Imaging prices at West Jefferson Medical Center

Marrero, LA · every code in this section with a posted price and a Medicare benchmark.

493 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) $1,850.40 $11,565 1.4×
Abdomen 2 views (74019) $169.44 $1,059 1.7×
Acute gastrointestinal blood loss imaging (78278) $544.32 $3,402 1.5×
Angiography Adrenal Bilateral Slctv Rs&I (75733) $2,518.08 $15,738 0.8×
Angiography extremity bilateral rs&i (75716) $1,955.84 $12,224 0.7×
Angiography extremity unilateral rs&i (75710) $1,476.48 $9,228 0.5×
Angiography internal mammary rs&i (75756) $1,539.68 $9,623 0.5×
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure
$1,766.40 $11,040 0.3×
Angiography pulmonary bilateral slctv rs&i (75743) $1,420.48 $8,878 0.5×
Angiography pulmonary unilateral slctv rs&i (75741) $1,169.12 $7,307 0.4×
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure
$1,823.68 $11,398 0.3×
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure
$1,825.44 $11,409 0.3×
Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) $1,693.76 $10,586 0.6×
Angrph pulmonary nonslctv cath/ven njx rs&i (75746) $1,539.68 $9,623 0.5×
Ankle 2 views (73600) $110.56 $691 1.4×
Antegrade urography radiological supvj & interpj (74425) $220.48 $1,378 0.7×
Aortogram thoracic (75605)
likely a partial charge, not the full procedure
$1,328.64 $8,304 0.3×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $1,961.44 $12,259 0.7×
Aortography abdominal serialography rs&i (75625) $1,764.32 $11,027 0.6×
Aortography thoracic w/o serialography rs&i (75600) $2,518.08 $15,738 0.8×
Artery X-Rays Adrenal Gland (75731) $824.32 $5,152 0.3×
Arthrogram elbow (73085) $203.52 $1,272 0.6×
Arthrogram hip (73525) $191.68 $1,198 0.6×
Arthrogram shoulder (73040) $195.04 $1,219 0.6×
Arthrogram wrist (73115) $195.04 $1,219 0.6×
Arthrography knee lt (73580) $196.48 $1,228 0.6×
Basic radiation dosimetry calculation (77300) $80.96 $506 0.6×
Bone &/Joint Imaging Limited Area (78300) $335.20 $2,095 0.9×
Bone &/Joint Imaging Multiple Areas (78305) $294.72 $1,842 0.8×
Bone &/joint imaging whole body (78306) $607.20 $3,795 1.6×
Bone age studies (77072) $105.28 $658 1.1×
Bone Imaging 3 Phase (78315) $799.68 $4,998 2.1×
Bone Marrow Imaging Limited Area (78102) $463.68 $2,898 1.2×
Bone survey complete (77075) $279.52 $1,747 2.8×
Brachytx isodose complex (77318) $276 $1,725 0.8×
Brachytx isodose intermed (77317) $363.20 $2,270 1.0×
Brachytx isodose pln smpl w/dosimetry cal (77316) $173.92 $1,087 0.5×
Brain image w/flow 4 + views (78606) $317.60 $1,985 0.6×
Brain imaging < 4 static views (78600) $299.68 $1,873 0.8×
Brain imaging < 4 static views w vascular flow (78601) $194.88 $1,218 0.5×
Brain Imaging Minimum 4 Static Views (78605) $299.68 $1,873 0.6×
Brain Imaging Pet Metabolic Evaluation (78608) $2,160.96 $13,506 1.6×
Brain Imaging Vascular Flow Only (78610) $268.96 $1,681 0.5×
Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) $350.88 $2,193 0.9×
Cardiac MRI w/w/o contrast & further seq (75561) $758.56 $4,741 2.3×
Cardiac shunt detection (78428) $350.88 $2,193 0.9×
Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) $427.04 $2,669 0.8×
Cervical spine 2 or 3 views (72040) $100.80 $630 1.2×
Chest 1 view (71045) $91.84 $574 1.1×
Chest 3 views (71047) $107.04 $669 1.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $239.68 $1,498 1.5×
Cineradiography/videoradiography (76120) $63.68 $398 0.6×
Cisternography Positive Contrast Rs&I (70015) $389.12 $2,432 0.5×
Clavicle complete (73000) $88.80 $555 1.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $48.16 $301 0.5×
Continuing medical physics consltj pr wk (77336) $185.76 $1,161 1.5×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $211.20 $1,320 1.3×
Corpora cavernosography (74445) $122.88 $768 1.3×
CT abdomen and pelvis without and with contrast (74178) $738.56 $4,616 2.3×
