| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,952.80 |
$4,882 |
1.3× |
| Abdomen 1 View (74018) |
$147.20 |
$368 |
1.5× |
| Abdomen 2 views (74019) |
$282.80 |
$707 |
2.4× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$521.20 |
$1,303 |
1.2× |
| Angio internal mammary (75756) |
$1,247.20 |
$3,118 |
0.4× |
| Angio pulmonary bilat (75743) |
$3,070.40 |
$7,676 |
0.9× |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
$2,892 |
$7,230 |
0.8× |
| Angiography extremity bilateral rs&i (75716) |
$2,679.20 |
$6,698 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,350 |
$5,875 |
0.7× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,886 |
$7,215 |
0.8× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$1,320.40 |
$3,301 |
0.4× |
| Ankle 2 views (73600) |
$253.20 |
$633 |
2.6× |
Aortography thoracic serialography rs&i (75605)
unusually low: confirm this is the full procedure |
$2,207.20 |
$5,518 |
0.4× |
Artery X-Rays Abdomen (75726)
unusually low: confirm this is the full procedure |
$2,632.80 |
$6,582 |
0.4× |
| Artery X-Rays Adrenal Gland (75731) |
$2,438.40 |
$6,096 |
0.7× |
Artery X-Rays Pelvis (75736)
unusually low: confirm this is the full procedure |
$2,486.80 |
$6,217 |
0.4× |
| Arthrogram hip (73525) |
$516.40 |
$1,291 |
1.3× |
| Arthrogram Wrist (73115) |
$522.80 |
$1,307 |
1.3× |
| Basic radiation dosimetry calculation (77300) |
$208 |
$520 |
1.4× |
| Bone age studies (77072) |
$138.40 |
$346 |
1.2× |
| Bone Imaging 3 Phase (78315) |
$936.40 |
$2,341 |
2.1× |
| Bone Imaging Limited Area (78300) |
$621.60 |
$1,554 |
1.4× |
| Bone Imaging Multiple Areas (78305) |
$750.80 |
$1,877 |
1.7× |
| Bone Imaging Whole Body (78306) |
$807.20 |
$2,018 |
1.8× |
| Bone marrow imaging limited area (78102) |
$478.80 |
$1,197 |
1.1× |
| Bone marrow imaging; multiple areas (78103) |
$478.80 |
$1,197 |
1.1× |
| Bone survey infant (77076) |
$138.40 |
$346 |
1.2× |
| Brachytx isodose intermed (77317) |
$592.40 |
$1,481 |
1.4× |
| Brachytx Isodose Plan Simple (77316) |
$822.80 |
$2,057 |
2.0× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,880.40 |
$4,701 |
1.2× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,112 |
$2,780 |
2.9× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$656.40 |
$1,641 |
1.1× |
| Cerebrospinal Fluid Scan (78630) |
$656.40 |
$1,641 |
1.1× |
| Chest 1 view (71045) |
$141.20 |
$353 |
1.5× |
| Chest 2 views (71046) |
$217.60 |
$544 |
2.2× |
| Chest 3 views (71047) |
$278.40 |
$696 |
2.9× |
| Chest 4 or more views (71048) |
$298 |
$745 |
2.6× |
| Cholecystography Oral Contrast (74290) |
$240.80 |
$602 |
1.2× |
| Clavicle complete (73000) |
$225.20 |
$563 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$628 |
$1,570 |
5.4× |
| Continuing medical physics consltj pr wk (77336) |
$250.40 |
$626 |
1.7× |
| Contrast Exam Abdominl Aorta (75625) |
$2,733.60 |
$6,834 |
0.8× |
| Contrast X-Ray Bladder (74430) |
$467.60 |
$1,169 |
1.2× |
| Contrast X-Ray Of Elbow (73085) |
$522.80 |
$1,307 |
1.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$516.40 |
$1,291 |
1.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,725.20 |
$6,813 |
7.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,543.20 |
$3,858 |
5.8× |
| CT abdomen w contrast (74160) |
$1,667.60 |
$4,169 |
8.5× |
| CT abdomen w wo contrast (74170) |
$1,901.20 |
$4,753 |
9.7× |
| CT abdomen w/o contrast (74150) |
$1,084 |
$2,710 |
9.3× |
| CT Angio Abdomen and Pelvis (74174) |
$1,415.60 |
$3,539 |
3.6× |
| CT Angio Chest (71275) |
$976 |
$2,440 |
5.0× |
| CT Angio Head (70496) |
$863.60 |
$2,159 |
4.4× |
