CPT 70010 70015 70015 70015 70030 70030 70030 70100 70100 70100 70110 70110 70110 70120 70120 70120 70130 70130 70130 70134 70134 70134 70140 70140 70140 70150 70150 70150 70160 70160 70160 70170 70170 70170 70190 70190 70190 70200 70200 70200 70210 70210 70210 70220 70220 70220 Mod Status TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A Description Contrast x‐ray of brain Contrast x‐ray of brain Contrast x‐ray of brain Contrast x‐ray of brain X‐ray eye for foreign body X‐ray eye for foreign body X‐ray eye for foreign body X‐ray exam of jaw <4views X‐ray exam of jaw <4views X‐ray exam of jaw <4views X‐ray exam of jaw 4/> views X‐ray exam of jaw 4/> views X‐ray exam of jaw 4/> views X‐ray exam of mastoids X‐ray exam of mastoids X‐ray exam of mastoids X‐ray exam of mastoids X‐ray exam of mastoids X‐ray exam of mastoids X‐ray exam of middle ear X‐ray exam of middle ear X‐ray exam of middle ear X‐ray exam of facial bones X‐ray exam of facial bones X‐ray exam of facial bones X‐ray exam of facial bones X‐ray exam of facial bones X‐ray exam of facial bones X‐ray exam of nasal bones X‐ray exam of nasal bones X‐ray exam of nasal bones X‐ray exam of tear duct X‐ray exam of tear duct X‐ray exam of tear duct X‐ray exam of eye sockets X‐ray exam of eye sockets X‐ray exam of eye sockets X‐ray exam of eye sockets X‐ray exam of eye sockets X‐ray exam of eye sockets X‐ray exam of sinuses X‐ray exam of sinuses X‐ray exam of sinuses X‐ray exam of sinuses X‐ray exam of sinuses X‐ray exam of sinuses 2013 Payment 2014 Payment Subject to % Change Rate Rate DRA Cap $62.60 $65.62 4.80% $99.35 $92.37 ‐7.00% Y $157.53 $153.00 ‐2.90% Y $58.18 $60.63 4.20% Y $21.77 $21.04 ‐3.40% Y $29.94 $29.60 ‐1.10% Y $8.17 $8.56 4.80% Y $26.88 $26.04 ‐3.10% Y $35.72 $35.31 ‐1.20% Y $8.85 $9.27 4.80% Y $28.58 $27.46 ‐3.90% Y $40.83 $39.95 ‐2.20% Y $12.25 $12.48 1.90% Y $28.24 $27.11 ‐4.00% Y $37.09 $36.38 ‐1.90% Y $8.85 $9.27 4.80% Y $43.89 $41.02 ‐6.60% Y $60.56 $58.13 ‐4.00% Y $16.67 $17.12 2.70% Y $15.99 $18.19 13.70% Y $47.29 $55.99 18.40% Y $31.30 $37.81 20.80% Y $21.09 $20.33 ‐3.60% Y $30.96 $30.67 ‐0.90% Y $9.87 $10.34 4.80% Y $31.30 $29.96 ‐4.30% Y $43.89 $43.16 ‐1.70% Y $12.59 $13.20 4.80% Y $26.20 $25.32 ‐3.30% Y $34.70 $33.88 ‐2.40% Y $8.51 $8.56 0.60% Y $14.97 $15.34 2.40% Y $0.00 $0.00 Y $0.00 $0.00 Y $26.88 $26.04 ‐3.10% Y $37.43 $37.09 ‐0.90% Y $10.55 $11.06 4.80% Y $31.30 $30.32 ‐3.20% Y $44.91 $44.58 ‐0.70% Y $13.61 $14.27 4.80% Y $23.48 $22.47 ‐4.30% Y $31.98 $31.39 ‐1.90% Y $8.92 4.80% Y $8.51 $27.90 $26.39 ‐5.40% Y $40.15 $39.23 ‐2.30% Y $12.25 $12.84 4.80% Y 70240 70240 70240 70250 70250 70250 70260 70260 70260 70300 70300 70300 70310 70310 70310 70320 70320 70320 70328 70328 70328 70330 70330 70330 70332 70332 70332 70336 70336 70336 70350 70350 70350 70355 70355 70355 70360 70360 70360 70370 70370 70370 70371 70371 70371 70373 70373 70373 70380 70380 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X‐ray exam pituitary saddle X‐ray exam pituitary saddle X‐ray exam pituitary saddle X‐ray exam of skull X‐ray exam of skull X‐ray exam of skull X‐ray exam of skull X‐ray exam of skull X‐ray exam of skull X‐ray exam of teeth X‐ray exam of teeth X‐ray exam of teeth X‐ray exam of teeth X‐ray exam of teeth X‐ray exam of teeth Full mouth x‐ray of teeth Full mouth x‐ray of teeth Full mouth x‐ray of teeth X‐ray exam of jaw joint X‐ray exam of jaw joint X‐ray exam of jaw joint X‐ray exam of jaw joints X‐ray exam of jaw joints X‐ray exam of jaw joints X‐ray exam of jaw joint X‐ray exam of jaw joint X‐ray exam of jaw joint Magnetic image jaw joint Magnetic image jaw joint Magnetic image jaw joint X‐ray head for orthodontia X‐ray head for orthodontia X‐ray head for orthodontia Panoramic x‐ray of jaws Panoramic x‐ray of jaws Panoramic x‐ray of jaws X‐ray exam of neck X‐ray exam of neck X‐ray exam of neck Throat x‐ray & fluoroscopy Throat x‐ray & fluoroscopy Throat x‐ray & fluoroscopy Speech evaluation complex Speech evaluation complex Speech evaluation complex Contrast x‐ray of larynx Contrast x‐ray of larynx Contrast x‐ray of larynx X‐ray exam of salivary gland X‐ray exam of salivary gland $21.43 $30.96 $9.53 $26.20 $38.45 $12.25 $31.64 $48.31 $16.67 $9.53 $15.31 $5.78 $31.98 $39.81 $7.83 $11.57 $47.63 $36.06 $23.82 $33.00 $9.19 $37.77 $50.01 $12.25 $46.61 $72.81 $26.20 $295.66 $366.43 $70.77 $12.25 $22.11 $9.87 $10.55 $21.43 $10.89 $20.41 $28.58 $8.17 $68.39 $83.70 $15.31 $52.74 $93.56 $40.83 $21.09 $81.66 $60.56 $31.30 $40.49 $21.04 $31.03 $9.99 $25.32 $37.81 $12.48 $30.67 $48.15 $17.48 $8.92 $14.98 $6.06 $30.32 $38.52 $8.20 $11.77 $53.14 $41.37 $22.83 $32.46 $9.63 $36.38 $49.22 $12.84 $52.78 $84.17 $31.39 $248.59 $323.13 $74.54 $12.13 $22.11 $9.99 $9.99 $21.04 $11.06 $20.69 $29.25 $8.56 $66.34 $82.03 $15.69 $49.93 $93.09 $43.16 $22.47 $87.74 $65.27 $29.25 $38.52 ‐1.80% 0.20% 4.80% ‐3.30% ‐1.70% 1.90% ‐3.10% ‐0.30% 4.80% ‐6.40% ‐2.20% 4.80% ‐5.20% ‐3.20% 4.80% 1.70% 11.60% 14.70% ‐4.20% ‐1.70% 4.80% ‐3.70% ‐1.60% 4.80% 13.20% 15.60% 19.80% ‐15.90% ‐11.80% 5.30% ‐1.00% 0.00% 1.20% ‐5.30% ‐1.80% 1.60% 1.30% 2.30% 4.80% ‐3.00% ‐2.00% 2.50% ‐5.30% ‐0.50% 5.70% 6.50% 7.50% 7.80% ‐6.60% ‐4.90% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 70380 70390 70390 70390 70450 70450 70450 70460 70460 70460 70470 70470 70470 70480 70480 70480 70481 70481 70481 70482 70482 70482 70486 70486 70486 70487 70487 70487 70488 70488 70488 70490 70490 70490 70491 70491 70491 70492 70492 70492 70496 70496 70496 70498 70498 70498 70540 70540 70540 70542 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X‐ray exam of salivary gland X‐ray exam of salivary duct X‐ray exam of salivary duct X‐ray exam of salivary duct Ct head/brain w/o dye Ct head/brain w/o dye Ct head/brain w/o dye Ct head/brain w/dye Ct head/brain w/dye Ct head/brain w/dye Ct head/brain w/o & w/dye Ct head/brain w/o & w/dye Ct head/brain w/o & w/dye Ct orbit/ear/fossa w/o dye Ct orbit/ear/fossa w/o dye Ct orbit/ear/fossa w/o dye Ct orbit/ear/fossa w/dye Ct orbit/ear/fossa w/dye Ct orbit/ear/fossa w/dye Ct orbit/ear/fossa w/o&w/dye Ct orbit/ear/fossa w/o&w/dye Ct orbit/ear/fossa w/o&w/dye Ct maxillofacial w/o dye Ct maxillofacial w/o dye Ct maxillofacial w/o dye Ct maxillofacial w/dye Ct maxillofacial w/dye Ct maxillofacial w/dye Ct maxillofacial w/o & w/dye Ct maxillofacial w/o & w/dye Ct maxillofacial w/o & w/dye Ct soft tissue neck w/o dye Ct soft tissue neck w/o dye Ct soft tissue neck w/o dye Ct soft tissue neck w/dye Ct soft tissue neck w/dye Ct soft tissue neck w/dye Ct sft tsue nck w/o & w/dye Ct sft tsue nck w/o & w/dye Ct sft tsue nck w/o & w/dye Ct angiography head Ct angiography head Ct angiography head Ct angiography neck Ct angiography neck Ct angiography neck Mri orbit/face/neck w/o dye Mri orbit/face/neck w/o dye Mri orbit/face/neck w/o dye Mri orbit/face/neck w/dye $9.19 $85.74 $104.45 $18.71 $126.57 $167.39 $40.83 $165.35 $219.45 $54.10 $160.59 $221.83 $61.24 $173.52 $235.44 $61.92 $259.26 $325.94 $66.69 $291.24 $360.98 $69.75 $173.52 $228.63 $55.12 $216.05 $278.65 $62.60 $267.08 $335.47 $68.39 $163.65 $225.57 $61.92 $205.16 $271.84 $66.69 $254.83 $324.58 $69.75 $339.21 $423.59 $84.38 $339.21 $423.59 $84.38 $338.53 $403.51 $64.98 $387.86 $9.27 $82.39 $102.00 $19.62 $107.71 $150.15 $42.44 $140.88 $197.94 $57.06 $138.38 $202.94 $64.55 $114.94 $179.85 $64.91 $221.84 $291.74 $69.90 $249.30 $322.41 $73.11 $114.94 $172.72 $57.78 $183.68 $249.30 $65.62 $227.19 $299.23 $72.04 $114.94 $179.85 $64.91 $175.12 $245.02 $69.90 $217.56 $291.03 $73.47 $283.78 $372.23 $88.45 $283.78 $372.23 $88.45 $283.19 $351.31 $68.12 $329.55 0.90% ‐3.90% ‐2.30% 4.80% ‐14.90% ‐10.30% 4.00% ‐14.80% ‐9.80% 5.50% ‐13.80% ‐8.50% 5.40% ‐33.80% ‐23.60% 4.80% ‐14.40% ‐10.50% 4.80% ‐14.40% ‐10.70% 4.80% ‐33.80% ‐24.50% 4.80% ‐15.00% ‐10.50% 4.80% ‐14.90% ‐10.80% 5.40% ‐29.80% ‐20.30% 4.80% ‐14.60% ‐9.90% 4.80% ‐14.60% ‐10.30% 5.30% ‐16.30% ‐12.10% 4.80% ‐16.30% ‐12.10% 4.80% ‐16.30% ‐12.90% 4.80% ‐15.00% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 70542 70542 70543 70543 70543 70544 70544 70544 70545 70545 70545 70546 70546 70546 70547 70547 70547 70548 70548 70548 70549 70549 70549 70551 70551 70551 70552 70552 70552 70553 70553 70553 70554 70554 70554 70555 70555 70555 70557 70557 70557 70558 70558 70558 70559 70559 70559 71010 71010 71010 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC 26 TC 26 TC TC 26 A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C A C C A C C A A A Mri orbit/face/neck w/dye Mri orbit/face/neck w/dye Mri orbt/fac/nck w/o &w/dye Mri orbt/fac/nck w/o &w/dye Mri orbt/fac/nck w/o &w/dye Mr angiography head w/o dye Mr angiography head w/o dye Mr angiography head w/o dye Mr angiography head w/dye Mr angiography head w/dye Mr angiography head w/dye Mr angiograph head w/o&w/dye Mr angiograph head w/o&w/dye Mr angiograph head w/o&w/dye Mr angiography neck w/o dye Mr angiography neck