| 3-D radiotherapy plan dose-volume histograms (77295) |
$4,942.40 |
$6,178 |
3.8× |
| Abdomen 2 views (74019) |
$471.20 |
$589 |
4.8× |
| Acute gastrointestinal blood loss imaging (78278) |
$2,692.80 |
$3,366 |
7.2× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$4,326.40 |
$5,408 |
1.5× |
| Angiography extremity bilateral rs&i (75716) |
$6,612 |
$8,265 |
2.2× |
| Angiography extremity unilateral rs&i (75710) |
$6,612 |
$8,265 |
2.2× |
| Angiography internal mammary rs&i (75756) |
$2,105.60 |
$2,632 |
0.7× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$4,015.20 |
$5,019 |
0.8× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$4,015.20 |
$5,019 |
1.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,861.60 |
$3,577 |
1.0× |
| Angiography Spinal Selective Rs&I (75705) |
$3,163.20 |
$3,954 |
0.6× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$4,015.20 |
$5,019 |
0.8× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,033.60 |
$3,792 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,592 |
$3,240 |
0.9× |
| Ankle 2 views (73600) |
$388.80 |
$486 |
4.8× |
| Antegrade urography radiological supvj & interpj (74425) |
$432.80 |
$541 |
1.3× |
| Aortogram thoracic (75605) |
$4,015.20 |
$5,019 |
0.8× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$7,273.60 |
$9,092 |
2.5× |
| Aortography abdominal serialography rs&i (75625) |
$7,273.60 |
$9,092 |
2.5× |
| Artery X-Rays Adrenal Gland (75731) |
$4,015.20 |
$5,019 |
1.4× |
| Arthrogram hip (73525) |
$1,337.60 |
$1,672 |
4.1× |
| Arthrogram shoulder (73040) |
$1,244.80 |
$1,556 |
3.8× |
| Arthrogram wrist (73115) |
$960.80 |
$1,201 |
2.9× |
| Arthrography knee lt (73580) |
$575.20 |
$719 |
1.8× |
| Basic radiation dosimetry calculation (77300) |
$502.40 |
$628 |
4.0× |
| Bone &/joint imaging whole body (78306) |
$2,682.40 |
$3,353 |
7.2× |
| Bone age studies (77072) |
$336 |
$420 |
3.4× |
| Bone Imaging 3 Phase (78315) |
$2,682.40 |
$3,353 |
7.2× |
| Bone Marrow Imaging Limited Area (78102) |
$925.60 |
$1,157 |
2.5× |
| Bone survey complete (77075) |
$841.60 |
$1,052 |
8.6× |
| Brachytx isodose complex (77318) |
$1,248 |
$1,560 |
3.6× |
| Brachytx isodose intermed (77317) |
$1,139.20 |
$1,424 |
3.2× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$519.20 |
$649 |
1.5× |
| Brain image w/flow 4 + views (78606) |
$2,799.20 |
$3,499 |
5.5× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$4,259.20 |
$5,324 |
3.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$2,128.80 |
$2,661 |
6.5× |
| Cardiac shunt detection (78428) |
$2,682.40 |
$3,353 |
7.2× |
| Cervical spine 2 or 3 views (72040) |
$489.60 |
$612 |
6.0× |
| Chest 1 view (71045) |
$411.20 |
$514 |
5.0× |
| Chest 3 views (71047) |
$533.60 |
$667 |
6.5× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$731.20 |
$914 |
4.4× |
| Cisternography Positive Contrast Rs&I (70015) |
$3,072.80 |
$3,841 |
4.2× |
| Clavicle complete (73000) |
$398.40 |
$498 |
4.9× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$236.80 |
$296 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$751.20 |
$939 |
6.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,588.80 |
$5,736 |
14.0× |
| CT abdomen and pelvis without contrast (74176) |
$3,612 |
$4,515 |
16.1× |
| CT abdomen w contrast (74160) |
$2,148.80 |
$2,686 |
13.1× |
| CT abdomen w wo contrast (74170) |
$2,240.80 |
$2,801 |
13.6× |
| CT abdomen w/o contrast (74150) |
$1,996.80 |
$2,496 |
20.4× |
| CT angio hrt w/3d image (75574) |
$1,108.80 |
$1,386 |
3.4× |