CT abdomen and pelvis without contrast (74176) $710.56 $4,441 3.2×
CT abdomen w contrast (74160) $797.44 $4,984 4.8×
CT abdomen w wo contrast (74170) $929.76 $5,811 5.6×
CT abdomen w/o contrast (74150) $792 $4,950 8.1×
CT angio hrt w/3d image (75574) $905.12 $5,657 2.8×
CT angiography upper extremity lt (73206) $526.40 $3,290 3.2×
CT c-spine w/o contrast (72125) $624.64 $3,904 6.4×
CT cervical spine w&w/o contrast (72127) $903.68 $5,648 5.5×
CT cervical spine with contrast (72126) $777.76 $4,861 2.4×
CT chest w/wo contrast (71270) $1,029.12 $6,432 6.3×
CT chest with contrast (71260) $916.48 $5,728 5.6×
CT colonography screening (74263) $625.92 $3,912 2.8×
CT colonography w/dye (74262) $301.92 $1,887 1.8×
CT colonography w/o cntrst (74261) $475.68 $2,973 4.8×
CT head/brain with contrast (70460) $705.92 $4,412 4.3×
CT head/brain without and with contrast (70470) $776.96 $4,856 4.7×
CT heart contrast eval cardiac structure&morph (75572) $409.76 $2,561 1.3×
CT heart no contrast quant eval coronry calcium (75571) $310.56 $1,941 3.8×
CT hrt w/3d image congen (75573) $486.56 $3,041 1.5×
CT iac w contrast (70481) $513.92 $3,212 3.1×
CT limited/localized follow up study (76380) $288.64 $1,804 3.5×
CT lower ext w/o (73700) $570.56 $3,566 5.8×
CT lower extremity w wo contrast (73702) $780.32 $4,877 4.7×
CT lower extremity with contrast (73701) $717.28 $4,483 4.4×
CT lumbar spine w & w/o contrast (72133) $913.44 $5,709 5.5×
CT lumbar spine w/o contrast (72131) $671.36 $4,196 6.8×
CT lumbar spine with contrast (72132) $908 $5,675 2.8×
CT maxillofacial w contrast (70487) $443.04 $2,769 2.7×
CT maxillofacial w/o contrast (70486) $500 $3,125 5.1×
CT maxillofacial w/wo contrast (70488) $827.68 $5,173 5.0×
CT neck soft tissue w contrast (70491) $593.44 $3,709 3.6×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $543.52 $3,397 3.3×
CT orbits w/o contrast (70480) $484.48 $3,028 4.9×
CT pelvis w & w/o contrast (72194) $880.48 $5,503 5.3×
CT pelvis w/o contrast (72192) $530.56 $3,316 5.4×
CT soft tissue neck w/o & w/contrast material (70492) $857.92 $5,362 5.2×
CT soft tissue neck w/o contrast (70490) $614.56 $3,841 6.3×
CT thoracic spine w/contrast (72129) $764.80 $4,780 4.6×
CT thoracic spine w/o contrast (72128) $683.04 $4,269 7.0×
CT thoracic spine w/wo contrast (72130) $547.52 $3,422 3.3×
CT thorax w/o contrast (71250) $667.36 $4,171 6.8×
CT unlisted procedure (76497) $122.08 $763 1.5×
CT upper extremity w/o & w/contrast material (73202) $816.96 $5,106 5.0×
CT upper extremity w/o contrast rt (73200) $416.32 $2,602 4.2×
CT upper extremity with contrast (73201) $518.56 $3,241 1.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $957.12 $5,982 5.8×
Cta Abdomen (74175) $902.24 $5,639 5.5×
CTA abdomen pelvis (74174) $1,166.88 $7,293 3.6×
CTA chest (71275) $811.04 $5,069 4.9×
Cta Head (70496) $849.12 $5,307 5.2×
CTA lwr ext w&w/o contrast (73706) $573.60 $3,585 3.5×
Cta Neck (70498) $569.92 $3,562 3.5×
Cta Pelvis (72191) $772.64 $4,829 4.7×
Cystography minimum 3 views rs&i (74430) $176.96 $1,106 0.5×
Dacryocystography (70170) $171.20 $1,070 0.8×
Diskogram cervical (72285) $871.20 $5,445 0.5×
Diskography lumbar (72295) $545.12 $3,407 0.3×
Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) $50.24 $314 0.5×
Doppler Echo Fetal Spectral Display Complete (76827) $235.36 $1,471 2.4×
Doppler Fetal Mid Cerebral Artery (76821) $191.68 $1,198 2.0×
Dx ophthalmic us ant segment immersion uni/bi (76513) $122.24 $764 1.2×
Dxa bone density study 1/> sites axial skel (77080) $207.20 $1,295 2.1×
Dxa bone density study 1/>sites appendiclr skel (77081) $104.96 $656 1.3×
Dxa bone density study axial skeleton (77085) $109.92 $687 1.1×
Echo exam of fetal heart (76825) $338.40 $2,115 0.7×
Echo fetal cardiovasc w/wo m-mode repeat std (76826) $170.72 $1,067 0.8×
Echoencephalography real time imaging (76506) $154.24 $964 1.6×
