| 3-D radiotherapy plan dose-volume histograms (77295) |
$3,605.73 |
$6,111.40 |
2.2× |
| Abdomen 1 View (74018) |
$134.34 |
$227.70 |
1.3× |
| Abdomen 2 views (74019) |
$243.45 |
$412.63 |
1.9× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$910.06 |
$1,542.47 |
1.9× |
| Angio internal mammary (75756) |
$5,301.93 |
$8,986.33 |
1.4× |
| Angio pulmonary bilat (75743) |
$5,970.72 |
$10,119.87 |
1.6× |
| Angiography extremity bilateral rs&i (75716) |
$5,970.72 |
$10,119.87 |
1.6× |
| Angiography extremity unilateral rs&i (75710) |
$5,970.72 |
$10,119.87 |
1.6× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$5,970.72 |
$10,119.87 |
1.6× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,745.73 |
$4,653.78 |
0.7× |
| Ankle 2 views (73600) |
$134.34 |
$227.70 |
1.3× |
| Aortography thoracic serialography rs&i (75605) |
$9,071.36 |
$15,375.18 |
1.4× |
| Artery X-Rays Abdomen (75726) |
$9,071.36 |
$15,375.18 |
1.4× |
| Artery X-Rays Adrenal Gland (75731) |
$5,970.72 |
$10,119.87 |
1.6× |
| Artery X-Rays Pelvis (75736) |
$9,071.36 |
$15,375.18 |
1.4× |
| Artery X-Rays Spine (75705) |
$4,368.37 |
$7,404.02 |
0.7× |
| Arthrogram ankle (73615) |
$975.40 |
$1,653.22 |
2.3× |
| Arthrogram hip (73525) |
$975.40 |
$1,653.22 |
2.3× |
| Arthrogram Wrist (73115) |
$673.57 |
$1,141.65 |
1.6× |
| Basic radiation dosimetry calculation (77300) |
$387.31 |
$656.45 |
2.4× |
| Bone age studies (77072) |
$244.45 |
$414.32 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$910.06 |
$1,542.47 |
1.9× |
| Bone Imaging Limited Area (78300) |
$722.58 |
$1,224.72 |
1.5× |
| Bone Imaging Multiple Areas (78305) |
$722.58 |
$1,224.72 |
1.5× |
| Bone Imaging Whole Body (78306) |
$722.58 |
$1,224.72 |
1.5× |
| Bone marrow imaging limited area (78102) |
$753.66 |
$1,277.39 |
1.6× |
| Bone marrow imaging; multiple areas (78103) |
$753.66 |
$1,277.39 |
1.6× |
| Bone marrow imaging; whole body (78104) |
$753.66 |
$1,277.39 |
1.6× |
| Bone survey infant (77076) |
$244.45 |
$414.32 |
2.0× |
| Brachytx isodose complex (77318) |
$675.96 |
$1,145.70 |
1.5× |
| Brachytx isodose intermed (77317) |
$675.96 |
$1,145.70 |
1.5× |
| Brachytx Isodose Plan Simple (77316) |
$981.71 |
$1,663.91 |
2.2× |
| Brain Image W/Flow < 4 Views (78601) |
$1,233.59 |
$2,090.83 |
2.6× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$1,233.59 |
$2,090.83 |
1.9× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,867.62 |
$4,860.37 |
1.7× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$831.36 |
$1,409.08 |
1.7× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,478.63 |
$2,506.16 |
3.5× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$1,478.63 |
$2,506.16 |
1.6× |
| Cat Scan Follow-Up Study (76380) |
$266.56 |
$451.80 |
2.6× |
| Cerebrospinal Fluid Scan (78630) |
$1,233.59 |
$2,090.83 |
1.9× |
| Chest 1 view (71045) |
$134.34 |
$227.70 |
1.3× |
| Chest 2 views (71046) |
$134.34 |
$227.70 |
1.3× |
| Chest 3 views (71047) |
$191.25 |
$324.16 |
1.8× |
| Chest 4 or more views (71048) |
$243.45 |
$412.63 |
1.9× |
| Chg us nrv&acc strux 1 xtr compre w/img pr extremity (76883) |
$260.23 |
$441.07 |
2.1× |
| Clavicle complete (73000) |
$134.34 |
$227.70 |
1.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$303.02 |
$513.59 |
2.4× |
| Continuing medical physics consltj pr wk (77336) |
$416.60 |
$706.10 |
2.6× |
| Contrast Exam Abdominl Aorta (75625) |
$5,970.72 |
$10,119.87 |
1.6× |
| Contrast X-Ray Bladder (74430) |
$642.78 |
$1,089.45 |
1.5× |
| Contrast X-Ray Of Elbow (73085) |
$970.68 |
$1,645.22 |
2.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$975.40 |
$1,653.22 |
2.3× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$439.47 |
$744.87 |
2.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,298.74 |
