| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,856.40 |
$6,188 |
1.5× |
| Abdomen 2 views (74019) |
$173.10 |
$577 |
1.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$336.30 |
$1,121 |
0.9× |
| Angiography extremity bilateral rs&i (75716) |
$2,085.60 |
$6,952 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$1,750.50 |
$5,835 |
0.6× |
| Angiography internal mammary rs&i (75756) |
$1,069.80 |
$3,566 |
0.4× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,879.50 |
$6,265 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$2,151.60 |
$7,172 |
0.8× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$1,378.80 |
$4,596 |
0.5× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$2,506.80 |
$8,356 |
0.5× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$958.80 |
$3,196 |
0.3× |
| Ankle 2 views (73600) |
$204.75 |
$682.50 |
2.6× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,869.60 |
$6,232 |
0.4× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,922.40 |
$6,408 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$1,137.60 |
$3,792 |
0.4× |
| Arthrogram hip (73525) |
$270.60 |
$902 |
0.9× |
| Arthrogram shoulder (73040) |
$284.70 |
$949 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$374.40 |
$1,248 |
3.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$530.10 |
$1,767 |
1.5× |
| Bone &/joint imaging whole body (78306) |
$806.70 |
$2,689 |
2.2× |
| Bone age studies (77072) |
$138.30 |
$461 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$849.90 |
$2,833 |
2.3× |
| Bone Marrow Imaging Limited Area (78102) |
$400.50 |
$1,335 |
1.1× |
| Bone survey complete (77075) |
$128.40 |
$428 |
1.4× |
| Brachytx isodose intermed (77317) |
$418.20 |
$1,394 |
1.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$389.10 |
$1,297 |
1.1× |
| Brain imaging < 4 static views w vascular flow (78601) |
$315.30 |
$1,051 |
0.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,209.60 |
$4,032 |
0.9× |
| Brain Imaging Vascular Flow Only (78610) |
$242.40 |
$808 |
0.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$279.60 |
$932 |
0.9× |
| Cardiac shunt detection (78428) |
$588.60 |
$1,962 |
1.6× |
| Cervical spine 2 or 3 views (72040) |
$168.30 |
$561 |
2.1× |
| Chest 1 view (71045) |
$144 |
$480 |
1.8× |
| Chest 3 views (71047) |
$157.20 |
$524 |
2.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$207 |
$690 |
1.3× |
| Clavicle complete (73000) |
$79.20 |
$264 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$113.10 |
$377 |
1.2× |
| Continuing medical physics consltj pr wk (77336) |
$384.90 |
$1,283 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$230.40 |
$768 |
0.7× |
| CT abdomen and pelvis without contrast (74176) |
$149.10 |
$497 |
0.7× |
| CT abdomen w contrast (74160) |
$152.70 |
$509 |
1.0× |
| CT abdomen w wo contrast (74170) |
$175.50 |
$585 |
1.1× |
| CT abdomen w/o contrast (74150) |
$118.50 |
$395 |
1.2× |
| CT angio hrt w/3d image (75574) |
$237.30 |
$791 |
0.7× |
| CT angiography upper extremity lt (73206) |
$217.50 |
$725 |
1.4× |
| CT c-spine w/o contrast (72125) |
$118.50 |
$395 |
1.2× |
| CT cervical spine w&w/o contrast (72127) |
$189 |
$630 |
1.2× |
| CT cervical spine with contrast (72126) |
$152.40 |
$508 |
0.5× |
| CT chest w/wo contrast (71270) |
$231.30 |
$771 |
1.5× |
| CT chest with contrast (71260) |
$173.40 |
$578 |
1.1× |
| CT head/brain with contrast (70460) |
$123.90 |
$413 |
0.8× |
| CT head/brain without and with contrast (70470) |
$123.90 |
$413 |
0.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$117 |
$390 |
1.5× |
| CT iac w contrast (70481) |
$188.70 |
$629 |
1.2× |
| CT limited/localized follow up study (76380) |
$117 |
$390 |
1.5× |
| CT lower ext w/o (73700) |
$177.90 |
$593 |
1.9× |
| CT lower extremity w wo contrast (73702) |
$194.70 |
$649 |
1.2× |
| CT lower extremity with contrast (73701) |
$229.50 |
$765 |
1.4× |
| CT lumbar spine w & w/o contrast (72133) |
$187.80 |
$626 |
1.2× |
| CT lumbar spine w/o contrast (72131) |
$118.50 |
$395 |
1.2× |
| CT lumbar spine with contrast (72132) |
$152.40 |
$508 |
0.5× |
| CT maxillofacial w contrast (70487) |
$173.40 |
$578 |
1.1× |
| CT maxillofacial w/o contrast (70486) |
$118.50 |
$395 |
1.2× |
| CT maxillofacial w/wo contrast (70488) |
$202.20 |
$674 |
1.3× |