Esophageal motility (78258) $392.80 $2,455 1.0×
Esophagus (74220) $178.08 $1,113 1.1×
Fetal biophysical profile non-stress testing (76818) $171.84 $1,074 1.8×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $203.04 $1,269 2.1×
Fluoroscopy up to 1 hr (76000) $173.92 $1,087 0.8×
Foot 2 views (73620) $106.08 $663 1.3×
Forearm 2 views (73090) $104.16 $651 1.3×
Functional MRI brain by tech (70554) $383.84 $2,399 1.7×
Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) $223.20 $1,395 0.4×
Gastric mucosa imaging (78261) $292.32 $1,827 0.8×
Gastrointestinal Protein Loss (78282) $291.52 $1,822 0.8×
Gated Heart Planar Single (78472) $490.24 $3,064 1.3×
Hand 2 views (73120) $77.92 $487 0.8×
Hand 3 views (73130) $83.04 $519 1.0×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $641.44 $4,009 1.0×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $641.44 $4,009 1.0×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $641.44 $4,009 1.0×
Heart Infarct Image (78466) $350.88 $2,193 0.9×
Heart infarct image w ef (78468) $187.68 $1,173 0.4×
Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) $824.64 $5,154 0.3×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $282.56 $1,766 0.6×
Hepatobiliary syst imaging including gallbladder (78226) $583.36 $3,646 1.6×
Ht muscle image spect sing (78451) $731.04 $4,569 0.6×
Humerus Min 2 Views Left (73060) $90.08 $563 1.1×
Hysterosalpingogram (74740) $260.96 $1,631 1.2×
Interstitial radiation source applic complex (77778) $1,413.60 $8,835 2.2×
Intracavitary Radiation Source Applic Complex (77763) $744.32 $4,652 1.1×
Intracavitary Radiation Source Applic Intermed (77762) $180.80 $1,130 0.3×
Intracavitary radiation source applic simple (77761) $629.28 $3,933 1.2×
Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) $52.48 $328 0.5×
Kidney funcj study non-img radioisotopic study (78725) $326.72 $2,042 0.9×
Kidney imaging morphology (78700) $255.84 $1,599 0.7×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $680.32 $4,252 1.3×
Kidney img morphology vascular flow 1 w/rx (78708) $516.96 $3,231 1.0×
Kidney Img Morphology Vascular Flow Multiple (78709) $432 $2,700 0.8×
Knee 3 views (73562) $93.92 $587 1.1×
Liver & spleen imaging static only (78215) $425.28 $2,658 1.1×
Liver & Spleen Imaging W/Vascular Flow (78216) $548.80 $3,430 1.5×
Liver imaging static only (78201) $591.36 $3,696 1.2×
Liver imaging w/vascular flow (78202) $596.16 $3,726 1.2×
Lung perf&ventilat diferentl (78598) $276.80 $1,730 0.5×
Lung perfusion differential (78597) $487.04 $3,044 1.3×
Lung Ventilation Imaging (78579) $376.64 $2,354 1.0×
Lymphangio extrem unilat - ir lymphangiogram extremity (75801) $365.28 $2,283 0.6×
Lymphangiography extremity only bilateral rs&i (75803) $756.64 $4,729 0.5×
Lymphoscintigraphy (78195) $458.24 $2,864 0.9×
Mammary ductogram or galactogram multiple (77054) $139.04 $869 0.6×
Mammary ductogram or galactogram single (77053) $160.64 $1,004 0.7×
Manual appl stress pfrmd phys/qhp joint films (77071) $52.48 $328 0.6×
Meckels Diverticulum (78290) $380.64 $2,379 1.0×
Mlc imrt design & construction per imrt plan (77338) $258.08 $1,613 0.7×
Mr elastography (76391) $540.96 $3,381 2.4×
Mr safety determination physician/other qhp (76016) $38.72 $242 0.5×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $26.08 $163 0.5×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $10.72 $67 0.4×
Mr safety implt electronics prepj supvj phys/qhp (76018) $40.32 $252 0.5×
Mr safety med physics xm customization plng&mntr (76017) $106.40 $665 0.5×
MRA head w & w/o contrast (70546) $1,182.56 $7,391 3.6×
MRA head w/o contrast (70544) $785.76 $4,911 3.5×
MRA head with contrast (70545) $944.96 $5,906 2.9×
MRA neck w contrast (70548) $947.04 $5,919 2.9×
Mra Neck W/O &W/Contrast Material (70549) $911.36 $5,696 2.8×
MRA neck w/o contrast (70547) $737.60 $4,610 3.3×