| CT angio hrt w/3d image (75574) |
$304.40 |
$761 |
0.8× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,648 |
$4,120 |
8.4× |
| CT Angio Neck (70498) |
$1,384 |
$3,460 |
7.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$742 |
$1,855 |
3.8× |
| CT Cere Prfuj Alys C+ W/O CT/Cta Same Anatomy (70473) |
$1,450.40 |
$3,626 |
7.4× |
| CT cervical spine w/ contrast (72126) |
$1,677.20 |
$4,193 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$1,148.80 |
$2,872 |
9.9× |
| CT cervical spine w/wo cont (72127) |
$1,746 |
$4,365 |
8.9× |
| CT chest w contrast (71260) |
$1,064.40 |
$2,661 |
5.4× |
| CT chest w/wo contrast (71270) |
$1,277.20 |
$3,193 |
6.5× |
| CT head/brain with contrast (70460) |
$1,472.80 |
$3,682 |
7.5× |
| CT head/brain without and with contrast (70470) |
$1,723.60 |
$4,309 |
8.8× |
| CT heart contrast eval cardiac structure&morph (75572) |
$304.40 |
$761 |
0.8× |
| CT heart no contrast quant eval coronry calcium (75571) |
$102.80 |
$257 |
1.1× |
| CT iac w contrast (70481) |
$738.80 |
$1,847 |
3.8× |
| CT l-spine w&w/o contrast (72133) |
$2,035.20 |
$5,088 |
10.4× |
| CT lower ext w/o (73700) |
$1,109.60 |
$2,774 |
9.5× |
| CT lower extremity w/contrast material (73701) |
$1,575.60 |
$3,939 |
8.1× |
| CT lumbar spine w contrast (72132) |
$1,723.20 |
$4,308 |
4.4× |
| CT lumbar spine w/o contrast (72131) |
$1,356.80 |
$3,392 |
11.6× |
| CT maxillofacial w contrast (70487) |
$1,060.80 |
$2,652 |
5.4× |
| CT maxillofacial wo contrast (70486) |
$884 |
$2,210 |
7.6× |
| CT neck tissue combo (70492) |
$588.40 |
$1,471 |
3.0× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$807.60 |
$2,019 |
4.1× |
| CT orbits w/o contrast (70480) |
$626 |
$1,565 |
5.4× |
| CT pelvis w&w/o contrast (72194) |
$1,500 |
$3,750 |
7.7× |
| CT pelvis w/o contrast (72192) |
$705.20 |
$1,763 |
6.1× |
| CT scan of leg combo (73702) |
$1,786.40 |
$4,466 |
9.1× |
| CT scans face/jaw combo (70488) |
$1,299.20 |
$3,248 |
6.6× |
| CT soft tissue neck w contrast (70491) |
$486.40 |
$1,216 |
2.5× |
| CT soft tissue neck w/o contrast (70490) |
$403.60 |
$1,009 |
3.5× |
| CT thoracic spine w contrast (72129) |
$1,518.80 |
$3,797 |
7.8× |
| CT thoracic spine w/o contrast (72128) |
$1,196 |
$2,990 |
10.3× |
| CT thoracic spine w/wo cont (72130) |
$1,806 |
$4,515 |
9.2× |
| CT thorax w/o contrast (71250) |
$883.60 |
$2,209 |
7.6× |
| CT upper ext wo (73200) |
$1,212.40 |
$3,031 |
10.4× |
| CT upper extremity with contrast (73201) |
$1,345.60 |
$3,364 |
3.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$836.80 |
$2,092 |
4.3× |
| Cta Abdomen (74175) |
$1,118 |
$2,795 |
5.7× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$2,247.60 |
$5,619 |
5.8× |
| CTA pelvis (72191) |
$976.80 |
$2,442 |
5.0× |
| Dilation ureters/urethra rs&i (74485) |
$3,250.40 |
$8,126 |
1.4× |
| Discography Cerv/Thor Spine (72285) |
$3,660.40 |
$9,151 |
1.7× |
| Diskography lumbar (72295) |
$3,660.40 |
$9,151 |
1.7× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$259.20 |
$648 |
2.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$159.60 |
$399 |
1.4× |
| Dxa Bone Density Axial (77080) |
$196 |
$490 |
1.7× |
| Dxa bone density study (77085) |
$196 |
$490 |
1.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$117.60 |
$294 |
1.2× |
| Echo Guide For Artery Repair (76936) |
$335.60 |
$839 |
1.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$306.40 |
$766 |
1.2× |
| Echograp Trans R Pros Study (76873) |
$536.40 |
$1,341 |
4.6× |
| Esophagram (74220) |
$384 |
$960 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$426.40 |
$1,066 |