w/o dye Mr angiography neck w/o dye Mr angiography neck w/dye Mr angiography neck w/dye Mr angiography neck w/dye Mr angiograph neck w/o&w/dye Mr angiograph neck w/o&w/dye Mr angiograph neck w/o&w/dye Mri brain stem w/o dye Mri brain stem w/o dye Mri brain stem w/o dye Mri brain stem w/dye Mri brain stem w/dye Mri brain stem w/dye Mri brain stem w/o & w/dye Mri brain stem w/o & w/dye Mri brain stem w/o & w/dye Fmri brain by tech Fmri brain by tech Fmri brain by tech Fmri brain by phys/psych Fmri brain by phys/psych Fmri brain by phys/psych Mri brain w/o dye Mri brain w/o dye Mri brain w/o dye Mri brain w/dye Mri brain w/dye Mri brain w/dye Mri brain w/o & w/dye Mri brain w/o & w/dye Mri brain w/o & w/dye Chest x‐ray 1 view frontal Chest x‐ray 1 view frontal Chest x‐ray 1 view frontal $466.46 $78.59 $469.18 $572.61 $103.43 $338.53 $396.37 $57.84 $401.13 $458.97 $57.84 $549.47 $636.57 $87.10 $338.53 $396.71 $58.18 $435.83 $494.01 $58.18 $549.47 $636.23 $86.76 $338.53 $409.98 $71.45 $401.81 $488.23 $86.42 $457.95 $571.93 $113.98 $395.01 $497.42 $102.41 $126.23 $0.00 $0.00 $170.12 $0.00 $0.00 $158.89 $0.00 $0.00 $159.23 $0.00 $0.00 $14.97 $23.82 $8.85 $411.93 $82.39 $395.88 $504.31 $108.42 $283.19 $344.18 $60.99 $337.75 $398.74 $60.99 $477.41 $568.71 $91.30 $283.19 $344.18 $60.99 $364.14 $425.13 $60.99 $477.41 $568.36 $90.95 $283.19 $358.09 $74.90 $337.04 $427.63 $90.59 $385.90 $505.38 $119.48 $344.88 $451.88 $107.00 $131.60 $0.00 $0.00 $176.54 $0.00 $0.00 $165.84 $0.00 $0.00 $166.20 $0.00 $0.00 $14.62 $23.90 $9.27 ‐11.70% 4.80% ‐15.60% ‐11.90% 4.80% ‐16.30% ‐13.20% 5.40% ‐15.80% ‐13.10% 5.40% ‐13.10% ‐10.70% 4.80% ‐16.30% ‐13.20% 4.80% ‐16.40% ‐13.90% 4.80% ‐13.10% ‐10.70% 4.80% ‐16.30% ‐12.70% 4.80% ‐16.10% ‐12.40% 4.80% ‐15.70% ‐11.60% 4.80% ‐12.70% ‐9.20% 4.50% 4.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 3.80% Y Y Y Y Y Y Y Y Y Y Y Y 4.40% 4.40% ‐2.30% 0.30% 4.80% 71015 71015 71015 71020 71020 71020 71021 71021 71021 71022 71022 71022 71023 71023 71023 71030 71030 71030 71034 71034 71034 71035 71035 71035 71100 71100 71100 71101 71101 71101 71110 71110 71110 71111 71111 71111 71120 71120 71120 71130 71130 71130 71250 71250 71250 71260 71260 71260 71270 71270 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Chest x‐ray stereo frontal Chest x‐ray stereo frontal Chest x‐ray stereo frontal Chest x‐ray 2vw frontal&latl Chest x‐ray 2vw frontal&latl Chest x‐ray 2vw frontal&latl Chest x‐ray frnt lat lordotc Chest x‐ray frnt lat lordotc Chest x‐ray frnt lat lordotc Chest x‐ray frnt lat oblique Chest x‐ray frnt lat oblique Chest x‐ray frnt lat oblique Chest x‐ray and fluoroscopy Chest x‐ray and fluoroscopy Chest x‐ray and fluoroscopy Chest x‐ray 4/> views Chest x‐ray 4/> views Chest x‐ray 4/> views Chest x‐ray&fluoro 4/> views Chest x‐ray&fluoro 4/> views Chest x‐ray&fluoro 4/> views Chest x‐ray special views Chest x‐ray special views Chest x‐ray special views X‐ray exam ribs uni 2 views X‐ray exam ribs uni 2 views X‐ray exam ribs uni 2 views X‐ray exam unilat ribs/chest X‐ray exam unilat ribs/chest X‐ray exam unilat ribs/chest X‐ray exam ribs bil 3 views X‐ray exam ribs bil 3 views X‐ray exam ribs bil 3 views X‐ray exam ribs/chest4/> vws X‐ray exam ribs/chest4/> vws X‐ray exam ribs/chest4/> vws X‐ray exam breastbone 2/>vws X‐ray exam breastbone 2/>vws X‐ray exam breastbone 2/>vws X‐ray strenoclavic jt 3/>vws X‐ray strenoclavic jt 3/>vws X‐ray strenoclavic jt 3/>vws Ct thorax w/o dye Ct thorax w/o dye Ct thorax w/o dye Ct thorax w/dye Ct thorax w/dye Ct thorax w/dye Ct thorax w/o & w/dye Ct thorax w/o & w/dye $21.09 $31.30 $10.21 $20.41 $30.96 $10.55 $25.18 $38.45 $13.27 $33.68 $48.99 $15.31 $49.33 $67.37 $18.03 $32.32 $46.95 $14.63 $66.00 $87.78 $21.77 $28.24 $36.74 $8.51 $22.46 $33.34 $10.89 $27.56 $40.49 $12.93 $28.58 $41.85 $13.27 $39.13 $54.78 $15.65 $22.80 $32.32 $9.53 $27.56 $38.45 $10.89 $163.99 $212.98 $48.99 $206.18 $266.40 $60.22 $256.53 $322.88 $19.97 $30.67 $10.70 $19.62 $30.67 $11.06 $23.90 $37.81 $13.91 $30.32 $47.08 $16.76 $47.43 $65.98 $18.55 $31.03 $46.36 $15.34 $65.27 $87.74 $22.47 $27.46 $36.38 $8.92 $21.76 $33.17 $11.41 $26.75 $40.30 $13.55 $27.46 $41.37 $13.91 $37.81 $54.21 $16.41 $22.11 $32.10 $9.99 $26.39 $37.45 $11.06 $114.94 $166.30 $51.36 $175.83 $238.96 $63.13 $218.63 $288.18 ‐5.30% ‐2.00% 4.80% ‐3.90% ‐0.90% 4.80% ‐5.10% ‐1.70% 4.80% ‐10.00% ‐3.90% 9.50% ‐3.90% ‐2.10% 2.90% ‐4.00% ‐1.30% 4.80% ‐1.10% 0.00% 3.20% ‐2.80% ‐1.00% 