MRI abdomen w contrast (74182) $542.56 $3,391 1.7×
MRI abdomen w/o & w/contrast material (74183) $1,004.16 $6,276 3.1×
MRI abdomen w/o contrast (74181) $779.52 $4,872 3.5×
MRI any jnt lwr ext with con lt (73722) $848 $5,300 1.2×
MRI any jt upper extremity w/contrast matrl (73222) $1,080.48 $6,753 1.5×
MRI bone marrow blood supply (77084) $1,536.64 $9,604 6.9×
MRI breast w/o contrast bilateral (77047) $309.44 $1,934 1.4×
MRI breast w/o contrast unilat (77046) $1,234.56 $7,716 5.5×
MRI c-spine with contrast (72142) $1,033.92 $6,462 3.2×
MRI cardiac w/o contrast (75557) $713.92 $4,462 3.2×
MRI cervical spine w/o contrast (72141) $923.52 $5,772 4.1×
MRI chest w/o & w/contrast material (71552) $1,004.64 $6,279 3.1×
MRI chest w/o contrast (71550) $882.24 $5,514 3.9×
MRI chest with contrast (71551) $537.76 $3,361 0.7×
MRI fetal sngl/1st gestation (74712) $244.48 $1,528 1.1×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $852.80 $5,330 2.6×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $913.44 $5,709 2.8×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $889.28 $5,558 4.0×
MRI orbit face &/neck w/o contrast (70540) $875.04 $5,469 3.9×
MRI orbit/face/neck w&w/o cont (70543) $1,008.48 $6,303 3.1×
MRI orbit/face/neck w/contrast (70542) $670.72 $4,192 2.0×
MRI pelvis w contrast (72196) $547.36 $3,421 1.7×
MRI pelvis w/o & w/contrast material (72197) $1,028.96 $6,431 3.1×
MRI pelvis w/o contrast (72195) $875.52 $5,472 3.9×
MRI scan of arm joint before and after contrast (73223) $1,163.04 $7,269 3.6×
MRI scan of heart before and after contrast with stress imaging (75563) $623.52 $3,897 0.8×
MRI scan of leg joint before and after contrast (73723) $1,205.28 $7,533 3.7×
MRI spectroscopy (76390) $455.68 $2,848 5.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,196.64 $7,479 3.7×
MRI spinal canal lumbar w/contrast material (72149) $869.92 $5,437 2.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,223.84 $7,649 3.7×
MRI spinal canal thoracic w/contrast matrl (72147) $909.60 $5,685 2.8×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,178.72 $7,367 3.6×
MRI thoracic spine w/o contrast (72146) $767.52 $4,797 3.4×
MRI tmj (70336) $548.16 $3,426 2.4×
MRI upper ext joint w/o contrast (73221) $1,080.48 $6,753 4.8×
MRI upper extrem other than jt w/o & w/contras (73220) $1,068.64 $6,679 3.3×
MRI upper extremity oth than jt w/o contr matrl (73218) $852.48 $5,328 3.8×
Myelogram Cervical (72240) $328.48 $2,053 0.4×
Myelogram Lumbar (72265) $306.08 $1,913 0.4×
Myelogram thoracic (72255) $297.92 $1,862 0.4×
Myelography 2 or more regions (72270) $385.44 $2,409 0.5×
Myocardial Imaging Pet Metabolic Evaluation (78459) $1,448.32 $9,052 1.2×
Myocardial infarct spect (78469) $350.88 $2,193 0.7×
Myocardial Spect Multiple Studies (78452) $1,193.60 $7,460 1.0×
Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) $834.40 $5,215 0.6×
Neck soft tissue (70360) $65.60 $410 0.8×
Nfs/Instlj Radioelmnt Sln 3 Mo Follow-Up Care (77750) $169.28 $1,058 0.5×
Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) $109.28 $683 0.3×
Nm adrenal scan (78075) $506.88 $3,168 0.4×
Nm bone marrow multiple (78103) $317.76 $1,986 0.8×
Nm bone marrow wb (78104) $430.88 $2,693 1.1×
Nm cisternogram (78630) $286.24 $1,789 0.6×
Nm csf leak detection (78650) $451.68 $2,823 0.4×
Nm gastric emptying study (78264) $407.04 $2,544 1.1×
Nm gastroesophageal reflux study (78262) $471.36 $2,946 1.3×
Nm peritoneal-venous shunt patency (78291) $393.60 $2,460 1.0×
Nm red cell sequestration (78140) $494.40 $3,090 1.3×
Nm whole blood volume (78122) $494.40 $3,090 1.0×
Ntsty modul radthx pln dose-vol histos (77301) $1,823.84 $11,399 1.4×
Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) $1,198.40 $7,490 0.9×
Nuclear medicine of heart muscle at rest with stress (78454) $1,109.12 $6,932 0.9×
Nuclear medicine of heart pumping function (78473) $236.96 $1,481 0.6×