| CT angiography upper extremity lt (73206) |
$2,054.40 |
$2,568 |
12.5× |
| CT c-spine w/o contrast (72125) |
$2,128 |
$2,660 |
21.7× |
| CT cervical spine w&w/o contrast (72127) |
$2,247.20 |
$2,809 |
13.7× |
| CT cervical spine with contrast (72126) |
$2,226.40 |
$2,783 |
6.8× |
| CT chest w/wo contrast (71270) |
$2,736.80 |
$3,421 |
16.6× |
| CT chest with contrast (71260) |
$2,688 |
$3,360 |
16.3× |
| CT head/brain with contrast (70460) |
$1,705.60 |
$2,132 |
10.4× |
| CT head/brain without and with contrast (70470) |
$1,746.40 |
$2,183 |
10.6× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,494.40 |
$3,118 |
7.6× |
| CT heart no contrast quant eval coronry calcium (75571) |
$84 |
$105 |
1.0× |
| CT iac w contrast (70481) |
$2,049.60 |
$2,562 |
12.5× |
| CT limited/localized follow up study (76380) |
$312.80 |
$391 |
3.8× |
| CT lower ext w/o (73700) |
$1,823.20 |
$2,279 |
18.6× |
| CT lower extremity w wo contrast (73702) |
$2,814 |
$3,517.50 |
17.1× |
| CT lower extremity with contrast (73701) |
$1,982.40 |
$2,478 |
12.1× |
| CT lumbar spine w & w/o contrast (72133) |
$2,412 |
$3,015 |
14.7× |
| CT lumbar spine w/o contrast (72131) |
$2,268 |
$2,835 |
23.1× |
| CT lumbar spine with contrast (72132) |
$2,366.40 |
$2,958 |
7.2× |
| CT maxillofacial w contrast (70487) |
$829.60 |
$1,037 |
5.0× |
| CT maxillofacial w/o contrast (70486) |
$740 |
$925 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$876.80 |
$1,096 |
5.3× |
| CT neck soft tissue w contrast (70491) |
$1,884 |
$2,355 |
11.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$2,071.20 |
$2,589 |
12.6× |
| CT orbits w/o contrast (70480) |
$1,193.60 |
$1,492 |
12.2× |
| CT pelvis w & w/o contrast (72194) |
$3,060.80 |
$3,826 |
18.6× |
| CT pelvis w/o contrast (72192) |
$1,893.60 |
$2,367 |
19.3× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,922.40 |
$2,403 |
11.7× |
| CT soft tissue neck w/o contrast (70490) |
$1,815.20 |
$2,269 |
18.5× |
| CT thoracic spine w/contrast (72129) |
$2,193.60 |
$2,742 |
13.3× |
| CT thoracic spine w/o contrast (72128) |
$2,074.40 |
$2,593 |
21.2× |
| CT thoracic spine w/wo contrast (72130) |
$2,412 |
$3,015 |
14.7× |
| CT thorax w/o contrast (71250) |
$2,343.20 |
$2,929 |
23.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,046.40 |
$2,558 |
12.4× |
| CT upper extremity w/o contrast rt (73200) |
$2,278.80 |
$2,848.50 |
23.2× |
| CT upper extremity with contrast (73201) |
$1,742.40 |
$2,178 |
5.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,444 |
$3,055 |
14.9× |
| Cta Abdomen (74175) |
$2,240.80 |
$2,801 |
13.6× |
| CTA abdomen pelvis (74174) |
$2,480 |
$3,100 |
7.6× |
| CTA chest (71275) |
$1,867.20 |
$2,334 |
11.4× |
| Cta Head (70496) |
$1,882.40 |
$2,353 |
11.4× |
| CTA lwr ext w&w/o contrast (73706) |
$1,960 |
$2,450 |
11.9× |
| Cta Neck (70498) |
$1,882.40 |
$2,353 |
11.4× |
| Cta Pelvis (72191) |
$2,148 |
$2,685 |
13.1× |
| Diskography lumbar (72295) |
$3,352 |
$4,190 |
1.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$691.20 |
$864 |
7.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$140 |
$175 |
1.7× |
| Echoencephalography real time imaging (76506) |
$1,038.40 |
$1,298 |
10.6× |
| Esophagus (74220) |
$620.80 |
$776 |
3.8× |
| Fetal biophysical profile non-stress testing (76818) |
$1,681.60 |
$2,102 |
17.2× |
| Fluoroscopy up to 1 hr (76000) |
$627.20 |
$784 |
2.8× |
| Foot 2 views (73620) |
$360.80 |
$451 |
4.4× |
| Forearm 2 views (73090) |
$389.60 |
$487 |
4.8× |
| Functional MRI brain by tech (70554) |
$3,191.20 |