4.80% ‐3.10% ‐0.50% 4.80% ‐2.90% ‐0.50% 4.80% ‐3.90% ‐1.10% 4.80% ‐3.40% ‐1.00% 4.80% ‐3.00% ‐0.70% 4.80% ‐4.20% ‐2.60% 1.60% ‐29.90% ‐21.90% 4.80% ‐14.70% ‐10.30% 4.80% ‐14.80% ‐10.70% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 71270 71275 71275 71275 71550 71550 71550 71551 71551 71551 71552 71552 71552 71555 71555 71555 72010 72010 72010 72020 72020 72020 72040 72040 72040 72040 72040 72040 72050 72050 72050 72050 72050 72050 72052 72052 72052 72052 72052 72052 72069 72069 72069 72070 72070 72070 72072 72072 72072 72074 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC TC 26 26 TC TC 26 26 TC TC 26 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Ct thorax w/o & w/dye Ct angiography chest Ct angiography chest Ct angiography chest Mri chest w/o dye Mri chest w/o dye Mri chest w/o dye Mri chest w/dye Mri chest w/dye Mri chest w/dye Mri chest w/o & w/dye Mri chest w/o & w/dye Mri chest w/o & w/dye Mri angio chest w or w/o dye Mri angio chest w or w/o dye Mri angio chest w or w/o dye X‐ray exam spine ap&lat X‐ray exam spine ap&lat X‐ray exam spine ap&lat X‐ray exam of spine 1 view X‐ray exam of spine 1 view X‐ray exam of spine 1 view X‐ray exam neck spine 3/<vws X‐ray exam neck spine 3/<vws X‐ray exam neck spine 3/<vws X‐ray exam neck spine 3/<vws X‐ray exam neck spine 3/<vws X‐ray exam neck spine 3/<vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 4/5vws X‐ray exam neck spine 6/>vws X‐ray exam neck spine 6/>vws X‐ray exam neck spine 6/>vws X‐ray exam neck spine 6/>vws X‐ray exam neck spine 6/>vws X‐ray exam neck spine 6/>vws X‐ray exam trunk spine stand X‐ray exam trunk spine stand X‐ray exam trunk spine stand X‐ray exam thorac spine 2vws X‐ray exam thorac spine 2vws X‐ray exam thorac spine 2vws X‐ray exam thorac spine 3vws X‐ray exam thorac spine 3vws X‐ray exam thorac spine 3vws X‐ray exam thorac spine4/>vw $66.34 $317.09 $409.64 $92.54 $338.53 $408.62 $70.09 $447.40 $530.76 $83.36 $549.47 $658.00 $108.53 $383.78 $470.88 $87.10 $58.86 $81.66 $22.80 $16.67 $24.16 $7.49 $25.18 $25.18 $36.74 $36.74 $11.57 $11.57 $34.02 $34.02 $49.67 $49.67 $15.65 $15.65 $45.93 $45.93 $63.96 $63.96 $18.03 $18.03 $28.24 $39.81 $11.57 $23.82 $34.70 $10.89 $27.56 $38.11 $10.55 $35.04 $69.55 $275.34 $372.35 $97.01 $283.19 $357.02 $73.83 $381.62 $469.00 $87.38 $476.85 $590.62 $113.77 $323.48 $414.43 $90.95 $55.99 $79.53 $23.54 $15.69 $23.54 $7.85 $24.25 $24.25 $36.38 $36.38 $12.13 $12.13 $32.81 $32.81 $49.22 $49.22 $16.41 $16.41 $44.22 $44.22 $63.13 $63.13 $18.90 $18.90 $26.75 $38.88 $12.13 $22.83 $34.24 $11.41 $26.75 $37.81 $11.06 $33.88 4.80% ‐13.20% ‐9.10% 4.80% ‐16.30% ‐12.60% 5.30% ‐14.70% ‐11.60% 4.80% ‐13.20% ‐10.20% 4.80% ‐15.70% ‐12.00% 4.40% ‐4.90% ‐2.60% 3.30% ‐5.90% ‐2.60% 4.80% ‐3.70% ‐3.70% ‐1.00% ‐1.00% 4.80% 4.80% ‐3.60% ‐3.60% ‐0.90% ‐0.90% 4.80% 4.80% ‐3.70% ‐3.70% ‐1.30% ‐1.30% 4.80% 4.80% ‐5.30% ‐2.30% 4.80% ‐4.20% ‐1.30% 4.80% ‐2.90% ‐0.80% 4.80% ‐3.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 72074 72074 72080 72080 72080 72090 72090 72090 72100 72100 72100 72110 72110 72110 72114 72114 72114 72120 72120 72120 72125 72125 72125 72126 72126 72126 72127 72127 72127 72128 72128 72128 72129 72129 72129 72130 72130 72130 72131 72131 72131 72132 72132 72132 72133 72133 72133 72141 72141 72141 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X‐ray exam thorac spine4/>vw X‐ray exam thorac spine4/>vw X‐ray exam trunk spine 2 vws X‐ray exam trunk spine 2 vws X‐ray exam trunk spine 2 vws X‐ray exam scloiosis erect X‐ray exam scloiosis erect X‐ray exam scloiosis erect X‐ray exam l‐s spine 2/3 vws X‐ray exam l‐s spine 2/3 vws X‐ray exam l‐s spine 2/3 vws X‐ray exam l‐2 spine 4/>vws X‐ray exam l‐2 spine 4/>vws X‐ray exam l‐2 spine 4/>vws X‐ray exam l‐s spine bending X‐ray exam l‐s spine bending X‐ray exam l‐s spine bending X‐ray bend only l‐s spine X‐ray bend only l‐s spine X‐ray bend only l‐s spine Ct neck spine w/o dye Ct neck spine w/o dye Ct neck spine w/o dye Ct neck spine w/dye Ct neck spine w/dye Ct neck spine w/dye Ct neck spine w/o & w/dye Ct neck spine w/o & w/dye Ct neck spine w/o & w/dye Ct chest spine w/o dye Ct chest spine w/o dye Ct chest spine w/o dye Ct chest spine w/dye Ct chest spine w/dye Ct chest spine w/dye Ct chest spine w/o & w/dye Ct chest spine w/o & w/dye Ct chest spine w/o & w/dye Ct lumbar spine w/o dye Ct lumbar spine w/o dye Ct lumbar spine w/o dye Ct lumbar spine w/dye Ct lumbar spine w/dye Ct lumbar spine w/dye