Nuclear medicine of heart pumping function by first pass technique (78483) $350.88 $2,193 0.7×
Nuclear medicine study from skull base to mid-thigh (78812) $1,484 $9,275 1.1×
Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) $1,198.40 $7,490 0.9×
Nuclear medicine study of heart muscle at rest with stress (78453) $771.20 $4,820 0.6×
Nuclear medicine study of kidney and blood flow (78701) $383.04 $2,394 1.0×
Nuclear medicine study of limited area for thyroid cancer (78015) $374.40 $2,340 1.0×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $235.84 $1,474 0.6×
Nuclear medicine study to assess blood clot in vein of side (78457) $174.56 $1,091 0.3×
Nuclear Rx Oral Admin (79005) $432 $2,700 2.0×
Nuclr Rx Interstit Colloid (79300) $201.60 $1,260 0.9×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $191.04 $1,194 1.9×
Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) $164.32 $1,027 1.3×
Ophthalmic biometry us echograpy a-scan (76516) $73.28 $458 0.7×
Ophthalmic us dx quantitative a-scan only (76511) $112.48 $703 1.1×
Orthopantogram (70355) $40.96 $256 0.5×
Osseous survey infant (77076) $51.84 $324 0.5×
Osseous survey limited (77074) $211.84 $1,324 2.2×
Parathyrd planar w/spect&CT (78072) $365.28 $2,283 0.7×
Parathyrd planar w/wo subtrj (78071) $366.56 $2,291 1.0×
Parathyroid imaging (78070) $448.96 $2,806 1.2×
Pelvis 1 or 2 views (72170) $106.24 $664 1.1×
Perineogram (74775) $237.76 $1,486 1.1×
Peritoneogram rs&i (74190) $289.92 $1,812 0.6×
PET image w/CT, skull-thigh (78815) $2,351.36 $14,696 1.8×
PET imaging CT for attenuation limited area (78814) $1,694.56 $10,591 1.3×
PET imaging for CT attenuation whole body (78816) $2,155.52 $13,472 1.6×
PET imaging limited area chest head/neck (78811) $1,379.20 $8,620 1.1×
PET whole body (78813) $1,484 $9,275 1.1×
Platelet survival study (78191) $223.20 $1,395 0.6×
Pr csf ventriculography (78635) $520 $3,250 1.0×
Pr heart first pass single,planar (78481) $350.88 $2,193 0.7×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,033.60 $6,460 3.2×
Pr non-imaging heart function (78414) $350.88 $2,193 0.7×
Pr red cell survival study (78130) $414.08 $2,588 1.1×
Pr sono bone density measure,peripheral (76977) $136.96 $856 1.4×
Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) $1,102.40 $6,890 0.4×
Prq transhepatc portograpy w/o hemodyn evl intrp (75887) $1,539.68 $9,623 0.5×
Pulmonary Perfusion Imaging Particulate (78580) $450.40 $2,815 1.2×
Pulmonary Ventilation & Perfusion Imaging (78582) $633.28 $3,958 1.2×
Radex abscess/fistula/sinus tract rs&i (76080) $175.68 $1,098 0.3×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $89.92 $562 1.1×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $105.44 $659 1.1×
Radex hips bilateral with pelvis 2 views (73521) $211.04 $1,319 2.2×
Radex mastoids compl minimum 3 views pr side (70130) $132 $825 1.3×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $140.80 $880 1.4×
Radiation Delivery Stereotactic Cranial Linear (77372) $8,283.20 $51,770 1.2×
Radiation treatment delivery 1 mev >= complex (77412) $277.76 $1,736 0.5×
Radiation treatment delivery 1 mev >= simple (77402) $114.24 $714 1.2×
Radiation tx delivery 1 mev >= intermediate (77407) $177.60 $1,110 0.5×
Radiolog exam mandible compl minimum 4 views (70110) $126.88 $793 1.3×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $84.80 $530 1.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $231.04 $1,444 2.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $103.20 $645 1.3×
Radiologic exam colon single contrast study (74270) $177.44 $1,109 1.1×
Radiologic Exam Esophagus Double Contrast Study (74221) $121.92 $762 0.7×
Radiologic exam upr gi trc double contrast study (74246) $236.96 $1,481 1.4×
Radiologic exam upr gi trc single contrast study (74240) $164.96 $1,031 1.0×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $92.96 $581 1.1×