3.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$311.20 |
$778 |
2.7× |
| Fluoroscopy up to 1 hr (76000) |
$346.40 |
$866 |
1.3× |
| Follow-Up Angiography (75898) |
$1,074.80 |
$2,687 |
0.3× |
| Foot 2 views (73620) |
$209.20 |
$523 |
2.2× |
| Forearm 2 views (73090) |
$229.20 |
$573 |
2.4× |
| Gastric emptying imaging study (78264) |
$534.40 |
$1,336 |
1.2× |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
$594.40 |
$1,486 |
1.3× |
| Gated Heart Planar Single (78472) |
$478.80 |
$1,197 |
1.1× |
| Hand 2 views (73120) |
$222.40 |
$556 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$918 |
$2,295 |
1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$900 |
$2,250 |
1.2× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$900 |
$2,250 |
1.2× |
| Hepatobil Syst Image W/Drug (78227) |
$840 |
$2,100 |
1.4× |
| Hepatobiliary System Imaging (78226) |
$613.20 |
$1,533 |
1.4× |
| Ht Muscle Image Spect Sing (78451) |
$1,907.60 |
$4,769 |
1.3× |
| Hysterosalpingogram (74740) |
$344.40 |
$861 |
1.3× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$219.60 |
$549 |
2.3× |
| K Flow/Funct Image Multiple (78709) |
$1,522 |
$3,805 |
2.5× |
| K Flow/Funct Image W/Drug (78708) |
$718 |
$1,795 |
1.2× |
| K Flow/Funct Image W/O Drug (78707) |
$954.80 |
$2,387 |
1.6× |
| Kidney Imaging Morphol (78700) |
$710.80 |
$1,777 |
1.6× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$919.20 |
$2,298 |
2.1× |
| Knee 3 Views (73562) |
$401.60 |
$1,004 |
4.1× |
| Liver & Spleen Imaging Static Only (78215) |
$478.80 |
$1,197 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$478.80 |
$1,197 |
1.1× |
| Liver imaging static only (78201) |
$1,466.80 |
$3,667 |
2.4× |
| Liver imaging w/vascular flow (78202) |
$1,466.80 |
$3,667 |
2.4× |
| Lung Perf&Ventilat Diferentl (78598) |
$621.60 |
$1,554 |
1.0× |
| Lung perfusion differential (78597) |
$478.80 |
$1,197 |
1.1× |
| Lung Ventilat&Perfus Imaging (78582) |
$839.60 |
$2,099 |
1.4× |
| Lung Ventilation Imaging (78579) |
$478.40 |
$1,196 |
1.1× |
| Lymph System Imaging (78195) |
$833.20 |
$2,083 |
1.4× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,453.20 |
$13,633 |
1.5× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$3,635.20 |
$9,088 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$349.20 |
$873 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$435.20 |
$1,088 |
1.6× |
| Meckels Divert Exam (78290) |
$521.20 |
$1,303 |
1.2× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,223.20 |
$3,058 |
2.9× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$66 |
$165 |
2.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,358.80 |
$5,897 |
6.1× |
| MRA head w/o contrast (70544) |
$1,268.40 |
$3,171 |
4.8× |
| MRA head with contrast (70545) |
$1,306.40 |
$3,266 |
3.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,559.20 |
$3,898 |
4.0× |
| MRA neck w/o contrast (70547) |
$842 |
$2,105 |
3.2× |
| MRI abdomen w contrast (74182) |
$1,469.20 |
$3,673 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$793.20 |
$1,983 |
3.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,818.80 |
$4,547 |
2.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,333.20 |
$5,833 |
6.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,505.20 |
$3,763 |
1.7× |
| MRI bone marrow blood supply (77084) |
$1,042 |
$2,605 |
3.9× |
| MRI brain functional w/o physician admnistration (70554) |
$1,110.40 |
$2,776 |
4.2× |
| MRI Breast W/O Contrast Bilateral (77047) |
$292.40 |
$731 |
1.1× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$292.40 |
$731 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$966.80 |