Ct lumbar spine w/o & w/dye Ct lumbar spine w/o & w/dye Ct lumbar spine w/o & w/dye Mri neck spine w/o dye Mri neck spine w/o dye Mri neck spine w/o dye $45.59 $10.55 $26.20 $37.77 $11.57 $38.79 $53.76 $14.97 $25.52 $37.09 $11.57 $34.70 $50.35 $15.65 $49.33 $66.00 $16.67 $31.98 $43.89 $11.91 $166.37 $217.75 $51.37 $207.20 $266.06 $58.86 $257.21 $318.46 $61.24 $165.35 $213.32 $47.97 $208.22 $267.08 $58.86 $258.92 $320.16 $61.24 $164.67 $212.64 $47.97 $207.54 $266.40 $58.86 $257.55 $318.46 $60.90 $309.61 $387.18 $77.57 $44.94 $11.06 $24.97 $37.09 $12.13 $37.09 $52.78 $15.69 $24.61 $36.74 $12.13 $33.53 $49.93 $16.41 $47.43 $64.91 $17.48 $29.25 $41.37 $12.13 $114.94 $168.79 $53.85 $176.90 $238.96 $62.06 $220.41 $284.61 $64.20 $114.94 $165.58 $50.64 $177.26 $239.31 $62.06 $223.26 $287.46 $64.20 $114.94 $165.58 $50.64 $176.19 $237.89 $61.70 $220.77 $284.97 $64.20 $260.00 $341.67 $81.67 ‐1.40% 4.80% ‐4.70% ‐1.80% 4.80% ‐4.40% ‐1.80% 4.80% ‐3.60% ‐0.90% 4.80% ‐3.40% ‐0.80% 4.80% ‐3.90% ‐1.70% 4.80% ‐8.60% ‐5.70% 1.80% ‐30.90% ‐22.50% 4.80% ‐14.60% ‐10.20% 5.40% ‐14.30% ‐10.60% 4.80% ‐30.50% ‐22.40% 5.60% ‐14.90% ‐10.40% 5.40% ‐13.80% ‐10.20% 4.80% ‐30.20% ‐22.10% 5.60% ‐15.10% ‐10.70% 4.80% ‐14.30% ‐10.50% 5.40% ‐16.00% ‐11.80% 5.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 72142 72142 72142 72146 72146 72146 72147 72147 72147 72148 72148 72148 72149 72149 72149 72156 72156 72156 72157 72157 72157 72158 72158 72158 72159 72159 72159 72170 72170 72170 72190 72190 72190 72191 72191 72191 72192 72192 72192 72193 72193 72193 72194 72194 72194 72195 72195 72195 72196 72196 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A A A A A A A A Mri neck spine w/dye Mri neck spine w/dye Mri neck spine w/dye Mri chest spine w/o dye Mri chest spine w/o dye Mri chest spine w/o dye Mri chest spine w/dye Mri chest spine w/dye Mri chest spine w/dye Mri lumbar spine w/o dye Mri lumbar spine w/o dye Mri lumbar spine w/o dye Mri lumbar spine w/dye Mri lumbar spine w/dye Mri lumbar spine w/dye Mri neck spine w/o & w/dye Mri neck spine w/o & w/dye Mri neck spine w/o & w/dye Mri chest spine w/o & w/dye Mri chest spine w/o & w/dye Mri chest spine w/o & w/dye Mri lumbar spine w/o & w/dye Mri lumbar spine w/o & w/dye Mri lumbar spine w/o & w/dye Mr angio spine w/o&w/dye Mr angio spine w/o&w/dye Mr angio spine w/o&w/dye X‐ray exam of pelvis X‐ray exam of pelvis X‐ray exam of pelvis X‐ray exam of pelvis X‐ray exam of pelvis X‐ray exam of pelvis Ct angiograph pelv w/o&w/dye Ct angiograph pelv w/o&w/dye Ct angiograph pelv w/o&w/dye Ct pelvis w/o dye Ct pelvis w/o dye Ct pelvis w/o dye Ct pelvis w/dye Ct pelvis w/dye Ct pelvis w/dye Ct pelvis w/o & w/dye Ct pelvis w/o & w/dye Ct pelvis w/o & w/dye Mri pelvis w/o dye Mri pelvis w/o dye Mri pelvis w/o dye Mri pelvis w/dye Mri pelvis w/dye $404.87 $498.10 $93.22 $310.29 $387.86 $77.57 $347.03 $439.92 $92.88 $309.95 $382.08 $72.13 $395.01 $481.43 $86.42 $447.74 $572.27 $124.52 $407.26 $531.78 $124.52 $445.02 $560.02 $115.00 $396.03 $481.77 $85.74 $20.75 $29.94 $9.19 $33.68 $44.91 $11.23 $319.48 $406.92 $87.44 $124.18 $176.24 $52.06 $221.83 $277.97 $56.14 $252.79 $311.65 $58.86 $338.53 $409.64 $71.11 $396.37 $480.06 $339.18 $436.90 $97.72 $260.36 $341.67 $81.32 $292.46 $389.82 $97.37 $260.00 $335.97 $75.97 $332.76 $423.35 $90.59 $377.70 $508.23 $130.53 $344.17 $474.71 $130.53 $375.56 $496.10 $120.55 $340.96 $431.19 $90.23 $19.97 $29.60 $9.63 $31.74 $43.51 $11.77 $283.78 $375.44 $91.66 $108.07 $162.99 $54.92 $197.23 $256.43 $59.20 $222.19 $283.90 $61.70 $283.19 $358.09 $74.90 $335.61 $423.35 ‐16.20% ‐12.30% 4.80% ‐16.10% ‐11.90% 4.80% ‐15.70% ‐11.40% 4.80% ‐16.10% ‐12.10% 5.30% ‐15.80% ‐12.10% 4.80% ‐15.60% ‐11.20% 4.80% ‐15.50% ‐10.70% 4.80% ‐15.60% ‐11.40% 4.80% ‐13.90% ‐10.50% 5.20% ‐3.80% ‐1.10% 4.80% ‐5.80% ‐3.10% 4.80% ‐11.20% ‐7.70% 4.80% ‐13.00% ‐7.50% 5.50% ‐11.10% ‐7.80% 5.50% ‐12.10% ‐8.90% 4.80% ‐16.30% ‐12.60% 5.30% ‐15.30% ‐11.