$2,201.25 |
3.1× |
| CT abdomen and pelvis without contrast (74176) |
$823.59 |
$1,395.91 |
2.9× |
| CT abdomen w contrast (74160) |
$799.68 |
$1,355.39 |
3.8× |
| CT abdomen w wo contrast (74170) |
$886.35 |
$1,502.28 |
4.2× |
| CT abdomen w/o contrast (74150) |
$467.38 |
$792.17 |
3.7× |
| CT Angio Abdomen and Pelvis (74174) |
$1,298.74 |
$2,201.25 |
3.1× |
| CT Angio Chest (71275) |
$913.24 |
$1,547.86 |
4.3× |
| CT Angio Head (70496) |
$913.24 |
$1,547.86 |
4.3× |
| CT angio hrt w/3d image (75574) |
$719 |
$1,218.64 |
1.7× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$913.24 |
$1,547.86 |
4.3× |
| CT Angio Neck (70498) |
$913.24 |
$1,547.86 |
4.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$913.24 |
$1,547.86 |
4.3× |
| CT cervical spine w/ contrast (72126) |
$924.59 |
$1,567.11 |
2.2× |
| CT cervical spine w/o contrast (72125) |
$467.38 |
$792.17 |
3.7× |
| CT cervical spine w/wo cont (72127) |
$886.35 |
$1,502.28 |
4.2× |
| CT chest w contrast (71260) |
$799.68 |
$1,355.39 |
3.8× |
| CT chest w/wo contrast (71270) |
$886.35 |
$1,502.28 |
4.2× |
| CT colonography screening (74263) |
$1,873.10 |
$3,174.74 |
6.5× |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
$596.09 |
$1,010.32 |
4.8× |
| CT head/brain with contrast (70460) |
$799.68 |
$1,355.39 |
3.8× |
| CT head/brain without and with contrast (70470) |
$886.35 |
$1,502.28 |
4.2× |
| CT heart contrast eval cardiac structure&morph (75572) |
$719 |
$1,218.64 |
1.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$156.71 |
$265.61 |
1.5× |
| CT hrt w/3d image congen (75573) |
$719 |
$1,218.64 |
1.7× |
| CT iac w contrast (70481) |
$799.68 |
$1,355.39 |
3.8× |
| CT l-spine w&w/o contrast (72133) |
$886.35 |
$1,502.28 |
4.2× |
| CT lower ext w/o (73700) |
$467.38 |
$792.17 |
3.7× |
| CT lower extremity w/contrast material (73701) |
$799.68 |
$1,355.39 |
3.8× |
| CT lumbar spine w contrast (72132) |
$924.59 |
$1,567.11 |
2.2× |
| CT lumbar spine w/o contrast (72131) |
$467.38 |
$792.17 |
3.7× |
| CT maxillofacial w contrast (70487) |
$799.68 |
$1,355.39 |
3.8× |
| CT maxillofacial wo contrast (70486) |
$467.38 |
$792.17 |
3.7× |
| CT neck tissue combo (70492) |
$886.35 |
$1,502.28 |
4.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$886.35 |
$1,502.28 |
4.2× |
| CT orbits w/o contrast (70480) |
$467.38 |
$792.17 |
3.7× |
| CT pelvis w&w/o contrast (72194) |
$886.35 |
$1,502.28 |
4.2× |
| CT pelvis w/o contrast (72192) |
$467.38 |
$792.17 |
3.7× |
| CT scan of leg combo (73702) |
$886.35 |
$1,502.28 |
4.2× |
| CT scans face/jaw combo (70488) |
$886.35 |
$1,502.28 |
4.2× |
| CT soft tissue neck w contrast (70491) |
$799.68 |
$1,355.39 |
3.8× |
| CT soft tissue neck w/o contrast (70490) |
$467.38 |
$792.17 |
3.7× |
| CT thoracic spine w contrast (72129) |
$799.68 |
$1,355.39 |
3.8× |
| CT thoracic spine w/o contrast (72128) |
$467.38 |
$792.17 |
3.7× |
| CT thoracic spine w/wo cont (72130) |
$431.24 |
$730.91 |
2.1× |
| CT thorax w/o contrast (71250) |
$467.38 |
$792.17 |
3.7× |
| CT unlisted procedure (76497) |
$266.56 |
$451.80 |
2.6× |
| CT upper ext wo (73200) |
$467.38 |
$792.17 |
3.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$886.35 |
$1,502.28 |
4.2× |
| CT upper extremity with contrast (73201) |
$799.68 |
$1,355.39 |
1.9× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$913.24 |
$1,547.86 |
4.3× |
| Cta Abdomen (74175) |
$913.24 |
$1,547.86 |
4.3× |
| CTA pelvis (72191) |
$913.24 |
$1,547.86 |
4.3× |
| Discography Cerv/Thor Spine (72285) |
$4,601.63 |
$7,799.37 |
2.0× |
| Diskography lumbar (72295) |
$3,682.84 |
$6,242.11 |
1.6× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$244.45 |
$414.32 |
2.0× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$490.09 |