Radiologic Examination Salivary Gland Calculus (70380) $61.60 $385 0.8×
Radiological examination surgical specimen (76098) $200.80 $1,255 0.4×
Radiopharm Dacryocystography (78660) $299.68 $1,873 0.8×
Radiopharmaceutical therapy, by intra-articular administration Age Under 21 (79440) $299.20 $1,870 1.4×
Red Cell Volume Determination Spx 1 Sampling (78120) $427.04 $2,669 1.1×
Red Cell Volume Determination Spx Mult Samplings (78121) $494.40 $3,090 1.0×
Review by radiologist of adrenal gland vein image (75840) $2,518.08 $15,738 0.8×
Review by radiologist of liver vein image with assessment of blood flow (75889) $1,227.68 $7,673 0.4×
Ribs bilateral 3 views (71110) $184.16 $1,151 1.9×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $528.64 $3,304 1.4×
Rp loclzj tum plnr whole body single day imaging (78802) $644.80 $4,030 1.3×
Rp loclzj tum spect 1 area single day imaging (78803) $527.52 $3,297 1.0×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $569.92 $3,562 0.5×
Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) $139.04 $869 0.6×
Rp therapy intra-arterial particulate admn (79445) $541.60 $3,385 2.5×
Rp Therapy Intravenous Administration (79101) $502.72 $3,142 2.3×
Sacroiliac Joints < 3 Views (72200) $57.76 $361 0.6×
Saline Infus Sonohysterography W/Color Doppler (76831) $289.28 $1,808 1.3×
Salivary gland function study (78232) $291.52 $1,822 0.8×
Salivary gland imaging (78230) $291.52 $1,822 0.8×
Salivary gland imaging serial images (78231) $257.28 $1,608 0.7×
Scanogram (77073) $194.32 $1,214.50 2.0×
Scapula complete (73010) $72.80 $455 0.7×
Screening digital breast tomosynthesis (77063) $30.08 $188 1.3×
Sella turcica (70240) $45.12 $282 0.6×
Shuntogram indwelling nonvascular shunt rs&i (75809) $220 $1,375 2.2×
Sialogram (70390) $119.84 $749 0.5×
Simulation intermediate (77285) $197.92 $1,237 0.6×
Small bowel series (74250) $246.88 $1,543 1.5×
Spec medical radj physics consltj (77370) $409.44 $2,559 3.2×
Spec telethx port pln parts hemibdy tot bdy (77321) $244.64 $1,529 0.7×
Special dosimetry (77331) $120.80 $755 1.0×
Special treatment procedure (77470) $599.68 $3,748 1.2×
Speech evaluation complex (70371) $129.76 $811 0.6×
Spine thoracic 3 views (72072) $170.08 $1,063 1.7×
Spleen imaging only (78185) $317.76 $1,986 0.8×
Splenoportograpy rs&i (75810) $820.32 $5,127 0.3×
Stereotactic body radiation delivery (77373) $5,190.40 $32,440 3.1×
Superior sagittal sinus venogram (75870) $893.60 $5,585 0.3×
Telethx isodose pln cplx w/basic dosimetry (77307) $425.28 $2,658 1.2×
Telethx isodose pln smpl w/dosimetry calculation (77306) $397.28 $2,483 1.1×
Temporomandble Jt Arthrography Rs&I (70332) $338.88 $2,118 1.5×
Testicular Imaging With Vascular Flow (78761) $248 $1,550 0.7×
Ther rad simulaj-aided field setting complex (77290) $568.16 $3,551 1.6×
Ther rad simulaj-aided field setting simple (77280) $267.52 $1,672 2.1×
Therapeutic Enema (74283) $116.48 $728 0.7×
Thoracolumbar 2 views (72080) $114.56 $716 1.4×
Thyroid carcinoma metastases img addl study (78016) $340.48 $2,128 0.9×
Thyroid carcinoma metastases img whole body (78018) $647.20 $4,045 1.3×
Thyroid Imaging With Vascular Flow (78013) $148.16 $926 0.4×
Thyroid uptake measurement (78012) $330.72 $2,067 0.9×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $372.80 $2,330 1.0×
Tmj unilateral (70328) $57.76 $361 0.7×
Tomogram (76100) $134.88 $843 1.4×
Treatment device intermediate (77333) $184.16 $1,151 1.5×
Treatment devices simple (77332) $145.60 $910 1.2×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $629.60 $3,935 1.2×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $350.40 $2,190 0.9×
Tx devices design & construction complex (77334) $525.60 $3,285 1.5×
Ultrasound elastography first target lesion (76982) $181.76 $1,136 1.9×
Ultrasound scan of cornea to determine thickness (76514) $32.16 $201 1.2×