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 72196 72197 72197 72197 72198 72198 72198 72200 72200 72200 72202 72202 72202 72220 72220 72220 72240 72240 72240 72255 72255 72255 72265 72265 72265 72270 72270 72270 72275 72275 72275 72285 72285 72285 72291 72291 72291 72292 72292 72292 72295 72295 72295 73000 73000 73000 73010 73010 73010 73020 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C A A A A A A A A A A Mri pelvis w/dye Mri pelvis w/o & w/dye Mri pelvis w/o & w/dye Mri pelvis w/o & w/dye Mr angio pelvis w/o & w/dye Mr angio pelvis w/o & w/dye Mr angio pelvis w/o & w/dye X‐ray exam si joints X‐ray exam si joints X‐ray exam si joints X‐ray exam si joints 3/> vws X‐ray exam si joints 3/> vws X‐ray exam si joints 3/> vws X‐ray exam sacrum tailbone X‐ray exam sacrum tailbone X‐ray exam sacrum tailbone Myelography neck spine Myelography neck spine Myelography neck spine Myelography thoracic spine Myelography thoracic spine Myelography thoracic spine Myelography l‐s spine Myelography l‐s spine Myelography l‐s spine Myelogphy 2/> spine regions Myelogphy 2/> spine regions Myelogphy 2/> spine regions Epidurography Epidurography Epidurography Discography cerv/thor spine Discography cerv/thor spine Discography cerv/thor spine Perq verte/sacroplsty fluor Perq verte/sacroplsty fluor Perq verte/sacroplsty fluor Perq verte/sacroplsty ct Perq verte/sacroplsty ct Perq verte/sacroplsty ct X‐ray of lower spine disk X‐ray of lower spine disk X‐ray of lower spine disk X‐ray exam of collar bone X‐ray exam of collar bone X‐ray exam of collar bone X‐ray exam of shoulder blade X‐ray exam of shoulder blade X‐ray exam of shoulder blade X‐ray exam of shoulder $83.70 $477.34 $585.88 $108.53 $388.54 $474.96 $86.42 $22.11 $30.62 $8.51 $26.54 $35.72 $9.19 $21.43 $29.94 $8.51 $87.44 $131.33 $43.89 $80.97 $125.20 $44.23 $88.80 $128.95 $40.15 $136.43 $200.74 $64.30 $84.04 $123.16 $39.13 $59.54 $119.08 $59.54 $71.11 $0.00 $0.00 $72.47 $0.00 $0.00 $61.58 $104.45 $42.87 $21.77 $29.94 $8.17 $23.82 $33.34 $9.53 $17.01 $87.74 $402.66 $516.43 $113.77 $329.19 $419.42 $90.23 $21.40 $29.96 $8.56 $25.68 $35.31 $9.63 $20.69 $29.60 $8.92 $84.53 $130.89 $46.36 $78.11 $124.47 $46.36 $85.24 $126.97 $41.73 $130.18 $197.59 $67.41 $78.11 $118.77 $40.66 $54.57 $116.98 $62.41 $73.47 $0.00 $0.00 $75.25 $0.00 $0.00 $57.06 $101.29 $44.22 $21.04 $29.60 $8.56 $22.83 $32.81 $9.99 $16.41 4.80% ‐15.60% ‐11.90% 4.80% ‐15.30% ‐11.70% 4.40% ‐3.20% ‐2.20% 0.60% ‐3.20% ‐1.20% 4.80% ‐3.50% ‐1.10% 4.80% ‐3.30% ‐0.30% 5.60% ‐3.50% ‐0.60% 4.80% ‐4.00% ‐1.50% 3.90% ‐4.60% ‐1.60% 4.80% ‐7.10% ‐3.60% 3.90% ‐8.40% ‐1.80% 4.80% 3.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 3.80% ‐7.30% ‐3.00% 3.20% ‐3.40% ‐1.10% 4.80% ‐4.20% ‐1.60% 4.80% ‐3.60% Y Y Y Y Y Y Y Y Y Y 73020 73020 73030 73030 73030 73040 73040 73040 73050 73050 73050 73060 73060 73060 73070 73070 73070 73080 73080 73080 73085 73085 73085 73090 73090 73090 73092 73092 73092 73100 73100 73100 73110 73110 73110 73115 73115 73115 73120 73120 73120 73130 73130 73130 73140 73140 73140 73200 73200 73200 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X‐ray exam of shoulder X‐ray exam of shoulder X‐ray exam of shoulder X‐ray exam of shoulder X‐ray exam of shoulder Contrast x‐ray of shoulder Contrast x‐ray of shoulder Contrast x‐ray of shoulder X‐ray exam of shoulders X‐ray exam of shoulders X‐ray exam of shoulders X‐ray exam of humerus X‐ray exam of humerus X‐ray exam of humerus X‐ray exam of elbow X‐ray exam of elbow X‐ray exam of elbow X‐ray exam of elbow X‐ray exam of elbow X‐ray exam of elbow Contrast x‐ray of elbow Contrast x‐ray of elbow Contrast x‐ray of elbow X‐ray exam of forearm X‐ray exam of forearm X‐ray exam of forearm X‐ray exam of arm infant X‐ray exam of arm infant X‐ray exam of arm infant X‐ray exam of wrist X‐ray exam of wrist X‐ray exam of wrist X‐ray exam of wrist X‐ray exam of wrist X‐ray exam of wrist Contrast x‐ray of wrist Contrast x‐ray of wrist Contrast x‐ray of wrist X‐ray exam of hand X‐ray exam of hand X‐ray exam of hand X‐ray exam of hand X‐ray exam of hand X‐ray exam of hand X‐ray exam of finger(s) X‐ray exam of finger(s) X‐ray exam of finger(s) Ct upper extremity w/o dye Ct upper extremity w/o dye Ct upper extremity w/o dye $24.50 $7.49 $22.11 $31.98 $9.87 $82.34 $109.21 $26.88 $30.96 $41.85 $10.89 $21.43 $29.94 $8.51 $21.77 $29.60 $7.83 $26.20 $34.70 $8.51 $76.89 $105.13 $28.24 $20.75 $28.92 $8.17 $25.52 $33.68 $8.17 $24.16 $33.34 $9.19 $30.62 $39.13 $8.51 $87.44 $115.00 $27.56 $20.41 $28.58 $8.17 $25.18 $33.68 $8.51 $28.24 $35.04 $6.80 $163.31 $211.96 $48.65 $24.25 $7.85 $21.04 $31.39 $10.34 $78.11 $106.28 $28.18 $28.89 $40.30 $11.41 $20.69 $29.60 $8.92 $20.69 $28.89 $8.20 $25.32 $34.24 $8.92 $74.18 $103.43 $29.25 $19.97 $28.53 $8.56 $20.33 $28.53 $8.20 $22.83 $32.10 $9.27 $29.25 $38.16 $8.92 $83.46 $112.35 $28.89 $19.62 $28.18 $8.56 $24.25 $33.17 $8.92 $26.75 $33.88 $7.13 $114.94 $166.30 $51.36 ‐1.00% 4.80% ‐4.90% ‐1.90% 