$830.66 |
3.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$244.45 |
$414.32 |
2.0× |
| Dxa Bone Density Axial (77080) |
$244.45 |
$414.32 |
2.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$134.34 |
$227.70 |
1.3× |
| Echo exam of fetal heart (76825) |
$1,035.17 |
$1,754.52 |
1.6× |
| Echo exam uterus (76831) |
$490.09 |
$830.66 |
1.7× |
| Echo Guide For Artery Repair (76936) |
$529.25 |
$897.04 |
2.0× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$494.11 |
$837.48 |
1.7× |
| Esophageal Motility Study (78258) |
$789.42 |
$1,338 |
1.6× |
| Esophagram (74220) |
$537.57 |
$911.13 |
2.6× |
| Fetal Biophys Profile W/Nst (76818) |
$267.75 |
$453.82 |
2.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$267.75 |
$453.82 |
2.1× |
| Fetal MRI w/placntl matrnl plvc img sing/1st ges (74712) |
$736.33 |
$1,248.02 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$490.09 |
$830.66 |
1.7× |
| Follow-Up Angiography (75898) |
$2,745.73 |
$4,653.78 |
0.7× |
| Foot 2 views (73620) |
$134.34 |
$227.70 |
1.3× |
| Forearm 2 views (73090) |
$134.34 |
$227.70 |
1.3× |
| Gastric emptying imaging study (78264) |
$775.08 |
$1,313.70 |
1.6× |
| Gastroesophageal Reflux Exam (78262) |
$722.58 |
$1,224.71 |
1.5× |
| Gated Heart Planar Single (78472) |
$831.36 |
$1,409.08 |
1.7× |
| Hand 2 views (73120) |
$244.45 |
$414.32 |
2.0× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77772) |
$1,978.29 |
$3,353.03 |
2.4× |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
$1,602.35 |
$2,715.85 |
1.9× |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
$1,602.35 |
$2,715.85 |
1.9× |
| Heart Image (Pet) Multiple (78492) |
$2,867.62 |
$4,860.37 |
1.7× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$5,970.72 |
$10,119.87 |
1.6× |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
$5,301.93 |
$8,986.33 |
1.4× |
| Hepatobil Syst Image W/Drug (78227) |
$1,181.40 |
$2,002.38 |
1.8× |
| Hepatobiliary System Imaging (78226) |
$846.30 |
$1,434.41 |
1.8× |
| Ht Musc Image Planar Mult (78454) |
$2,489.43 |
$4,219.38 |
1.6× |
| Ht Muscle Image Spect Sing (78451) |
$2,471.37 |
$4,188.76 |
1.6× |
| Hysterosalpingogram (74740) |
$687.92 |
$1,165.96 |
2.4× |
| Image fusion (77399) |
$306.33 |
$519.20 |
1.9× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$194.84 |
$330.24 |
1.9× |
| Infant hip ultrasound, limited static exam (76886) |
$195.81 |
$331.88 |
1.9× |
| Interstitial radiation source applic complex (77778) |
$1,602.35 |
$2,715.85 |
1.9× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$1,073.42 |
$1,819.35 |
1.6× |
| Intraop radiaj tx deliver xray single tx session (77424) |
$16,139.48 |
$27,355.05 |
1.8× |
| K Flow/Funct Image W/Drug (78708) |
$963.68 |
$1,633.35 |
1.5× |
| K Flow/Funct Image W/O Drug (78707) |
$963.68 |
$1,633.35 |
1.5× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$722.58 |
$1,224.72 |
1.5× |
| Kidney Imaging Morphol (78700) |
$895.91 |
$1,518.49 |
1.9× |
| Knee 3 Views (73562) |
$134.34 |
$227.70 |
1.3× |
| Leveen/Shunt Patency Exam (78291) |
$722.58 |
$1,224.72 |
1.5× |
| Liver & Spleen Imaging Static Only (78215) |
$846.30 |
$1,434.41 |
1.8× |
| Liver imaging static only (78201) |
$1,035.76 |
$1,755.53 |
1.6× |
| Lung Perf&Ventilat Diferentl (78598) |
$963.68 |
$1,633.35 |
1.5× |
| Lung perfusion differential (78597) |
$722.58 |
$1,224.72 |
1.5× |
| Lung Ventilat&Perfus Imaging (78582) |
$963.68 |
$1,633.35 |
1.5× |
| Lung Ventilation Imaging (78579) |
$722.58 |
$1,224.72 |
1.5× |
| Lymph System Imaging (78195) |
$963.68 |
$1,633.35 |
1.5× |
| Lymphangiography extremity only unilateral rs&i (75801) |
$1,302.91 |
$2,208.32 |
1.7× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$5,301.93 |
$8,986.33 |
1.4× |