$3,989 |
14.3× |
| Gated Heart Planar Single (78472) |
$3,245.60 |
$4,057 |
8.7× |
| Hand 2 views (73120) |
$389.60 |
$487 |
4.0× |
| Hand 3 views (73130) |
$389.60 |
$487 |
4.8× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$3,787.20 |
$4,734 |
5.8× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$4,047.20 |
$5,059 |
6.2× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$4,308.80 |
$5,386 |
6.6× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$2,650.40 |
$3,313 |
7.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$2,584 |
$3,230 |
7.1× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$2,797.60 |
$3,497 |
0.9× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$2,940 |
$3,675 |
5.8× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$2,940 |
$3,675 |
7.8× |
| Ht muscle image spect sing (78451) |
$3,766.40 |
$4,708 |
3.1× |
| Humerus Min 2 Views Left (73060) |
$444.80 |
$556 |
5.4× |
| Hysterosalpingogram (74740) |
$745.60 |
$932 |
3.3× |
| Interstitial radiation source applic complex (77778) |
$7,315.20 |
$9,144 |
11.2× |
| Intracavitary Radiation Source Applic Complex (77763) |
$7,218.40 |
$9,023 |
11.1× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$7,147.20 |
$8,934 |
13.8× |
| Intracavitary radiation source applic simple (77761) |
$6,982.40 |
$8,728 |
13.5× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$200.80 |
$251 |
2.0× |
| Kidney imaging morphology (78700) |
$1,596.80 |
$1,996 |
4.3× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$2,007.20 |
$2,509 |
3.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$2,555.20 |
$3,194 |
5.0× |
| Knee 3 views (73562) |
$534.40 |
$668 |
6.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$2,628 |
$3,285 |
7.0× |
| Liver imaging static only (78201) |
$956 |
$1,195 |
1.9× |
| Lymphoscintigraphy (78195) |
$1,801.60 |
$2,252 |
3.5× |
| Mammary ductogram or galactogram multiple (77054) |
$386.40 |
$483 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$345.60 |
$432 |
1.5× |
| Meckels Diverticulum (78290) |
$1,612 |
$2,015 |
4.3× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,752.80 |
$2,191 |
5.0× |
| MRA head w & w/o contrast (70546) |
$3,699.20 |
$4,624 |
11.3× |
| MRA head w/o contrast (70544) |
$3,320.80 |
$4,151 |
14.8× |
| MRA head with contrast (70545) |
$3,598.40 |
$4,498 |
11.0× |
| MRA neck w contrast (70548) |
$3,513.60 |
$4,392 |
10.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$3,564.80 |
$4,456 |
10.9× |
| MRA neck w/o contrast (70547) |
$3,457.60 |
$4,322 |
15.5× |
| MRI abdomen w contrast (74182) |
$3,617.60 |
$4,522 |
11.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$3,860.80 |
$4,826 |
11.8× |
| MRI abdomen w/o contrast (74181) |
$3,044.80 |
$3,806 |
13.6× |
| MRI any jnt lwr ext with con lt (73722) |
$3,560.80 |
$4,451 |
4.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$3,336 |
$4,170 |
4.5× |
| MRI breast w/o contrast bilateral (77047) |
$2,816.80 |
$3,521 |
12.6× |
| MRI c-spine with contrast (72142) |
$3,696 |
$4,620 |
11.3× |
| MRI cardiac w/o contrast (75557) |
$1,744 |
$2,180 |
7.8× |
| MRI cervical spine w/o contrast (72141) |
$2,923.60 |
$3,654.50 |
13.1× |
| MRI chest w/o & w/contrast material (71552) |
$3,948.80 |
$4,936 |
12.1× |
| MRI chest w/o contrast (71550) |
$3,204.80 |
$4,006 |
14.3× |
| MRI chest with contrast (71551) |
$3,472 |
$4,340 |
4.7× |
| MRI fetal sngl/1st gestation (74712) |
$3,354.40 |
$4,193 |
15.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$3,366.40 |
$4,208 |