| CT neck soft tissue w contrast (70491) |
$173.40 |
$578 |
1.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$207.90 |
$693 |
1.3× |
| CT orbits w/o contrast (70480) |
$149.10 |
$497 |
1.6× |
| CT pelvis w & w/o contrast (72194) |
$181.50 |
$605 |
1.1× |
| CT pelvis w/o contrast (72192) |
$118.50 |
$395 |
1.2× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$117 |
$390 |
1.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$231.30 |
$771 |
1.5× |
| CT soft tissue neck w/o contrast (70490) |
$118.50 |
$395 |
1.2× |
| CT thoracic spine w/contrast (72129) |
$153 |
$510 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$118.50 |
$395 |
1.2× |
| CT thoracic spine w/wo contrast (72130) |
$183.30 |
$611 |
1.2× |
| CT thorax w/o contrast (71250) |
$118.50 |
$395 |
1.2× |
| CT unlisted procedure (76497) |
$357.90 |
$1,193 |
4.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$197.70 |
$659 |
1.2× |
| CT upper extremity w/o contrast rt (73200) |
$223.65 |
$745.50 |
2.4× |
| CT upper extremity with contrast (73201) |
$225 |
$750 |
0.7× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$231.30 |
$771 |
1.5× |
| Cta Abdomen (74175) |
$210 |
$700 |
1.3× |
| CTA abdomen pelvis (74174) |
$805.50 |
$2,685 |
2.5× |
| CTA chest (71275) |
$231.30 |
$771 |
1.5× |
| Cta Head (70496) |
$288.90 |
$963 |
1.8× |
| CTA lwr ext w&w/o contrast (73706) |
$225 |
$750 |
1.4× |
| Cta Neck (70498) |
$288.90 |
$963 |
1.8× |
| Cta Pelvis (72191) |
$196.20 |
$654 |
1.2× |
| Cystography minimum 3 views rs&i (74430) |
$218.40 |
$728 |
0.7× |
| Dxa bone density study 1/> sites axial skel (77080) |
$175.80 |
$586 |
1.9× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$93.60 |
$312 |
1.2× |
| Echoencephalography real time imaging (76506) |
$71.70 |
$239 |
0.8× |
| Esophagus (74220) |
$208.80 |
$696 |
1.3× |
| Fetal biophysical profile non-stress testing (76818) |
$130.20 |
$434 |
1.4× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$85.50 |
$285 |
0.9× |
| Fluoroscopy up to 1 hr (76000) |
$192.60 |
$642 |
0.9× |
| Foot 2 views (73620) |
$210.15 |
$700.50 |
2.7× |
| Forearm 2 views (73090) |
$186 |
$620 |
2.4× |
| Gated Heart Planar Single (78472) |
$437.10 |
$1,457 |
1.2× |
| Hand 2 views (73120) |
$213.75 |
$712.50 |
2.3× |
| Hand 3 views (73130) |
$234.45 |
$781.50 |
3.0× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$1,436.40 |
$4,788 |
2.3× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$1,724.70 |
$5,749 |
2.7× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$1,299.90 |
$4,333 |
0.5× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$652.80 |
$2,176 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$611.40 |
$2,038 |
1.7× |
| Ht muscle image spect sing (78451) |
$1,379.70 |
$4,599 |
1.2× |
| Humerus Min 2 Views Left (73060) |
$76.80 |
$256 |
1.0× |
| Hysterosalpingogram (74740) |
$269.10 |
$897 |
1.2× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$113.70 |
$379 |
1.2× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$423.90 |
$1,413 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$438.60 |
$1,462 |
0.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$930 |
$3,100 |
1.9× |
| Knee 3 views (73562) |
$241.20 |
$804 |
3.1× |
| Liver & spleen imaging static only (78215) |
$548.40 |
$1,828 |
1.5× |
| Liver imaging w/vascular flow (78202) |
$729.90 |
$2,433 |
1.5× |
| Lung perf&ventilat diferentl (78598) |
$878.10 |
$2,927 |
1.8× |
| Lung perfusion differential (78597) |
$600.90 |
$2,003 |
1.7× |
| Lymphoscintigraphy (78195) |
$400.80 |
$1,336 |
0.8× |
| Mammary ductogram or galactogram single (77053) |
$80.40 |
$268 |
0.4× |
| Meckels Diverticulum (78290) |
$304.50 |
$1,015 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$475.20 |
$1,584 |
1.4× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$23.10 |
$77 |
0.9× |
| MRA head w/o contrast (70544) |
$287.10 |
$957 |
1.3× |
| MRA head with contrast (70545) |
$340.80 |
$1,136 |
1.1× |
| MRA neck w contrast (70548) |
$340.80 |
$1,136 |
1.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$377.10 |
$1,257 |
1.2× |
| MRA neck w/o contrast (70547) |
$287.10 |
$957 |
1.3× |
| MRI abdomen w contrast (74182) |
$270.60 |
$902 |
0.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$340.80 |
$1,136 |
1.1× |
| MRI abdomen w/o contrast (74181) |