$2,417 |
3.6× |
| MRI cervical spine w contrast (72142) |
$1,798.40 |
$4,496 |
4.6× |
| MRI cervical spine w/o cont (72141) |
$1,634.80 |
$4,087 |
6.1× |
| MRI chest w/o contrast (71550) |
$888.40 |
$2,221 |
3.3× |
| MRI chest with contrast (71551) |
$1,645.20 |
$4,113 |
1.9× |
| MRI chest wo w contrast (71552) |
$1,645.20 |
$4,113 |
4.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,638.80 |
$4,097 |
4.2× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,596 |
$3,990 |
4.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,425.20 |
$3,563 |
5.4× |
| MRI lumbar spine w contrast (72149) |
$1,605.20 |
$4,013 |
4.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,272.40 |
$5,681 |
5.8× |
| MRI orbit face &/neck w/o contrast (70540) |
$573.60 |
$1,434 |
2.2× |
| MRI orbit face neck w contrast (70542) |
$1,062.40 |
$2,656 |
2.7× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,062.40 |
$2,656 |
2.7× |
| MRI pelvis w contrast (72196) |
$1,190.80 |
$2,977 |
3.1× |
| MRI pelvis w/o & w contrast (72197) |
$1,452 |
$3,630 |
3.7× |
| MRI pelvis w/o contrast (72195) |
$1,074.40 |
$2,686 |
4.0× |
| MRI spectroscopy (76390) |
$753.20 |
$1,883 |
7.8× |
| MRI thoracic spine w/o contrast (72146) |
$1,515.20 |
$3,788 |
5.7× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,366.40 |
$5,916 |
6.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,272.40 |
$3,181 |
4.8× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,366.40 |
$5,916 |
6.1× |
| MRI, abdomen, combo (74183) |
$1,469.20 |
$3,673 |
3.8× |
| MRI, dorsal spine combo (72157) |
$2,076 |
$5,190 |
5.3× |
| MRI, dorsal spine contrast (72147) |
$1,666.80 |
$4,167 |
4.3× |
| MRI, joint upper extrem (73221) |
$1,254.40 |
$3,136 |
4.7× |
| MRI, joint upper extrem combo (73223) |
$1,794 |
$4,485 |
4.6× |
| MRI, lumbar spine combo (72158) |
$1,791.60 |
$4,479 |
4.6× |
| Myelography thoracic (72255) |
$825.20 |
$2,063 |
0.9× |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
$1,970.40 |
$4,926 |
1.4× |
Myocardial Spect Multiple Studies (78452)
range across 2 matching MRF lines |
$1,907.60–$3,658 |
$4,769–$9,145 |
varies |
| Neck soft tissue (70360) |
$192.80 |
$482 |
2.0× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$478.80 |
$1,197 |
1.1× |
| Nm csf leak detection (78650) |
$1,658.80 |
$4,147 |
1.1× |
| Nm myocard infarct spect (78469) |
$1,466.80 |
$3,667 |
2.4× |
| Nonvascular Shunt X-Ray (75809) |
$287.60 |
$719 |
2.5× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$3,093.60 |
$7,734 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$466 |
$1,165 |
1.8× |
| Ob us nuchal meas 1 gest (76813) |
$165.20 |
$413 |
1.4× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$159.20 |
$398 |
1.4× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$858 |
$2,145 |
1.4× |
| Parathyroid Planar Imaging (78070) |
$478.80 |
$1,197 |
1.1× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$738 |
$1,845 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$271.60 |
$679 |
2.3× |
| Pet Image W/Ct Lmtd (78814) |
$2,922 |
$7,305 |
1.8× |
| PET image w/CT, full body (78816) |
$3,311.60 |
$8,279 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,246.80 |
$8,117 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$554 |
$1,385 |
1.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$282.80 |
$707 |
2.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$613.60 |
$1,534 |
1.0× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$342.40 |
$856 |
3.5× |
| Radex Calcaneus Minimum 2 Views (73650) |
$182.80 |
$457 |
1.9× |
