× |
| Ophthalmic biometry us echograpy a-scan (76516) |
$105.30 |
$270 |
1.0× |
| Orthopantogram (70355) |
$136.70 |
$350.50 |
1.6× |
| Osseous survey infant (77076) |
$303.03 |
$777 |
2.9× |
| Osseous survey limited (77074) |
$152.10 |
$390 |
1.4× |
| Parathyrd planar w/spect&CT (78072) |
$622.83 |
$1,597 |
1.1× |
| Parathyrd planar w/wo subtrj (78071) |
$587.14 |
$1,505.50 |
1.5× |
| Parathyroid imaging (78070) |
$450.45 |
$1,155 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$133.96 |
$343.50 |
1.3× |
| Peritoneogram rs&i (74190) |
$223.47 |
$573 |
0.4× |
| PET image w/CT, skull-thigh (78815) |
$2,234.50 |
$5,729.50 |
1.6× |
| PET imaging CT for attenuation limited area (78814) |
$2,117.90 |
$5,430.50 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,234.50 |
$5,729.50 |
1.6× |
| Plasma Vol Radiopharm Vol Dilute Spx Mult Smples (78111) |
$1,877.46 |
$4,814 |
1.4× |
| Plasma volume, radiopharmaceutical volume-dilution technique (separate procedure); single sampling Age Under 21 (78110) |
$1,877.46 |
$4,814 |
1.4× |
| Platelet survival study (78191) |
$545.61 |
$1,399 |
1.4× |
| Pr csf ventriculography (78635) |
$714.87 |
$1,833 |
1.3× |
| Pr heart first pass single,planar (78481) |
$645.06 |
$1,654 |
1.2× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,254.82 |
$3,217.50 |
3.6× |
| Pr red cell survival study (78130) |
$545.61 |
$1,399 |
1.4× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$2,358.33 |
$6,047 |
0.7× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,015.91 |
$5,169 |
0.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$650.52 |
$1,668 |
1.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,503.06 |
$3,854 |
2.8× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$414.96 |
$1,064 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$159.90 |
$410 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$194.02 |
$497.50 |
1.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$148.20 |
$380 |
1.4× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$162.44 |
$416.50 |
1.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$322.14 |
$826 |
3.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$18,301.53 |
$46,927 |
2.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$652.08 |
$1,672 |
1.2× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$278.85 |
$715 |
2.7× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$378.69 |
$971 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$205.14 |
$526 |
1.9× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$155.22 |
$398 |
1.8× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$177.45 |
$455 |
1.7× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$159.70 |
$409.50 |
1.8× |
| Radiologic exam colon single contrast study (74270) |
$434.85 |
$1,115 |
2.5× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$434.85 |
$1,115 |
2.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$419.06 |
$1,074.50 |
2.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$295.23 |
$757 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$107.25 |
$275 |
1.2× |
| Radiological examination surgical specimen (76098) |
$457.47 |
$1,173 |
0.8× |
| Radiopharm Dacryocystography (78660) |
$470.34 |
$1,206 |
1.2× |
| Radiopharmaceutical therapy, by intracavitary administration Age Under 21 (79200) |
$372.06 |
$954 |
1.6× |
| Radiopharmaceutical therapy, unlisted procedure UNSCHEDULED (79999) |
$515.58 |
$1,322 |
2.2× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$545.61 |
$1,399 |
1.4× |
| Red Cell Volume Determination Spx Mult Samplings (78121) |
$657.93 |
$1,687 |
1.2× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,775.28 |
$4,552 |
0.6× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$2,442.57 |
$6,263 |
0.8× |
| Ribs bilateral 3 views (71110) |
$178.62 |
$458 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$877.50 |
$2,250 |
2.2× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$975 |
$2,500 |