| Lymphangiography, pelvic/abdominal, unilateral (75805) |
$2,745.73 |
$4,653.78 |
0.7× |
| Magnetic Image Jaw Joint (70336) |
$910.85 |
$1,543.81 |
3.2× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70558) |
$1,223.43 |
$2,073.61 |
5.8× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70557) |
$910.85 |
$1,543.81 |
1.4× |
| Magnetic resonance (eg, proton) imaging, brain (including brain stem andskull base), during open intracranial procedure… (70559) |
$1,765.82 |
$2,992.91 |
8.4× |
| Magnetic Resonance Elastography (76391) |
$496.07 |
$840.79 |
1.7× |
| Mammary ductogram or galactogram single (77053) |
$490.09 |
$830.66 |
1.7× |
| Meckels Divert Exam (78290) |
$910.06 |
$1,542.47 |
1.9× |
| Medical physics dose eval radiation expos w/rprt (76145) |
$817.53 |
$1,385.65 |
1.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,762.27 |
$2,986.90 |
3.9× |
| Mr safety determination physician/other qhp (76016) |
$217.34 |
$368.38 |
2.1× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$60.45 |
$102.45 |
1.7× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$226.57 |
$384.02 |
2.0× |
| Mr safety implt pos&/immoblj (76019) |
$146.62 |
$248.50 |
2.1× |
| Mr safety med physics xm customization plng&mntr (76017) |
$596.64 |
$1,011.26 |
2.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRA head w/o contrast (70544) |
$910.85 |
$1,543.81 |
3.2× |
| MRA head with contrast (70545) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRA neck w contrast (70548) |
$1,223.43 |
$2,073.61 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRA neck w/o contrast (70547) |
$910.85 |
$1,543.81 |
3.2× |
| MRI abdomen w contrast (74182) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRI abdomen w/o contrast (74181) |
$910.85 |
$1,543.81 |
3.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,425.45 |
$2,416.01 |
1.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,425.45 |
$2,416.01 |
1.5× |
| MRI brain functional w/o physician admnistration (70554) |
$910.85 |
$1,543.81 |
3.2× |
| MRI brain functional w/physician admnistration (70555) |
$1,182.39 |
$2,004.05 |
4.1× |
| MRI Breast W/O Contrast Bilateral (77047) |
$496.44 |
$841.42 |
1.7× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$496.44 |
$841.42 |
1.7× |
| MRI cardiac w/o contrast (75557) |
$910.85 |
$1,543.81 |
3.2× |
| MRI cervical spine w contrast (72142) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRI cervical spine w/o cont (72141) |
$910.85 |
$1,543.81 |
3.2× |
| MRI chest w/o contrast (71550) |
$910.85 |
$1,543.81 |
3.2× |
| MRI chest wo w contrast (71552) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$910.85 |
$1,543.81 |
3.2× |
| MRI lumbar spine w contrast (72149) |
$1,223.43 |
$2,073.61 |
2.9× |
| Mri Neck Spine W/O & W/Dye (72156) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI orbit face &/neck w/o contrast (70540) |
$910.85 |
$1,543.81 |
3.2× |
| MRI orbit face neck w contrast (70542) |
$1,223.43 |
$2,073.61 |
2.9× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI pelvis w contrast (72196) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRI pelvis w/o & w contrast (72197) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI pelvis w/o contrast (72195) |
$910.85 |
$1,543.81 |
3.2× |
| MRI spectroscopy (76390) |
$1,067.44 |
$1,809.22 |
10.2× |
| MRI thoracic spine w/o contrast (72146) |
$910.85 |
$1,543.81 |
3.2× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$691.18 |
$1,171.49 |
1.7× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$910.85 |
$1,543.81 |
3.2× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI, abdomen, combo (74183) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI, dorsal spine combo (72157) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI, dorsal spine contrast (72147) |