| Radex elbow complete minimum 3 views (73080) |
$346 |
$865 |
3.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$299.60 |
$749 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$232.80 |
$582 |
2.4× |
| Radex foot complete minimum 3 views (73630) |
$303.20 |
$758 |
3.1× |
| Radex Hand Minimum 3 Views (73130) |
$313.20 |
$783 |
3.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$104.40 |
$261 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$202.80 |
$507 |
1.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$267.20 |
$668 |
2.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$286.80 |
$717 |
3.0× |
| Radex shoulder complete minimum 2 views (73030) |
$428.80 |
$1,072 |
4.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$117.20 |
$293 |
1.2× |
| Radex Spine 1 View Specify Level (72020) |
$118.40 |
$296 |
1.2× |
| Radex Sternum Minimum 2 Views (71120) |
$205.20 |
$513 |
2.1× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$220.40 |
$551 |
2.3× |
| Radex Toe Minimum 2 Views (73660) |
$250 |
$625 |
2.6× |
| Radex upper extremity infant minimum 2 views (73092) |
$146.40 |
$366 |
1.3× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$342.80 |
$857 |
3.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$297.60 |
$744 |
2.6× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$9,874 |
$24,685 |
1.2× |
| Radiation treatment delivery level 1 (77402) |
$279.60 |
$699 |
2.5× |
| Radiation treatment delivery level 2 (77407) |
$736 |
$1,840 |
1.7× |
| Radiation treatment delivery level 3 (77412) |
$971.20 |
$2,428 |
1.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$276.40 |
$691 |
2.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$282.80 |
$707 |
2.4× |
| Radiologic exam colon double contrast study (74280) |
$519.60 |
$1,299 |
2.7× |
| Radiologic exam colon single contrast study (74270) |
$371.20 |
$928 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$437.60 |
$1,094 |
3.8× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$228 |
$570 |
2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$231.20 |
$578 |
1.2× |
| Radiologic exam swallow function contrast study (74230) |
$260.80 |
$652 |
1.3× |
| Radiologic exam teeth complete full mouth (70320) |
$418.40 |
$1,046 |
1.6× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$516.40 |
$1,291 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$360.80 |
$902 |
1.8× |
| Radiologic examination femur 1 view (73551) |
$118 |
$295 |
1.2× |
| Radiologic examination femur minimum 2 views (73552) |
$129.60 |
$324 |
1.3× |
| Radiologic examination knee 1/2 views (73560) |
$329.20 |
$823 |
3.4× |
| Radiologic Examination Osseous Survey Limited (77074) |
$209.60 |
$524 |
1.8× |
| Radiologic examination tibia & fibula 2 views (73590) |
$264.40 |
$661 |
2.7× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$430.80 |
$1,077 |
1.0× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$430.80 |
$1,077 |
1.0× |
| Ribs bilateral 3 views (71110) |
$428 |
$1,070 |
3.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$802 |
$2,005 |
1.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$1,924.80 |
$4,812 |
3.2× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$1,924.80 |
$4,812 |
3.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,162.80 |
$2,907 |
1.9× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$2,706.40 |
$6,766 |
1.7× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,004.80 |
$5,012 |
1.4× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$664 |
$1,660 |
2.6× |
| Rp Therapy Intravenous Administration (79101) |
$338.40 |
$846 |
1.3× |