1.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,209 |
$3,100 |
2.2× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$853.12 |
$2,187.50 |
0.7× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$872.62 |
$2,237.50 |
0.6× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$711.75 |
$1,825 |
0.5× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$928.98 |
$2,382 |
4.0× |
| Rp therapy intra-arterial particulate admn (79445) |
$644.67 |
$1,653 |
2.7× |
| Rp Therapy Intravenous Administration (79101) |
$892.71 |
$2,289 |
3.8× |
| Sacroiliac Joints < 3 Views (72200) |
$169.65 |
$435 |
1.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$448.50 |
$1,150 |
1.9× |
| Salivary gland function study (78232) |
$719.16 |
$1,844 |
1.8× |
| Salivary gland imaging (78230) |
$585 |
$1,500 |
1.5× |
| Salivary gland imaging serial images (78231) |
$585 |
$1,500 |
1.5× |
| Scanogram (77073) |
$132.99 |
$341 |
1.3× |
| Scapula complete (73010) |
$132.02 |
$338.50 |
1.3× |
| Screening digital breast tomosynthesis (77063) |
$43.10 |
$110.50 |
1.8× |
| Sella turcica (70240) |
$123.44 |
$316.50 |
1.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$400.92 |
$1,028 |
3.8× |
| Sialogram (70390) |
$270.08 |
$692.50 |
1.1× |
| Simulation intermediate (77285) |
$845.91 |
$2,169 |
2.2× |
| Small bowel series (74250) |
$328.58 |
$842.50 |
1.9× |
| Spec medical radj physics consltj (77370) |
$477.75 |
$1,225 |
3.5× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$696.93 |
$1,787 |
1.8× |
| Special dosimetry (77331) |
$353.34 |
$906 |
2.6× |
| Special treatment procedure (77470) |
$1,515.93 |
$3,887 |
2.7× |
| Speech evaluation complex (70371) |
$598.26 |
$1,534 |
2.5× |
| Spine thoracic 3 views (72072) |
$205.14 |
$526 |
1.9× |
| Spleen imaging only (78185) |
$662.02 |
$1,697.50 |
1.6× |
| Splenoportograpy rs&i (75810) |
$2,643.81 |
$6,779 |
0.8× |
| Stereotactic body radiation delivery (77373) |
$14,589.12 |
$37,408 |
8.1× |
| Superior sagittal sinus venogram (75870) |
$2,440.62 |
$6,258 |
0.8× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$251.55 |
$645 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,526.85 |
$3,915 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$1,368.51 |
$3,509 |
3.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$267.34 |
$685.50 |
1.1× |
| Testicular Imaging With Vascular Flow (78761) |
$296.40 |
$760 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,021.41 |
$2,619 |
2.7× |
| Ther rad simulaj-aided field setting simple (77280) |
$522.99 |
$1,341 |
3.9× |
| Therapeutic Enema (74283) |
$1,127.10 |
$2,890 |
6.4× |
| Thoracolumbar 2 views (72080) |
$164.78 |
$422.50 |
1.9× |
| Thyroid carcinoma metastases img addl study (78016) |
$607.23 |
$1,557 |
1.5× |
| Thyroid carcinoma metastases img whole body (78018) |
$1,024.14 |
$2,626 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$320 |
$820.50 |
0.8× |
| Thyroid uptake measurement (78012) |
$325.84 |
$835.50 |
0.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$394.10 |
$1,010.50 |
1.0× |
| Tmj unilateral (70328) |
$132.99 |
$341 |
1.5× |
| Tomogram (76100) |
$618.93 |
$1,587 |
5.9× |
| Treatment device intermediate (77333) |
$413.40 |
$1,060 |
3.1× |
| Treatment devices simple (77332) |
$400.92 |
$1,028 |
3.0× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,170 |
$3,000 |
2.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$780 |
$2,000 |
1.9× |
| Tx devices design & construction complex (77334) |
$776.49 |
$1,991 |
2.1× |
| Ultrasound elastography first target lesion (76982) |
$116.80 |
$299.50 |
1.1× |
| Ultrasound scan of cornea to determine thickness (76514) |
$32.37 |
$83 |
1.1× |
| Ultrasound scan to determine eye length and lens power (76519) |
$161.46 |
$414 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$490.62 |
$1,258 |
4.7× |
| Umbilical-artery Doppler (OB) (76820) |
$280.41 |
$719 |
2.7× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$146.25 |
$375 |
1.7× |
| Unlisted fluoroscopic procedure (76496) |
$139.23 |
$357 |