$1,223.43 |
$2,073.61 |
2.9× |
| MRI, joint upper extrem (73221) |
$910.85 |
$1,543.81 |
3.2× |
| MRI, joint upper extrem combo (73223) |
$1,478.63 |
$2,506.16 |
3.5× |
| MRI, lumbar spine combo (72158) |
$1,478.63 |
$2,506.16 |
3.5× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$2,841.32 |
$4,815.80 |
1.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,471.37 |
$4,188.76 |
1.6× |
| Myocrd Img Pet Metab Eval Single Study Cncrnt CT (78429) |
$3,190.43 |
$5,407.50 |
1.9× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$3,190.43 |
$5,407.50 |
1.9× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$5,755.99 |
$9,755.91 |
2.2× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,898.05 |
$9,996.69 |
2.2× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$5,898.05 |
$9,996.69 |
3.2× |
| N-invas est c ffr sw aly CTA (75580) |
$2,469.23 |
$4,185.13 |
2.4× |
| Neck soft tissue (70360) |
$134.34 |
$227.70 |
1.3× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$722.58 |
$1,224.72 |
1.5× |
| Nm myocard infarct spect (78469) |
$2,558.04 |
$4,335.66 |
3.9× |
| Nm whole blood volume (78122) |
$1,172.63 |
$1,987.51 |
1.8× |
| Nonvascular Shunt X-Ray (75809) |
$244.45 |
$414.32 |
2.0× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$5,647.48 |
$9,572 |
3.4× |
| Nuclear Rx Intra-Arterial (79445) |
$609.62 |
$1,033.26 |
2.2× |
| Nuclear Rx Oral Admin (79005) |
$637.12 |
$1,079.86 |
2.3× |
| Ob us nuchal meas 1 gest (76813) |
$262.83 |
$445.48 |
2.1× |
| Oph bmtry us echograpy a-scan io lens pwr cal (76519) |
$267.75 |
$453.82 |
2.1× |
| Oph us dx ant sgm us immersion b-scan/hr biom (76513) |
$267.75 |
$453.82 |
2.1× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$567.19 |
$961.34 |
3.6× |
| Ophthalmic Biometry US Echograpy a-Scan (76516) |
$243.45 |
$412.63 |
1.9× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$267.75 |
$453.82 |
2.1× |
| Panoramic X-ray of jaws (70355) |
$134.34 |
$227.70 |
1.3× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$973.72 |
$1,650.38 |
1.5× |
| Parathyroid Planar Imaging (78070) |
$722.58 |
$1,224.72 |
1.5× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$866.62 |
$1,468.85 |
1.8× |
| Pelvis 1 or 2 views (72170) |
$244.45 |
$414.32 |
2.0× |
| Perineogram (74775) |
$683.62 |
$1,158.67 |
2.4× |
| Peritoneogram Rs&I (74190) |
$1,166.51 |
$1,977.14 |
1.8× |
| Pet Image W/Ct Lmtd (78814) |
$2,867.62 |
$4,860.37 |
1.7× |
| PET image w/CT, full body (78816) |
$3,698.12 |
$6,268 |
2.2× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,698.12 |
$6,268 |
2.2× |
| Pet Myocardial Sngl Study (78491) |
$2,867.62 |
$4,860.37 |
1.7× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$5,970.72 |
$10,119.87 |
1.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$722.58 |
$1,224.72 |
1.5× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$244.45 |
$414.32 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$975.40 |
$1,653.22 |
1.5× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$134.34 |
$227.70 |
1.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$134.34 |
$227.70 |
1.3× |
| Radex elbow complete minimum 3 views (73080) |
$134.34 |
$227.70 |
1.3× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$244.45 |
$414.32 |
2.0× |
| Radex fingr minimum 2 views (73140) |
$134.34 |
$227.70 |
1.3× |
| Radex foot complete minimum 3 views (73630) |
$134.34 |
$227.70 |
1.3× |
| Radex Hand Minimum 3 Views (73130) |
$134.34 |
$227.70 |
1.3× |
| Radex lower extremity infant minimum 2 views (73592) |
$134.34 |
$227.70 |
1.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$244.45 |
$414.32 |
2.0× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$134.34 |
$227.70 |
1.3× |