10.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$3,757.60 |
$4,697 |
11.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$3,669.60 |
$4,587 |
16.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,632.80 |
$3,291 |
11.8× |
| MRI orbit/face/neck w&w/o cont (70543) |
$3,510.40 |
$4,388 |
10.7× |
| MRI orbit/face/neck w/contrast (70542) |
$2,942.40 |
$3,678 |
9.0× |
| MRI pelvis w contrast (72196) |
$3,598.40 |
$4,498 |
11.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$4,014.40 |
$5,018 |
12.3× |
| MRI pelvis w/o contrast (72195) |
$3,540.80 |
$4,426 |
15.8× |
| MRI scan of arm joint before and after contrast (73223) |
$3,987.20 |
$4,984 |
12.2× |
| MRI scan of leg joint before and after contrast (73723) |
$3,904.80 |
$4,881 |
11.9× |
| MRI spectroscopy (76390) |
$1,757.60 |
$2,197 |
21.5× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$3,828 |
$4,785 |
11.7× |
| MRI spinal canal lumbar w/contrast material (72149) |
$3,679.20 |
$4,599 |
11.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$3,828 |
$4,785 |
11.7× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$3,511.20 |
$4,389 |
10.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$3,828 |
$4,785 |
11.7× |
| MRI thoracic spine w/o contrast (72146) |
$2,923.60 |
$3,654.50 |
13.1× |
| MRI tmj (70336) |
$3,073.60 |
$3,842 |
13.7× |
| MRI upper ext joint w/o contrast (73221) |
$3,236 |
$4,045 |
14.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$3,488 |
$4,360 |
10.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$3,236 |
$4,045 |
14.5× |
| Myocardial Spect Multiple Studies (78452) |
$6,117.60 |
$7,647 |
5.0× |
| Neck soft tissue (70360) |
$216.80 |
$271 |
2.7× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$627.20 |
$784 |
1.7× |
| Nm adrenal scan (78075) |
$2,497.60 |
$3,122 |
2.1× |
| Nm bone marrow wb (78104) |
$1,051.20 |
$1,314 |
2.8× |
| Nm gastric emptying study (78264) |
$3,620 |
$4,525 |
9.7× |
| Nm gastroesophageal reflux study (78262) |
$2,343.20 |
$2,929 |
6.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$4,569.60 |
$5,712 |
3.5× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$6,059.20 |
$7,574 |
4.5× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$4,027.20 |
$5,034 |
3.3× |
| Nuclear Rx Oral Admin (79005) |
$1,382.40 |
$1,728 |
6.3× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$407.20 |
$509 |
4.2× |
| Osseous survey infant (77076) |
$507.20 |
$634 |
5.2× |
| Osseous survey limited (77074) |
$841.60 |
$1,052 |
8.6× |
| Parathyrd planar w/spect&CT (78072) |
$1,782.40 |
$2,228 |
3.5× |
| Parathyrd planar w/wo subtrj (78071) |
$1,628 |
$2,035 |
4.3× |
| Pelvis 1 or 2 views (72170) |
$339.20 |
$424 |
3.5× |
| Peritoneogram rs&i (74190) |
$529.60 |
$662 |
1.0× |
| PET image w/CT, skull-thigh (78815) |
$6,318.40 |
$7,898 |
4.7× |
| PET imaging CT for attenuation limited area (78814) |
$6,318.40 |
$7,898 |
4.7× |
| PET imaging for CT attenuation whole body (78816) |
$6,318.40 |
$7,898 |
4.7× |
| Pr MRI brain w/o & w/ dye (70559) |
$3,511.20 |
$4,389 |
21.3× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$3,857.60 |
$4,822 |
11.8× |
| Proton trmt simple w/comp (77522) |
$2,861.60 |
$3,577 |
2.4× |
| Proton tx delivery complex (77525) |
$3,421.60 |
$4,277 |
2.9× |
| Proton tx delivery intermediate (77523) |
$3,421.60 |
$4,277 |
2.9× |
| Proton tx delivery simple w/o compensation (77520) |
$2,861.60 |
$3,577 |
5.5× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$4,015.20 |
$5,019 |