1.6× |
| Unlisted magnetic resonance procedure (76498) |
$759.52 |
$1,947.50 |
8.7× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$239.85 |
$615 |
0.6× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$1,866.93 |
$4,787 |
18.2× |
| Unlisted respiratory procedure, diagnostic nuclear medicine UNSCHEDULED (78599) |
$545.61 |
$1,399 |
1.4× |
| Unlisted Ultrasound Procedure (76999) |
$291.33 |
$747 |
3.3× |
| Upper Extremity Infant (73092) |
$137.08 |
$351.50 |
1.3× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$694.20 |
$1,780 |
1.7× |
| Urethrocystography retrograde rs&i (74450) |
$253.50 |
$650 |
1.1× |
| Urethrocystography voiding (74455) |
$277.10 |
$710.50 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$277.68 |
$712 |
1.6× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$480.87 |
$1,233 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$182.91 |
$469 |
1.7× |
| Us breast unilateral complete (76641) |
$217.42 |
$557.50 |
2.1× |
| Us breast unilateral limited (76642) |
$217.42 |
$557.50 |
2.5× |
| Us chest (76604) |
$237.70 |
$609.50 |
2.3× |
| Us compl joint r-t w/image documentation (76881) |
$326.82 |
$838 |
3.1× |
| Us elastography parenchyma (76981) |
$116.80 |
$299.50 |
1.1× |
| Us fetal nuchal translucency 1st gestation (76813) |
$148.98 |
$382 |
1.4× |
| Us guided compression repair (76936) |
$1,147.38 |
$2,942 |
5.3× |
| Us infant hips dynamic (76885) |
$326.82 |
$838 |
3.7× |
| Us infant hips limited static (76886) |
$326.82 |
$838 |
3.7× |
| Us kidney transplant (76776) |
$202.41 |
$519 |
1.9× |
| Us ob detailed single fetus (76811) |
$539.37 |
$1,383 |
2.2× |
| Us ob transvaginal (76817) |
$190.12 |
$487.50 |
1.8× |
| Us pelvic non ob complete (76856) |
$356.07 |
$913 |
3.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$233.80 |
$599.50 |
2.2× |
| Us pregnancy ltd (76815) |
$148.98 |
$382 |
1.4× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$318.44 |
$816.50 |
3.0× |
| Us retroperitoneal complete (76770) |
$358.02 |
$918 |
3.4× |
| Us retroperitoneal limited (76775) |
$193.83 |
$497 |
1.8× |
| Us scrotum and contents (76870) |
$325.46 |
$834.50 |
3.1× |
| Us soft tissue head/neck (76536) |
$326.82 |
$838 |
3.1× |
| Us spinal canal and contents (76800) |
$311.02 |
$797.50 |
3.0× |
| Us transrectal (76872) |
$346.52 |
$888.50 |
3.3× |
| Us transrectal prostate volume (76873) |
$262.86 |
$674 |
2.5× |
| Us xtr non-vasc lmtd (76882) |
$234.20 |
$600.50 |
2.2× |
| Us, eye b-scan (76512) |
$145.08 |
$372 |
1.4× |
| Vascular flow imaging (78445) |
$384.15 |
$985 |
1.0× |
| Vasogram (74440) |
$205.14 |
$526 |
0.9× |
| Venogram extremity bilateral (75822) |
$604.70 |
$1,550.50 |
0.4× |
| Venogram orbital (75880) |
$1,438.32 |
$3,688 |
2.3× |
| Venography caval inferior serialography rs&i (75825) |
$1,994.85 |
$5,115 |
0.6× |
| Venography caval superior serialography rs&i (75827) |
$2,159.43 |
$5,537 |
1.4× |
| Venography extremity unilateral rs&i (75820) |
$717.02 |
$1,838.50 |
0.5× |
| Venography Renal Bilateral (75833) |
$2,623.14 |
$6,726 |
0.8× |
| Venography renal unilateral selective rs&i (75831) |
$2,006.94 |
$5,146 |
0.6× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,971.06 |
$5,054 |
0.6× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$2,944.11 |
$7,549 |
0.5× |
| Vertebral fracture assessment via dxa (77086) |
$104.13 |
$267 |
1.2× |
| Wrist 2 views (73100) |
$111.54 |
$286 |
1.3× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$186.62 |
$478.50 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$148.40 |
$380.50 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$143.32 |
$367.50 |
1.6× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$501.34 |
$1,285.50 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$109.20 |
$280 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$143.32 |
$367.50 |
1.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$244.14 |
$626 |
2.3× |
| X-ray exam hip uni 1 view (73501) |
$96.72 |