| Radex Ribs Unilateral 2 Views (71100) |
$134.34 |
$227.70 |
1.3× |
| Radex shoulder complete minimum 2 views (73030) |
$134.34 |
$227.70 |
1.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$134.34 |
$227.70 |
1.3× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$390.62 |
$662.06 |
1.9× |
| Radex Spine 1 View Specify Level (72020) |
$134.34 |
$227.70 |
1.3× |
| Radex Sternum Minimum 2 Views (71120) |
$134.34 |
$227.70 |
1.3× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$134.34 |
$227.70 |
1.3× |
| Radex Toe Minimum 2 Views (73660) |
$134.34 |
$227.70 |
1.3× |
| Radex upper extremity infant minimum 2 views (73092) |
$244.45 |
$414.32 |
2.0× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$134.34 |
$227.70 |
1.3× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$516.99 |
$876.25 |
4.1× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$27,961.72 |
$47,392.75 |
3.2× |
| Radiation treatment delivery level 1 (77402) |
$498.21 |
$844.43 |
4.1× |
| Radiation treatment delivery level 2 (77407) |
$588.11 |
$996.79 |
1.3× |
| Radiation treatment delivery level 3 (77412) |
$1,154.63 |
$1,957 |
1.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$244.45 |
$414.32 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$243.45 |
$412.63 |
1.9× |
| Radiologic exam colon double contrast study (74280) |
$537.57 |
$911.13 |
2.6× |
| Radiologic exam colon single contrast study (74270) |
$537.57 |
$911.13 |
2.6× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$390.62 |
$662.06 |
1.9× |
| Radiologic exam knee complete 4/more views (73564) |
$244.45 |
$414.32 |
2.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$244.45 |
$414.32 |
2.0× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$306.74 |
$519.89 |
1.5× |
| Radiologic exam swallow function contrast study (74230) |
$306.74 |
$519.89 |
1.5× |
| Radiologic exam teeth complete full mouth (70320) |
$490.09 |
$830.66 |
1.7× |
| Radiologic Exam Teeth Prtl Exam < Full Mouth (70310) |
$975.40 |
$1,653.22 |
3.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$537.57 |
$911.13 |
2.6× |
| Radiologic examination femur 1 view (73551) |
$164.36 |
$278.58 |
1.6× |
| Radiologic examination femur minimum 2 views (73552) |
$164.36 |
$278.58 |
1.6× |
| Radiologic examination knee 1/2 views (73560) |
$134.34 |
$227.70 |
1.3× |
| Radiologic Examination Osseous Survey Limited (77074) |
$244.45 |
$414.32 |
2.0× |
| Radiologic examination tibia & fibula 2 views (73590) |
$134.34 |
$227.70 |
1.3× |
| Radiologic examination, teeth; single view Non-Facility (70300) |
$134.34 |
$227.70 |
1.3× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77768) |
$874.99 |
$1,483.03 |
1.9× |
| Remote afterloading high dose rate radionuclide skin surface brachytherapy, includes basic dosimetry, when performed;… (77767) |
$545.08 |
$923.86 |
1.2× |
| Ribs bilateral 3 views (71110) |
$244.45 |
$414.32 |
2.0× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$807.45 |
$1,368.56 |
1.7× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,351.93 |
$2,291.41 |
2.8× |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
$2,570.58 |
$4,356.91 |
3.9× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$2,558.04 |
$4,335.66 |
3.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,351.93 |
$2,291.41 |
2.1× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$2,727.45 |
$4,622.79 |
1.8× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$3,094.30 |
$5,244.58 |
1.8× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$2,727.45 |
$4,622.79 |
1.8× |
| Rp Therapy Intravenous Administration (79101) |
$637.12 |
$1,079.86 |
2.3× |
| Salivary Gland Imaging Serial Images (78231) |
$722.58 |
$1,224.72 |
1.5× |
| Scapula (73010) |
$243.45 |
$412.63 |