4.80% ‐5.10% ‐2.70% 4.80% ‐6.70% ‐3.70% 4.80% ‐3.50% ‐1.10% 4.80% ‐5.00% ‐2.40% 4.80% ‐3.30% ‐1.30% 4.80% ‐3.50% ‐1.60% 3.60% ‐3.80% ‐1.30% 4.80% ‐20.30% ‐15.30% 0.50% ‐5.50% ‐3.70% 0.90% ‐4.50% ‐2.50% 4.80% ‐4.60% ‐2.30% 4.80% ‐3.90% ‐1.40% 4.80% ‐3.70% ‐1.50% 4.80% ‐5.30% ‐3.30% 4.80% ‐29.60% ‐21.50% 5.60% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 73201 73201 73201 73202 73202 73202 73206 73206 73206 73218 73218 73218 73219 73219 73219 73220 73220 73220 73221 73221 73221 73222 73222 73222 73223 73223 73223 73225 73225 73225 73500 73500 73500 73510 73510 73510 73520 73520 73520 73525 73525 73525 73530 73530 73530 73540 73540 73540 73550 73550 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A R R R A A A A A A A A A A A A A C C A A A A A Ct upper extremity w/dye Ct upper extremity w/dye Ct upper extremity w/dye Ct uppr extremity w/o&w/dye Ct uppr extremity w/o&w/dye Ct uppr extremity w/o&w/dye Ct angio upr extrm w/o&w/dye Ct angio upr extrm w/o&w/dye Ct angio upr extrm w/o&w/dye Mri upper extremity w/o dye Mri upper extremity w/o dye Mri upper extremity w/o dye Mri upper extremity w/dye Mri upper extremity w/dye Mri upper extremity w/dye Mri uppr extremity w/o&w/dye Mri uppr extremity w/o&w/dye Mri uppr extremity w/o&w/dye Mri joint upr extrem w/o dye Mri joint upr extrem w/o dye Mri joint upr extrem w/o dye Mri joint upr extrem w/dye Mri joint upr extrem w/dye Mri joint upr extrem w/dye Mri joint upr extr w/o&w/dye Mri joint upr extr w/o&w/dye Mri joint upr extr w/o&w/dye Mr angio upr extr w/o&w/dye Mr angio upr extr w/o&w/dye Mr angio upr extr w/o&w/dye X‐ray exam of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of hips X‐ray exam of hips X‐ray exam of hips Contrast x‐ray of hip Contrast x‐ray of hip Contrast x‐ray of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of hip X‐ray exam of pelvis & hips X‐ray exam of pelvis & hips X‐ray exam of pelvis & hips X‐ray exam of thigh X‐ray exam of thigh $204.14 $260.28 $56.14 $272.52 $331.38 $58.86 $285.11 $371.53 $86.42 $338.53 $403.85 $65.32 $392.97 $471.56 $78.59 $477.68 $581.45 $103.77 $215.37 $282.05 $66.69 $364.05 $442.64 $78.59 $444.34 $548.11 $103.77 $400.45 $482.45 $82.00 $19.05 $28.58 $9.53 $29.60 $40.83 $11.23 $28.92 $42.53 $13.61 $80.29 $108.87 $28.58 $14.29 $0.00 $0.00 $35.72 $46.61 $10.89 $20.41 $29.60 $174.05 $232.89 $58.85 $235.39 $297.09 $61.70 $244.31 $334.54 $90.23 $283.19 $351.67 $68.48 $333.83 $416.21 $82.39 $402.30 $511.08 $108.78 $184.75 $254.65 $69.90 $306.72 $389.11 $82.39 $374.13 $482.91 $108.78 $339.18 $425.49 $86.31 $18.19 $27.82 $9.63 $28.53 $40.30 $11.77 $27.82 $42.09 $14.27 $75.97 $105.21 $29.25 $14.98 $0.00 $0.00 $33.17 $44.22 $11.06 $19.62 $29.25 ‐14.70% ‐10.50% 4.80% ‐13.60% ‐10.30% 4.80% ‐14.30% ‐10.00% 4.40% ‐16.30% ‐12.90% 4.80% ‐15.00% ‐11.70% 4.80% ‐15.80% ‐12.10% 4.80% ‐14.20% ‐9.70% 4.80% ‐15.70% ‐12.10% 4.80% ‐15.80% ‐11.90% 4.80% ‐15.30% ‐11.80% 5.30% ‐4.50% ‐2.70% 1.10% ‐3.60% ‐1.30% 4.80% ‐3.80% ‐1.00% 4.80% ‐5.40% ‐3.40% 2.30% 4.80% ‐7.20% ‐5.10% 1.60% ‐3.90% ‐1.20% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 73550 73560 73560 73560 73562 73562 73562 73564 73564 73564 73565 73565 73565 73580 73580 73580 73590 73590 73590 73592 73592 73592 73600 73600 73600 73610 73610 73610 73615 73615 73615 73620 73620 73620 73630 73630 73630 73650 73650 73650 73660 73660 73660 73700 73700 73700 73701 73701 73701 73702 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X‐ray exam of thigh X‐ray exam of knee 1 or 2 X‐ray exam of knee 1 or 2 X‐ray exam of knee 1 or 2 X‐ray exam of knee 3 X‐ray exam of knee 3 X‐ray exam of knee 3 X‐ray exam knee 4 or more X‐ray exam knee 4 or more X‐ray exam knee 4 or more X‐ray exam of knees X‐ray exam of knees X‐ray exam of knees Contrast x‐ray of knee joint Contrast x‐ray of knee joint Contrast x‐ray of knee joint X‐ray exam of lower leg X‐ray exam of lower leg X‐ray exam of lower leg X‐ray exam of leg infant X‐ray exam of leg infant X‐ray exam of leg infant X‐ray exam of ankle X‐ray exam of ankle X‐ray exam of ankle X‐ray exam of ankle X‐ray exam of ankle X‐ray exam of ankle Contrast x‐ray of ankle Contrast x‐ray of ankle Contrast x‐ray of ankle X‐ray exam of foot X‐ray exam of foot X‐ray exam of foot X‐ray exam of foot X‐ray exam of foot X‐ray exam of foot X‐ray exam of heel X‐ray exam of heel X‐ray exam of heel X‐ray exam of toe(s) X‐ray exam of toe(s) X‐ray exam of toe(s) Ct lower extremity w/o dye Ct lower extremity