$248 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$107.25 |
$275 |
1.2× |
| X-ray exam hip uni 4/> views (73503) |
$148.20 |
$380 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$165.16 |
$423.50 |
1.6× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$165.16 |
$423.50 |
1.6× |
| X-ray exam of femur 1 (73551) |
$96.72 |
$248 |
1.1× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$759.72 |
$1,948 |
4.3× |
| X-ray eye for foreign body (70030) |
$131.82 |
$338 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$202.02 |
$518 |
1.9× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$142.94 |
$366.50 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$143.32 |
$367.50 |
1.6× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$821.73 |
$2,107 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$127.72 |
$327.50 |
1.5× |
| X-ray IV pyelogram+drip infusn (74410) |
$349.64 |
$896.50 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$119.54 |
$306.50 |
1.4× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$149.18 |
$382.50 |
1.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$126.16 |
$323.50 |
1.4× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$140.98 |
$361.50 |
1.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$183.50 |
$470.50 |
1.7× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$269.49 |
$691 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$183.88 |
$471.50 |
1.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$142.94 |
$366.50 |
1.6× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$142.54 |
$365.50 |
1.6× |
| X-ray of voice box or throat (70370) |
$113.10 |
$290 |
1.3× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$187.20 |
$480 |
1.8× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$144.88 |
$371.50 |
1.4× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$257.40 |
$660 |
0.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$633.36 |
$1,624 |
1.8× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$154.64 |
$396.50 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$176.28 |
$452 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$183.50 |
$470.50 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$151.12 |
$387.50 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$156.20 |
$400.50 |
1.8× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$151.12 |
$387.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$200.46 |
$514 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$121.88 |
$312.50 |
1.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$218.79 |
$561 |
2.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$151.12 |
$387.50 |
1.4× |
| X-Ray Spine One View - Xr Spine (72020) |
$103.74 |
$266 |
1.2× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$253.50 |
$650 |
2.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$167.31 |
$429 |
1.9× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$174.92 |
$448.50 |
1.7× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$219.96 |
$564 |
2.1× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$67.66 |
$173.50 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$130.26 |
$334 |
1.5× |
| Xr arthrogram ankle (73615) |
$213.52 |
$547.50 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$258.57 |
$663 |
2.5× |
| Xr chest 4+ views (71048) |
$205.53 |
$527 |
2.0× |
| Xr Cholecystography Oral Contrast (74290) |
$350.22 |
$898 |
2.0× |
| Xr finger(s) 2+ views (73140) |
$103.74 |
$266 |
1.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$63.38 |
$162.50 |
0.6× |
| Xr myelogram posterior fossa (70010) |
$735.93 |
$1,887 |
2.1× |
| Xr optic foramina (70190) |
$134.55 |
$345 |
1.5× |
| Xr shoulder 1 view (73020) |
$113.49 |
$291 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$232.24 |
$595.50 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$132.02 |
$338.50 |
1.5× |
| Xr tmj bilateral (70330) |
$148.40 |
$380.50 |
1.7× |
| Xray knee 1 or 2 views rt (73560) |
$99.45 |
$255 |
1.1× |