1.4× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$2,105.60 |
$2,632 |
0.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,950.40 |
$2,438 |
5.2× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$3,890.40 |
$4,863 |
7.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$660.80 |
$826 |
1.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$502.40 |
$628 |
6.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$621.60 |
$777 |
6.3× |
| Radex hips bilateral with pelvis 2 views (73521) |
$295.20 |
$369 |
3.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$536.80 |
$671 |
5.5× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$22,346.40 |
$27,933 |
3.2× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$777.60 |
$972 |
1.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$516.80 |
$646 |
5.4× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$589.60 |
$737 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$636 |
$795 |
6.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$351.20 |
$439 |
4.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$471.20 |
$589 |
4.8× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$432 |
$540 |
5.3× |
| Radiologic exam colon single contrast study (74270) |
$992 |
$1,240 |
6.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$620.80 |
$776 |
3.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$1,160.40 |
$1,450.50 |
7.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$1,324.80 |
$1,656 |
8.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$389.60 |
$487 |
4.8× |
| Radiological examination surgical specimen (76098) |
$415.20 |
$519 |
0.8× |
| Review by radiologist of adrenal gland vein image (75840) |
$4,015.20 |
$5,019 |
1.4× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$4,015.20 |
$5,019 |
1.4× |
| Ribs bilateral 3 views (71110) |
$439.20 |
$549 |
4.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,236 |
$2,795 |
4.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$2,448.80 |
$3,061 |
4.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,088 |
$3,860 |
2.5× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,407.20 |
$4,259 |
2.5× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$3,088 |
$3,860 |
2.5× |
| Rp therapy intra-arterial particulate admn (79445) |
$758.40 |
$948 |
3.5× |
| Rp Therapy Intravenous Administration (79101) |
$1,265.60 |
$1,582 |
5.8× |
| Sacroiliac Joints < 3 Views (72200) |
$451.20 |
$564 |
4.6× |
| Salivary gland imaging serial images (78231) |
$1,012 |
$1,265 |
2.7× |
| Scanogram (77073) |
$1,074.80 |
$1,343.50 |
11.0× |
| Scapula complete (73010) |
$517.60 |
$647 |
5.3× |
| Screening digital breast tomosynthesis (77063) |
$67.20 |
$84 |
2.9× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$813.60 |
$1,017 |
8.3× |
| Simulation intermediate (77285) |
$1,032.80 |
$1,291 |
2.9× |
| Small bowel series (74250) |
$446.40 |
$558 |
2.7× |
| Spec medical radj physics consltj (77370) |
$774.40 |
$968 |
6.1× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$674.40 |
$843 |
1.9× |
| Special dosimetry (77331) |
$502.40 |
$628 |
4.0× |
| Special treatment procedure (77470) |
$2,155.20 |
$2,694 |
4.2× |
| Spine thoracic 3 views (72072) |
$621.60 |
$777 |
6.3× |
| Spleen imaging only (78185) |
$1,342.40 |
$1,678 |
3.6× |
| Splenoportograpy rs&i (75810) |
$2,105.60 |
$2,632 |
0.7× |
| Stereotactic body radiation delivery (77373) |
$15,070.40 |
$18,838 |
9.0× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,436 |
$1,795 |
4.1× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$502.40 |