| Scapula (73010) |
$235.20 |
$588 |
2.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$49.60 |
$124 |
2.1× |
| Sella turcica (70240) |
$102.80 |
$257 |
1.1× |
| Shoulder 1 view (73020) |
$197.20 |
$493 |
2.0× |
| Shoulder Arthrography (73040) |
$548 |
$1,370 |
1.4× |
| Skull less than 4 views (70250) |
$294.80 |
$737 |
2.5× |
| Special dosimetry (77331) |
$185.20 |
$463 |
1.2× |
| Special Physics Consult (77370) |
$240.40 |
$601 |
1.6× |
| Special teletherapy port plan (77321) |
$494.40 |
$1,236 |
1.2× |
| Special treatment procedure (77470) |
$1,063.20 |
$2,658 |
1.7× |
| Spleen Imaging (78185) |
$478.80 |
$1,197 |
1.1× |
| Stereotactic Body Radiation Delivery (77373) |
$2,202.40 |
$5,506 |
1.1× |
| Sternoclavicular joints (71130) |
$250.40 |
$626 |
2.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$494.40 |
$1,236 |
1.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$494.40 |
$1,236 |
1.2× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$402 |
$1,005 |
1.5× |
| Testicular Imaging W/Flow (78761) |
$518.40 |
$1,296 |
1.2× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$683.20 |
$1,708 |
1.6× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$683.20 |
$1,708 |
1.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$334.80 |
$837 |
2.2× |
| Thoracic spine 2 views (72070) |
$394.40 |
$986 |
3.4× |
| Thoracic spine 3 views (72072) |
$402.40 |
$1,006 |
3.5× |
| Thoracolumbar 2 views (72080) |
$263.60 |
$659 |
2.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$478.80 |
$1,197 |
1.1× |
| Thyroid Met Imaging Body (78018) |
$621.60 |
$1,554 |
1.0× |
| Thyroid Uptake Measurement (78012) |
$478.80 |
$1,197 |
1.1× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$478.80 |
$1,197 |
1.1× |
| Tx Devices Design & Construction Complex (77334) |
$433.20 |
$1,083 |
1.0× |
| Tx devices design & construction intermediate (77333) |
$229.60 |
$574 |
1.5× |
| Tx devices design & construction simple (77332) |
$229.60 |
$574 |
1.5× |
| Ultrasound Breast Limited (76642) |
$254.80 |
$637 |
2.6× |
| Ultrasound Elastography Parenchyma (76981) |
$362.80 |
$907 |
3.1× |
| Ultrasound Exam Aaa Screen (76706) |
$228.80 |
$572 |
2.0× |
| Ultrasound, abdomen limited (76705) |
$363.20 |
$908 |
3.1× |
| Umbilical-artery Doppler (OB) (76820) |
$181.60 |
$454 |
1.6× |
| Unlisted fluoroscopic procedure (76496) |
$220 |
$550 |
2.3× |
| Unlisted us procedure (76999) |
$136 |
$340 |
1.4× |
| Upper gi w/o kub (74240) |
$550.40 |
$1,376 |
2.8× |
| Ureteral Reflux Study (78740) |
$518.40 |
$1,296 |
1.2× |
| Urethrocystogram voiding (74455) |
$335.60 |
$839 |
1.3× |
| Urethrocystography retrograde (74450) |
$353.20 |
$883 |
1.3× |
| Us breast unilateral complete (76641) |
$310.80 |
$777 |
2.7× |
| Us chest (76604) |
$164.40 |
$411 |
1.4× |
| Us complete joint (76881) |
$325.60 |
$814 |
2.8× |
| Us exam, pelvic, limited (76857) |
$474.80 |
$1,187 |
4.1× |
| Us head (76506) |
$170 |
$425 |
1.5× |
| Us kidney transplant (76776) |
$168.80 |
$422 |
1.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$279.20 |
$698 |
2.4× |
| Us ob detailed single fetus (76811) |
$292.40 |
$731 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$278.40 |
$696 |
2.4× |
| Us ob transvaginal (76817) |
$314.80 |
$787 |
2.7× |
| Us pelvic non ob complete (76856) |
$474.80 |
$1,187 |
4.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$351.60 |
$879 |
3.0× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$376 |
$940 |
3.2× |
| Us retroperitoneal complete (76770) |
$459.20 |
$1,148 |
3.9× |
| Us retroperitoneal limited (76775) |
$234 |
$585 |
2.0× |