Ultrasound scan to determine eye length and lens power (76519) $112.48 $703 1.1×
Ultrasound trgt dynamic microbubble 1st lesion (76978) $89.60 $560 0.3×
Ultrasound, abdomen limited (76705) $201.12 $1,257 2.0×
Umbilical-artery Doppler (OB) (76820) $170.56 $1,066 1.7×
Unlisted Diagnostic Radiographic Procedure (76499) $165.76 $1,036 2.0×
Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) $289.44 $1,809 0.8×
Unlisted Procedure Clinical Brachytherapy (77799) $500.96 $3,131 5.2×
Upper Extremity Infant (73092) $81.92 $512 0.8×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $235.52 $1,472 0.6×
Urethrocystography retrograde rs&i (74450) $206.40 $1,290 0.9×
Urethrocystography voiding (74455) $208.64 $1,304 0.9×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $370.24 $2,314 2.2×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $161.28 $1,008 1.0×
Us abdl aorta screen aaa (76706) $108.96 $681 1.1×
Us breast unilateral complete (76641) $168 $1,050 1.7×
Us breast unilateral limited (76642) $165.12 $1,032 2.0×
Us chest (76604) $132.80 $830 1.4×
Us compl joint r-t w/image documentation (76881) $202.88 $1,268 2.1×
Us elastography parenchyma (76981) $75.52 $472 0.8×
Us fetal nuchal translucency 1st gestation (76813) $202.88 $1,268 2.1×
Us guided compression repair (76936) $340.48 $2,128 1.7×
Us infant hips dynamic (76885) $192.32 $1,202 2.4×
Us infant hips limited static (76886) $82.56 $516 1.0×
Us kidney transplant (76776) $124.32 $777 1.3×
Us ob detailed single fetus (76811) $285.44 $1,784 1.3×
Us ob transvaginal (76817) $235.52 $1,472 2.4×
Us pelvic non ob complete (76856) $242.72 $1,517 2.5×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $219.68 $1,373 2.2×
Us pregnancy ltd (76815) $112.16 $701 1.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $245.76 $1,536 2.5×
Us retroperitoneal complete (76770) $184.16 $1,151 1.9×
Us retroperitoneal limited (76775) $241.60 $1,510 2.5×
Us scrotum and contents (76870) $213.12 $1,332 2.2×
Us soft tissue head/neck (76536) $212.32 $1,327 2.2×
Us spinal canal and contents (76800) $147.68 $923 1.5×
Us transrectal (76872) $250.40 $1,565 2.6×
Us transrectal prostate volume (76873) $135.04 $844 1.4×
Us xtr non-vasc lmtd (76882) $259.52 $1,622 2.6×
Us, eye b-scan (76512) $112.48 $703 1.1×
Use of body cavity probe generated heat to increase temperature of cancer cell (77620) $445.28 $2,783 0.9×
Use of externally generated heat to increase temperature of cancer cell, heating to depths more than 4.0 cm (77605) $445.28 $2,783 0.7×
Use of interstitial probe generated heat to increase temperature of cancer cell, more than 5 probes (77615) $445.28 $2,783 0.9×
Vascular flow imaging (78445) $184.48 $1,153 0.5×
Venogram extremity bilateral (75822) $686.88 $4,293 0.5×
Venogram orbital (75880) $812.32 $5,077 1.4×
Venography caval inferior serialography rs&i (75825) $1,389.60 $8,685 0.5×
Venography caval superior serialography rs&i (75827) $444.96 $2,781 0.3×
Venography epidural rs&i (75872) $812.32 $5,077 1.4×
Venography extremity unilateral rs&i (75820) $562.88 $3,518 0.4×
Venography Renal Bilateral (75833) $1,415.84 $8,849 0.5×
Venography renal unilateral selective rs&i (75831) $1,126.08 $7,038 0.4×
Venography venous sinus/jugular cath rs&i (75860) $1,693.76 $10,586 0.6×
Venous sampling thru cath w/wo angiography rs& (75893) $2,823.20 $17,645 0.5×
Wrist 2 views (73100) $78.88 $493 1.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $187.68 $1,173 1.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $59.68 $373 0.7×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $77.12 $482 0.9×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $227.36 $1,421 1.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $96.16 $601 1.2×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $96.96 $606 1.2×
X-ray exam entire spi 4/5 vw (72083) $206.24 $1,289 2.1×