$215.40 |
$718 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$274.20 |
$914 |
0.4× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$272.10 |
$907 |
0.4× |
| MRI bone marrow blood supply (77084) |
$202.80 |
$676 |
0.9× |
| MRI breast w/o contrast bilateral (77047) |
$243 |
$810 |
1.1× |
| MRI breast w/o contrast unilat (77046) |
$243 |
$810 |
1.1× |
| MRI c-spine with contrast (72142) |
$249.90 |
$833 |
0.8× |
| MRI cardiac w/o contrast (75557) |
$195 |
$650 |
0.9× |
| MRI cervical spine w/o contrast (72141) |
$215.40 |
$718 |
1.0× |
| MRI chest w/o & w/contrast material (71552) |
$406.50 |
$1,355 |
1.3× |
| MRI chest w/o contrast (71550) |
$243 |
$810 |
1.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$294 |
$980 |
0.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$238.50 |
$795 |
0.8× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$323.10 |
$1,077 |
1.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$185.70 |
$619 |
0.9× |
| MRI orbit/face/neck w&w/o cont (70543) |
$340.80 |
$1,136 |
1.1× |
| MRI pelvis w contrast (72196) |
$272.70 |
$909 |
0.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$340.80 |
$1,136 |
1.1× |
| MRI pelvis w/o contrast (72195) |
$258.30 |
$861 |
1.2× |
| MRI scan of arm joint before and after contrast (73223) |
$331.20 |
$1,104 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$511.20 |
$1,704 |
1.6× |
| MRI spectroscopy (76390) |
$75.90 |
$253 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$340.80 |
$1,136 |
1.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$249.90 |
$833 |
0.8× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$340.80 |
$1,136 |
1.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$249.90 |
$833 |
0.8× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$340.80 |
$1,136 |
1.1× |
| MRI thoracic spine w/o contrast (72146) |
$215.40 |
$718 |
1.0× |
| MRI tmj (70336) |
$226.80 |
$756 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$323.10 |
$1,077 |
1.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$358.80 |
$1,196 |
1.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$243 |
$810 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$1,878.60 |
$6,262 |
1.6× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$865.80 |
$2,886 |
1.1× |
| Neck soft tissue (70360) |
$108.90 |
$363 |
1.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$196.80 |
$656 |
0.5× |
| Nm cisternogram (78630) |
$383.10 |
$1,277 |
0.8× |
| Nm gastric emptying study (78264) |
$579.30 |
$1,931 |
1.6× |
| Nm gastroesophageal reflux study (78262) |
$815.40 |
$2,718 |
2.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$1,948.80 |
$6,496 |
1.6× |
| Nuclear Rx Oral Admin (79005) |
$518.70 |
$1,729 |
2.5× |
| Orthopantogram (70355) |
$143.40 |
$478 |
1.8× |
| Osseous survey limited (77074) |
$89.70 |
$299 |
0.9× |
| Parathyrd planar w/spect&CT (78072) |
$507.30 |
$1,691 |
1.0× |
| Parathyrd planar w/wo subtrj (78071) |
$507.30 |
$1,691 |
1.4× |
| Parathyroid imaging (78070) |
$475.20 |
$1,584 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$148.20 |
$494 |
1.6× |
| Peritoneogram rs&i (74190) |
$266.70 |
$889 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$1,937.70 |
$6,459 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$1,743.90 |
$5,813 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$1,937.70 |
$6,459 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$511.20 |
$1,704 |
1.6× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$1,422.60 |
$4,742 |
0.5× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$622.50 |
$2,075 |
0.2× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$561.90 |
$1,873 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$744.90 |
$2,483 |
1.5× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$251.10 |
$837 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$75.30 |
$251 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$192 |
$640 |
2.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$189 |
$630 |
2.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$211.80 |
$706 |
2.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$3,575.10 |
$11,917 |
0.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$384.30 |
$1,281 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$194.10 |