1.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$80.69 |
$136.76 |
3.5× |
| Shoulder 1 view (73020) |
$134.34 |
$227.70 |
1.3× |
| Shoulder Arthrography (73040) |
$970.68 |
$1,645.22 |
2.3× |
| Skull less than 4 views (70250) |
$244.45 |
$414.32 |
2.0× |
| Special dosimetry (77331) |
$306.33 |
$519.20 |
1.9× |
| Special Physics Consult (77370) |
$432.52 |
$733.09 |
2.7× |
| Special teletherapy port plan (77321) |
$981.71 |
$1,663.91 |
2.2× |
| Special treatment procedure (77470) |
$1,073.42 |
$1,819.35 |
1.6× |
| Stereotactic Body Radiation Delivery (77373) |
$4,988.45 |
$8,455 |
2.3× |
| Sternoclavicular joints (71130) |
$134.34 |
$227.70 |
1.3× |
| Superior sagittal sinus venogram (75870) |
$2,745.73 |
$4,653.78 |
0.7× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$289.31 |
$490.36 |
2.4× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$981.71 |
$1,663.91 |
2.2× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$675.96 |
$1,145.70 |
1.5× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$1,590.64 |
$2,696 |
3.5× |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
$1,182.19 |
$2,003.71 |
2.6× |
| Ther rad simulaj-aided field setting simple (77280) |
$869.66 |
$1,474 |
5.4× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$537.57 |
$911.13 |
2.6× |
| Thoracic spine 2 views (72070) |
$244.45 |
$414.32 |
2.0× |
| Thoracic spine 3 views (72072) |
$244.45 |
$414.32 |
2.0× |
| Thoracolumbar 2 views (72080) |
$134.34 |
$227.70 |
1.3× |
| Thyroid Imaging With Vascular Flow (78013) |
$722.58 |
$1,224.72 |
1.5× |
| Thyroid Met Imaging Body (78018) |
$963.68 |
$1,633.35 |
1.5× |
| Thyroid Uptake Measurement (78012) |
$722.58 |
$1,224.72 |
1.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$722.58 |
$1,224.72 |
1.5× |
| Tx Devices Design & Construction Complex (77334) |
$675.96 |
$1,145.70 |
1.5× |
| Tx devices design & construction intermediate (77333) |
$375.68 |
$636.75 |
2.3× |
| Tx devices design & construction simple (77332) |
$306.33 |
$519.20 |
1.9× |
| Ultrasound Breast Limited (76642) |
$195.29 |
$331 |
1.9× |
| Ultrasound Elastography Parenchyma (76981) |
$242.25 |
$410.60 |
1.9× |
| Ultrasound Exam Aaa Screen (76706) |
$303.61 |
$514.60 |
2.4× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$625.32 |
$1,059.86 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$267.75 |
$453.82 |
2.1× |
| Umbilical-artery Doppler (OB) (76820) |
$244.45 |
$414.32 |
2.0× |
| Unlisted Dx Radiographic Procedure (76499) |
$204.37 |
$346.39 |
2.0× |
| Unlisted fluoroscopic procedure (76496) |
$307.80 |
$521.70 |
3.0× |
| Unlisted magnetic resonance procedure (76498) |
$910.85 |
$1,543.81 |
8.7× |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
$722.58 |
$1,224.72 |
1.5× |
| Unlisted us procedure (76999) |
$174.52 |
$295.80 |
1.7× |
| Upper gi w/o kub (74240) |
$537.57 |
$911.13 |
2.6× |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
$48.41 |
$82.05 |
4.4× |
| Urea breath test c-14 isotopic analysis (78268) |
$417.77 |
$708.08 |
4.4× |
| Ureteral Reflux Study (78740) |
$895.91 |
$1,518.49 |
1.9× |
| Urethrocystogram voiding (74455) |
$564.20 |
$956.27 |
2.0× |
| Urethrocystography retrograde (74450) |
$683.62 |
$1,158.67 |
2.4× |
| Us breast unilateral complete (76641) |
$262.83 |
$445.48 |
2.1× |
| Us chest (76604) |
$244.45 |
$414.32 |
2.0× |
| Us complete joint (76881) |
$267.75 |
$453.82 |
2.1× |
| Us exam, pelvic, limited (76857) |
$244.45 |
$414.32 |
2.0× |
| Us head (76506) |
$244.45 |
$414.32 |
2.0× |
| Us kidney transplant (76776) |
$311.99 |
$528.80 |
2.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$243.45 |
$412.63 |
1.9× |
| Us ob detailed single fetus (76811) |
$467.34 |
$792.10 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$244.45 |