| Us scrotum and contents (76870) |
$474.80 |
$1,187 |
4.1× |
| Us spinal canal and contents (76800) |
$147.20 |
$368 |
1.3× |
| Us thyroid (76536) |
$346.40 |
$866 |
3.0× |
| Us transrectal (76872) |
$299.60 |
$749 |
2.6× |
| Vein X-Ray Chest (75827) |
$2,071.20 |
$5,178 |
1.2× |
| Venography caval inferior serialography rs&i (75825) |
$2,748.80 |
$6,872 |
0.8× |
| Venography extremity bilateral rs&i (75822) |
$832.40 |
$2,081 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$711.60 |
$1,779 |
0.4× |
| Venography Renal Bilateral (75833) |
$5,152.80 |
$12,882 |
1.5× |
| Venography Renal Unilateral (75831) |
$3,092 |
$7,730 |
0.9× |
| Vertebral fracture assessment via dxa (77086) |
$102.80 |
$257 |
1.1× |
| Wrist 2 views (73100) |
$174.80 |
$437 |
1.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$161.20 |
$403 |
1.7× |
| X-ray antegrade pyelogram tube (74425) |
$537.60 |
$1,344 |
1.4× |
| X-Ray Aorta Leg Arteries (75630) |
$3,375.20 |
$8,438 |
1.0× |
| X-Ray Bend Only L-S Spine (72120) |
$560.40 |
$1,401 |
4.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$197.20 |
$493 |
2.0× |
| X-Ray Exam Breast Specimen (76098) |
$705.60 |
$1,764 |
1.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$136.80 |
$342 |
1.4× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$159.20 |
$398 |
1.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$297.60 |
$744 |
2.6× |
| X-Ray Exam Hip Uni 1 View (73501) |
$118 |
$295 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$137.20 |
$343 |
1.4× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$159.20 |
$398 |
1.4× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$167.20 |
$418 |
1.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$167.20 |
$418 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$234.40 |
$586 |
2.0× |
| X-Ray Exam L-S Spine Bending (72114) |
$850.40 |
$2,126 |
7.3× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$460.80 |
$1,152 |
4.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$774 |
$1,935 |
6.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$415.60 |
$1,039 |
3.6× |
| X-ray humerus (73060) |
$210 |
$525 |
2.2× |
| X-ray IV pyelogram (ivp) (74400) |
$1,059.20 |
$2,648 |
5.4× |
| X-ray IV pyelogram+tomography (74415) |
$1,296 |
$3,240 |
6.6× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$240.40 |
$601 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$381.60 |
$954 |
3.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$483.20 |
$1,208 |
4.1× |
| X-ray nose-rectum child f.b. (76010) |
$202.80 |
$507 |
2.1× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$390.80 |
$977 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$222.40 |
$556 |
1.9× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$347.20 |
$868 |
3.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$364.40 |
$911 |
3.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$217.20 |
$543 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$368.40 |
$921 |
3.2× |
| X-ray thoracic spine 4 vw (72074) |
$453.60 |
$1,134 |
3.9× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$537.60 |
$1,344 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$244.40 |
$611 |
2.1× |
| X-Rays Bone Survey Complete (77075) |
$197.60 |
$494 |
1.7× |
| Xr c-spine 4 or 5 views (72050) |
$626.80 |
$1,567 |
5.4× |
| Xr facial bones less than 3 views (70140) |
$215.60 |
$539 |
2.2× |
| XR Mastoids < 3 Views Bilateral (70120) |
$138.40 |
$346 |
1.2× |
| Xr orbits complete 4 views (70200) |
$138.40 |
$346 |
1.2× |
| Xr Tomogram Single Plane (76100) |
$284 |
$710 |
2.4× |