$647 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$137.40 |
$458 |
1.7× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$175.50 |
$585 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$150.30 |
$501 |
1.9× |
| Radiologic exam colon single contrast study (74270) |
$299.40 |
$998 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$273 |
$910 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$241.50 |
$805 |
1.5× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$76.80 |
$256 |
1.0× |
| Radiological examination surgical specimen (76098) |
$258.60 |
$862 |
0.5× |
| Ribs bilateral 3 views (71110) |
$169.50 |
$565 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$657.30 |
$2,191 |
1.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,228.50 |
$4,095 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,622.40 |
$5,408 |
1.3× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$1,429.80 |
$4,766 |
1.2× |
| Rp therapy intra-arterial particulate admn (79445) |
$442.50 |
$1,475 |
2.1× |
| Rp Therapy Intravenous Administration (79101) |
$253.80 |
$846 |
1.2× |
| Sacroiliac Joints < 3 Views (72200) |
$125.40 |
$418 |
1.3× |
| Scanogram (77073) |
$130.20 |
$434 |
1.4× |
| Scapula complete (73010) |
$48.60 |
$162 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$82.20 |
$274 |
3.5× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$207.90 |
$693 |
2.2× |
| Small bowel series (74250) |
$238.20 |
$794 |
1.5× |
| Spec medical radj physics consltj (77370) |
$415.50 |
$1,385 |
3.4× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$394.20 |
$1,314 |
1.2× |
| Special dosimetry (77331) |
$174.90 |
$583 |
1.4× |
| Special treatment procedure (77470) |
$813.90 |
$2,713 |
1.6× |
| Spine thoracic 3 views (72072) |
$169.50 |
$565 |
1.8× |
| Stereotactic body radiation delivery (77373) |
$4,109.10 |
$13,697 |
2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$447 |
$1,490 |
1.3× |
| Ther rad simulaj-aided field setting complex (77290) |
$534.60 |
$1,782 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$450 |
$1,500 |
3.7× |
| Thoracolumbar 2 views (72080) |
$104.10 |
$347 |
1.3× |
| Thyroid carcinoma metastases img whole body (78018) |
$718.20 |
$2,394 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$198.30 |
$661 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$299.70 |
$999 |
0.8× |
| Tmj unilateral (70328) |
$94.80 |
$316 |
1.2× |
| Tomogram (76100) |
$125.10 |
$417 |
1.3× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,414.50 |
$4,715 |
2.9× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$425.70 |
$1,419 |
1.2× |
| Tx devices design & construction complex (77334) |
$417 |
$1,390 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$314.40 |
$1,048 |
3.3× |
| Unlisted magnetic resonance procedure (76498) |
$65.40 |
$218 |
0.8× |
| Upper Extremity Infant (73092) |
$39.60 |
$132 |
0.4× |
| Urethrocystography retrograde rs&i (74450) |
$206.10 |
$687 |
1.0× |
| Urethrocystography voiding (74455) |
$261.60 |
$872 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$153.60 |
$512 |
1.0× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$230.40 |
$768 |
1.4× |
| Us abdl aorta screen aaa (76706) |
$204 |
$680 |
2.2× |
| Us breast unilateral complete (76641) |
$399.60 |
$1,332 |
4.2× |
| Us breast unilateral limited (76642) |
$349.50 |
$1,165 |
4.4× |
| Us chest (76604) |
$213.60 |
$712 |
2.3× |
| Us guided compression repair (76936) |
$340.80 |
$1,136 |
1.7× |
| Us infant hips dynamic (76885) |
$234.60 |
$782 |
3.0× |
| Us kidney transplant (76776) |
$81 |
$270 |
0.9× |
| Us ob transvaginal (76817) |
$74.40 |
$248 |
0.8× |
| Us pelvic non ob complete (76856) |
$272.40 |
$908 |
2.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$217.20 |
$724 |
2.3× |
| Us pregnancy ltd (76815) |
$67.80 |
$226 |
0.7× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$226.20 |
$754 |
2.4× |
| Us retroperitoneal complete (76770) |
$348.30 |
$1,161 |
3.7× |
| Us retroperitoneal limited (76775) |
$286.80 |
$956 |
3.0× |
| Us scrotum and contents (76870) |
$226.20 |
$754 |
2.4× |
| Us soft tissue head/neck (76536) |
$240 |
$800 |
2.5× |
| Us spinal canal and contents (76800) |
$63 |
$210 |
0.7× |
| Us xtr non-vasc lmtd (76882) |
$209.10 |
$697 |
2.2× |