X-ray exam hip uni 1 view (73501) $137.76 $861 1.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $104.16 $651 1.3×
X-ray exam hip uni 4/> views (73503) $116.64 $729 1.2×
X-Ray Exam Hips Bi 3-4 Views (73522) $211.04 $1,319 2.2×
X-Ray Exam Hips Bi 5/> Views (73523) $226.08 $1,413 2.3×
X-ray exam of femur 1 (73551) $154.88 $968 1.9×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $405.92 $2,537 2.5×
X-ray eye for foreign body (70030) $56.64 $354 0.7×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $117.76 $736 1.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $67.68 $423 0.8×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $106.40 $665 1.3×
X-ray guide gu dilation - ir nephrostomy dilation (74485) $736.48 $4,603 0.4×
X-ray head for orthodontia (70350) $52.48 $328 0.6×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $76.48 $478 0.9×
X-ray IV pyelogram+drip infusn (74410) $129.12 $807 0.8×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $97.76 $611 1.2×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $107.68 $673 1.1×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $89.60 $560 1.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $62.72 $392 0.8×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $103.68 $648 1.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $152.16 $951 1.6×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $87.36 $546 0.9×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $83.04 $519 1.0×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $92.48 $578 1.1×
X-ray of voice box or throat (70370) $94.24 $589 1.2×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $144.64 $904 1.5×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $144.32 $902 1.5×
X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) $289.92 $1,812 0.6×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $229.60 $1,435 0.7×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $132.64 $829 1.6×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $174.72 $1,092 1.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $262.08 $1,638 2.7×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $126.88 $793 1.3×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $90.08 $563 1.1×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $120.80 $755 1.5×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $159.36 $996 2.0×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $80.96 $506 1.0×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $134.56 $841 1.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $109.76 $686 1.1×
X-Ray Spine One View - Xr Spine (72020) $71.84 $449 0.9×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $54.88 $343 0.7×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $93.92 $587 1.1×
X-Ray Teeth Single - Xr Teeth 1 View (70300) $40.16 $251 0.5×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $114.56 $716 1.2×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $174.24 $1,089 1.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $90.40 $565 1.1×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $84.96 $531 1.0×
Xr arthrogram ankle (73615) $202.56 $1,266 0.6×
Xr c-spine 6 or more views (72052) $197.92 $1,237 2.0×
Xr chest 4+ views (71048) $99.20 $620 1.0×
Xr Cholecystography Oral Contrast (74290) $135.04 $844 0.8×
Xr finger(s) 2+ views (73140) $68.48 $428 0.8×
Xr internal auditory meati complete (70134) $164.80 $1,030 0.3×
XR Mastoids < 3 Views Bilateral (70120) $80.80 $505 0.8×
Xr myelogram posterior fossa (70010) $385.28 $2,408 1.2×
Xr optic foramina (70190) $67.20 $420 0.8×
Xr shoulder 1 view (73020) $120.48 $753 1.5×
Xr spine cervical 4 or 5 views (72050) $211.84 $1,324 2.2×
Xr tibia/fibula 2 views (73590) $93.12 $582 1.1×
Xr tmj bilateral (70330) $90.24 $564 1.1×
Xray knee 1 or 2 views rt (73560) $81.12 $507 1.0×