$414.32 |
2.0× |
| Us ob transvaginal (76817) |
$244.45 |
$414.32 |
2.0× |
| Us pelvic non ob complete (76856) |
$267.75 |
$453.82 |
2.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$267.75 |
$453.82 |
2.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$244.45 |
$414.32 |
2.0× |
| Us retroperitoneal complete (76770) |
$267.75 |
$453.82 |
2.1× |
| Us retroperitoneal limited (76775) |
$267.75 |
$453.82 |
2.1× |
| Us scrotum and contents (76870) |
$267.75 |
$453.82 |
2.1× |
| Us spinal canal and contents (76800) |
$292.69 |
$496.09 |
2.3× |
| Us thyroid (76536) |
$267.75 |
$453.82 |
2.1× |
| Us transrectal (76872) |
$267.75 |
$453.82 |
2.1× |
| Vein X-Ray Chest (75827) |
$1,926.29 |
$3,264.90 |
1.0× |
| Vein X-Ray Liver W/O Hemodyn (75887) |
$2,745.73 |
$4,653.78 |
0.7× |
| Vein X-Ray Spleen/Liver (75810) |
$6,911.01 |
$11,713.58 |
1.8× |
| Venogram Sinus/Jugular (75860) |
$5,301.93 |
$8,986.33 |
1.4× |
| Venography Adrenal Unilateral (75840) |
$5,970.72 |
$10,119.87 |
1.6× |
| Venography caval inferior serialography rs&i (75825) |
$5,970.72 |
$10,119.87 |
1.6× |
| Venography extremity bilateral rs&i (75822) |
$2,745.73 |
$4,653.78 |
1.5× |
| Venography extremity unilateral rs&i (75820) |
$1,926.29 |
$3,264.90 |
1.0× |
| Venography Renal Bilateral (75833) |
$5,301.93 |
$8,986.33 |
1.4× |
| Venography Renal Unilateral (75831) |
$5,301.93 |
$8,986.33 |
1.4× |
| Venous sampling by catheter (75893) |
$4,182.49 |
$7,088.97 |
0.6× |
| Wrist 2 views (73100) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$134.34 |
$227.70 |
1.3× |
| X-ray antegrade pyelogram tube (74425) |
$975.40 |
$1,653.22 |
2.3× |
| X-Ray Aorta Leg Arteries (75630) |
$5,970.72 |
$10,119.87 |
1.6× |
| X-Ray Bend Only L-S Spine (72120) |
$243.45 |
$412.63 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Exam Breast Specimen (76098) |
$1,035.17 |
$1,754.52 |
1.6× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$164.36 |
$278.58 |
1.6× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$271.34 |
$459.90 |
2.2× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$516.99 |
$876.25 |
4.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$164.36 |
$278.58 |
1.6× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$164.36 |
$278.58 |
1.6× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$271.34 |
$459.90 |
2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$271.34 |
$459.90 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$271.34 |
$459.90 |
2.2× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$515.58 |
$873.87 |
4.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$244.45 |
$414.32 |
2.0× |
| X-ray eye for foreign body (70030) |
$134.34 |
$227.70 |
1.3× |
| X-ray head for orthodontia (70350) |
$164.61 |
$279 |
1.6× |
| X-ray humerus (73060) |
$134.34 |
$227.70 |
1.3× |
| X-ray IV pyelogram (ivp) (74400) |
$564.20 |
$956.27 |
2.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$244.45 |
$414.32 |
2.0× |
| X-ray nose-rectum child f.b. (76010) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$134.34 |
$227.70 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$191.25 |
$324.16 |
1.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Stress View (77071) |
$204.37 |
$346.39 |
2.0× |
| X-ray thoracic spine 4 vw (72074) |
$244.45 |
$414.32 |
2.0× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$975.40 |
$1,653.22 |
2.3× |
| X-Rays Bone Length Studies (77073) |
$243.45 |
$412.63 |
1.9× |
| X-Rays Bone Survey Complete (77075) |
$244.45 |
$414.32 |
2.0× |
| Xr c-spine 4 or 5 views (72050) |
$244.45 |
$414.32 |
2.0× |
| Xr facial bones less than 3 views (70140) |
$134.34 |
$227.70 |
1.3× |
| Xr orbits complete 4 views (70200) |
$244.45 |
$414.32 |
2.0× |