| Venogram extremity bilateral (75822) |
$769.50 |
$2,565 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,014.90 |
$3,383 |
0.4× |
| Venography caval superior serialography rs&i (75827) |
$897.30 |
$2,991 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$402.30 |
$1,341 |
0.3× |
| Venography Renal Bilateral (75833) |
$1,487.40 |
$4,958 |
0.5× |
| Venography renal unilateral selective rs&i (75831) |
$1,266.60 |
$4,222 |
0.4× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,033.50 |
$3,445 |
0.4× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,961.10 |
$6,537 |
0.4× |
| Wrist 2 views (73100) |
$224.55 |
$748.50 |
2.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$233.70 |
$779 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$50.10 |
$167 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$231.30 |
$771 |
2.9× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$389.40 |
$1,298 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$107.85 |
$359.50 |
1.4× |
| X-ray exam entire spi 4/5 vw (72083) |
$197.70 |
$659 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$65.70 |
$219 |
0.8× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$154.20 |
$514 |
2.0× |
| X-ray exam hip uni 4/> views (73503) |
$161.10 |
$537 |
1.7× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$189.90 |
$633 |
2.0× |
| X-ray exam of femur 1 (73551) |
$50.10 |
$167 |
0.6× |
| X-ray eye for foreign body (70030) |
$40.50 |
$135 |
0.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$76.20 |
$254 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$39.60 |
$132 |
0.5× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$235.80 |
$786 |
3.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$207.45 |
$691.50 |
2.6× |
| X-ray IV pyelogram+drip infusn (74410) |
$231.60 |
$772 |
1.5× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$145.20 |
$484 |
1.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$254.25 |
$847.50 |
2.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$96.75 |
$322.50 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$190.20 |
$634 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$300 |
$1,000 |
3.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$210.30 |
$701 |
2.2× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$57.30 |
$191 |
0.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$130.80 |
$436 |
1.7× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$63.60 |
$212 |
0.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$155.40 |
$518 |
1.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$194.10 |
$647 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$140.40 |
$468 |
1.8× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$141.30 |
$471 |
1.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$197.70 |
$659 |
2.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$160.80 |
$536 |
1.7× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$151.80 |
$506 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$207 |
$690 |
2.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$172.80 |
$576 |
2.2× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$98.40 |
$328 |
1.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$108.90 |
$363 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$51.60 |
$172 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$135.30 |
$451 |
1.7× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$33 |
$110 |
0.4× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$55.50 |
$185 |
0.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$141.30 |
$471 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$128.10 |
$427 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$228.15 |
$760.50 |
2.9× |
| Xr c-spine 6 or more views (72052) |
$272.10 |
$907 |
2.9× |
| Xr chest 4+ views (71048) |
$169.50 |
$565 |
1.8× |
| Xr finger(s) 2+ views (73140) |
$128.40 |
$428 |
1.6× |
| XR Mastoids < 3 Views Bilateral (70120) |
$51.45 |
$171.50 |
0.5× |
| Xr shoulder 1 view (73020) |
$91.50 |
$305 |
1.2× |
| Xr spine cervical 4 or 5 views (72050) |
$252.30 |
$841 |
2.7× |
| Xr tibia/fibula 2 views (73590) |
$236.25 |
$787.50 |
3.0× |
| Xr tmj bilateral (70330) |
$149.10 |
$497 |
1.9× |
| Xray knee 1 or 2 views rt (73560) |
$211.05 |
$703.50 |
2.7× |