$628 |
1.4× |
| Testicular Imaging With Vascular Flow (78761) |
$2,108.80 |
$2,636 |
5.6× |
| Ther rad simulaj-aided field setting complex (77290) |
$1,557.60 |
$1,947 |
4.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$855.20 |
$1,069 |
6.8× |
| Therapeutic Enema (74283) |
$1,266.40 |
$1,583 |
7.7× |
| Thoracolumbar 2 views (72080) |
$454.40 |
$568 |
5.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$2,373.60 |
$2,967 |
4.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$1,252.80 |
$1,566 |
3.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,566.40 |
$1,958 |
4.2× |
| Treatment device intermediate (77333) |
$907.20 |
$1,134 |
7.2× |
| Treatment devices simple (77332) |
$820.80 |
$1,026 |
6.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$2,768.80 |
$3,461 |
5.4× |
| Tx devices design & construction complex (77334) |
$1,020.80 |
$1,276 |
2.9× |
| Ultrasound scan to determine eye length and lens power (76519) |
$336 |
$420 |
3.4× |
| Ultrasound, abdomen limited (76705) |
$749.60 |
$937 |
7.6× |
| Unlisted magnetic resonance procedure (76498) |
$924 |
$1,155 |
11.3× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$745.60 |
$932 |
2.0× |
| Upper Extremity Infant (73092) |
$295.20 |
$369 |
3.0× |
| Urethrocystography retrograde rs&i (74450) |
$588 |
$735 |
2.6× |
| Urethrocystography voiding (74455) |
$588 |
$735 |
2.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$945.60 |
$1,182 |
5.7× |
| Us abdl aorta screen aaa (76706) |
$749.60 |
$937 |
7.6× |
| Us breast unilateral complete (76641) |
$512 |
$640 |
5.2× |
| Us breast unilateral limited (76642) |
$512 |
$640 |
6.3× |
| Us chest (76604) |
$774.40 |
$968 |
7.9× |
| Us compl joint r-t w/image documentation (76881) |
$467.20 |
$584 |
4.8× |
| Us elastography parenchyma (76981) |
$385.60 |
$482 |
3.9× |
| Us infant hips dynamic (76885) |
$423.20 |
$529 |
5.2× |
| Us kidney transplant (76776) |
$888.80 |
$1,111 |
9.1× |
| Us ob detailed single fetus (76811) |
$924.80 |
$1,156 |
4.1× |
| Us ob transvaginal (76817) |
$975.20 |
$1,219 |
9.9× |
| Us pelvic non ob complete (76856) |
$855.20 |
$1,069 |
8.7× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$206.40 |
$258 |
2.1× |
| Us pregnancy ltd (76815) |
$368.80 |
$461 |
3.8× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$924.80 |
$1,156 |
9.4× |
| Us retroperitoneal complete (76770) |
$1,072 |
$1,340 |
10.9× |
| Us retroperitoneal limited (76775) |
$749.60 |
$937 |
7.6× |
| Us scrotum and contents (76870) |
$768.80 |
$961 |
7.8× |
| Us soft tissue head/neck (76536) |
$696 |
$870 |
7.1× |
| Us spinal canal and contents (76800) |
$238.40 |
$298 |
2.4× |
| Us transrectal (76872) |
$863.20 |
$1,079 |
8.8× |
| Us xtr non-vasc lmtd (76882) |
$423.20 |
$529 |
4.3× |
| Us, eye b-scan (76512) |
$1,849.60 |
$2,312 |
18.9× |
| Venogram extremity bilateral (75822) |
$2,246.40 |
$2,808 |
1.5× |
| Venography caval inferior serialography rs&i (75825) |
$5,096.80 |
$6,371 |
1.7× |
| Venography caval superior serialography rs&i (75827) |
$2,952 |
$3,690 |
2.0× |
| Venography extremity unilateral rs&i (75820) |
$2,246.40 |
$2,808 |
1.5× |
| Venography Renal Bilateral (75833) |
$3,387.20 |
$4,234 |
1.1× |
| Venography renal unilateral selective rs&i (75831) |
$2,852.80 |
$3,566 |
1.0× |
| Venography venous sinus/jugular cath rs&i (75860) |
$2,542.40 |
$3,178 |
0.9× |
| Venous sampling thru cath w/wo angiography rs& (75893) |
$3,387.20 |
$4,234 |
0.6× |
| Wrist 2 views (73100) |
$389.60 |
$487 |
4.8× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$496.80 |
$621 |
5.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$388.80 |
$486 |
4.8× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$522.40 |
$653 |
6.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$1,228.80 |
$1,536 |
7.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$388.80 |
$486 |
4.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$411.20 |
$514 |
5.0× |
| X-ray exam entire spi 4/5 vw (72083) |
$738.40 |
$923 |
7.5× |
| X-ray exam hip uni 1 view (73501) |
$573.60 |
$717 |
7.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$612.80 |
$766 |
7.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$548 |
$685 |
5.6× |
| X-ray exam of femur 1 (73551) |
$356 |
$445 |
4.4× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$900.80 |
$1,126 |
5.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$603.20 |
$754 |
6.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$389.60 |
$487 |
4.8× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$692 |
$865 |
0.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$388.80 |
$486 |
4.8× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$575.20 |
$719 |
5.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$305.60 |
$382 |
3.7× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$277.60 |
$347 |
3.4× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$489.60 |
$612 |
5.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$960.80 |
$1,201 |
9.8× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$489.60 |
$612 |
5.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$424 |
$530 |
5.2× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$154.40 |
$193 |
1.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$583.20 |
$729 |
5.9× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$372 |
$465 |
3.8× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$1,017.60 |
$1,272 |
3.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$529.60 |
$662 |
6.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$775.20 |
$969 |
7.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$771.20 |
$964 |
7.9× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$480 |
$600 |
4.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$444.80 |
$556 |
5.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$489.60 |
$612 |
6.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$604.80 |
$756 |
7.4× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$517.60 |
$647 |
6.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$681.60 |
$852 |
7.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$389.60 |
$487 |
4.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$325.60 |
$407 |
4.0× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$411.20 |
$514 |
5.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$589.60 |
$737 |
7.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$621.60 |
$777 |
6.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$621.60 |
$777 |
6.3× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$389.60 |
$487 |
4.8× |
| Xr c-spine 6 or more views (72052) |
$960 |
$1,200 |
9.8× |
| Xr chest 4+ views (71048) |
$582.40 |
$728 |
5.9× |
| Xr shoulder 1 view (73020) |
$339.20 |
$424 |
4.2× |
| Xr spine cervical 4 or 5 views (72050) |
$796 |
$995 |
8.1× |
| Xr tibia/fibula 2 views (73590) |
$422.40 |
$528 |
5.2× |
| Xr tmj bilateral (70330) |
$529.60 |
$662 |
6.5× |
| Xray knee 1 or 2 views rt (73560) |
$408 |
$510 |
5.0× |