w/o dye Ct lower extremity w/o dye Ct lower extremity w/dye Ct lower extremity w/dye Ct lower extremity w/dye Ct lwr extremity w/o&w/dye $9.19 $22.80 $32.32 $9.53 $29.26 $39.13 $9.87 $33.68 $45.59 $11.91 $27.56 $37.43 $9.87 $106.49 $135.07 $28.58 $20.07 $28.58 $8.51 $21.09 $28.92 $7.83 $21.77 $29.94 $8.17 $26.20 $34.70 $8.51 $80.63 $108.87 $28.24 $21.09 $28.58 $7.49 $24.50 $32.66 $8.17 $21.77 $29.60 $7.83 $25.18 $31.64 $6.46 $163.99 $212.64 $48.65 $207.88 $264.02 $56.14 $271.84 $9.63 $21.76 $31.39 $9.63 $27.82 $38.16 $10.34 $32.10 $44.22 $12.13 $26.39 $36.38 $9.99 $99.51 $129.11 $29.60 $19.26 $28.18 $8.92 $20.33 $28.53 $8.20 $21.04 $29.25 $8.20 $24.97 $33.88 $8.92 $75.61 $104.86 $29.25 $19.97 $27.82 $7.85 $23.54 $32.10 $8.56 $20.69 $28.89 $8.20 $23.90 $30.67 $6.78 $114.94 $166.30 $51.36 $176.90 $236.10 $59.20 $232.89 4.80% ‐4.60% ‐2.90% 1.10% ‐4.90% ‐2.50% 4.80% ‐4.70% ‐3.00% 1.80% ‐4.20% ‐2.80% 1.20% ‐6.60% ‐4.40% 3.60% ‐4.10% ‐1.40% 4.80% ‐3.60% ‐1.30% 4.80% ‐3.40% ‐2.30% 0.50% ‐4.70% ‐2.40% 4.80% ‐6.20% ‐3.70% 3.60% ‐5.30% ‐2.70% 4.80% ‐3.90% ‐1.70% 4.80% ‐5.00% ‐2.40% 4.80% ‐5.10% ‐3.10% 4.80% ‐29.90% ‐21.80% 5.60% ‐14.90% ‐10.60% 5.50% ‐14.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 73702 73702 73706 73706 73706 73718 73718 73718 73719 73719 73719 73720 73720 73720 73721 73721 73721 73722 73722 73722 73723 73723 73723 73725 73725 73725 74000 74000 74000 74010 74010 74010 74020 74020 74020 74022 74022 74022 74150 74150 74150 74160 74160 74160 74170 74170 74170 74174 74174 74174 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A R R R A A A A A A A A A A A A A A A A A A A A A A A A Ct lwr extremity w/o&w/dye Ct lwr extremity w/o&w/dye Ct angio lwr extr w/o&w/dye Ct angio lwr extr w/o&w/dye Ct angio lwr extr w/o&w/dye Mri lower extremity w/o dye Mri lower extremity w/o dye Mri lower extremity w/o dye Mri lower extremity w/dye Mri lower extremity w/dye Mri lower extremity w/dye Mri lwr extremity w/o&w/dye Mri lwr extremity w/o&w/dye Mri lwr extremity w/o&w/dye Mri jnt of lwr extre w/o dye Mri jnt of lwr extre w/o dye Mri jnt of lwr extre w/o dye Mri joint of lwr extr w/dye Mri joint of lwr extr w/dye Mri joint of lwr extr w/dye Mri joint lwr extr w/o&w/dye Mri joint lwr extr w/o&w/dye Mri joint lwr extr w/o&w/dye Mr ang lwr ext w or w/o dye Mr ang lwr ext w or w/o dye Mr ang lwr ext w or w/o dye X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam of abdomen X‐ray exam series abdomen X‐ray exam series abdomen X‐ray exam series abdomen Ct abdomen w/o dye Ct abdomen w/o dye Ct abdomen w/o dye Ct abdomen w/dye Ct abdomen w/dye Ct abdomen w/dye Ct abdomen w/o & w/dye Ct abdomen w/o & w/dye Ct abdomen w/o & w/dye Ct angio abd&pelv w/o&w/dye Ct angio abd&pelv w/o&w/dye Ct angio abd&pelv w/o&w/dye $330.70 $58.86 $319.82 $411.34 $91.52 $338.53 $403.85 $65.32 $400.79 $479.38 $78.59 $481.77 $585.20 $103.43 $215.37 $282.05 $66.69 $369.83 $449.10 $79.27 $444.00 $547.77 $103.77 $390.58 $477.68 $87.10 $15.99 $24.84 $8.85 $28.58 $39.81 $11.23 $28.58 $41.51 $12.93 $34.70 $50.01 $15.31 $122.48 $179.98 $57.50 $221.15 $282.73 $61.58 $257.89 $325.60 $67.71 $400.79 $506.94 $106.15 $294.60 $61.70 $276.41 $371.99 $95.58 $283.19 $351.67 $68.48 $335.61 $418.00 $82.39 $405.51 $513.94 $108.42 $184.75 $254.65 $69.90 $311.36 $394.46 $83.10 $374.84 $483.62 $108.78 $328.83 $420.14 $91.30 $15.69 $24.97 $9.27 $27.46 $39.23 $11.77 $27.46 $41.02 $13.55 $33.53 $49.22 $15.69 $106.64 $166.91 $60.27 $196.52 $261.07 $64.55 $227.90 $298.88 $70.97 $356.30 $467.57 $111.28 ‐10.90% 4.80% ‐13.60% ‐9.60% 4.40% ‐16.30% ‐12.90% 4.80% ‐16.30% ‐12.80% 4.80% ‐15.80% ‐12.20% 4.80% ‐14.20% ‐9.70% 4.80% ‐15.80% ‐12.20% 4.80% ‐15.60% ‐11.70% 4.80% ‐15.80% ‐12.00% 4.80% ‐1.90% 0.50% 4.80% ‐3.90% ‐1.40% 4.80% ‐3.90% ‐1.20% 4.80% ‐3.40% ‐1.60% 2.50% ‐12.90% ‐7.30% 4.80% ‐11.10% ‐7.70% 4.80% ‐11.60% ‐8.20% 4.80% ‐11.10% ‐7.80% 4.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 74175 74175 74175 74176 74176 74176 74177 74177 74177 74178 74178 74178 74181 74181 74181 74182 74182 74182 74183 74183 74183 74185 74185 74185 74190 74190 74190 74210 74210 74210 74220 74220 74220 74230 74230 74230 74235 74235 74235 74240 74240 74240 74241 74241 74241 74245 74245 74245 74246 74246 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 26 TC TC A A A A A A A A A A A A A A A A A A A A A R R R A C C A A A A A A A A A A C C A A A A A A A A A A A Ct angio abdom w/o & w/dye Ct angio abdom w/o & w/dye Ct angio abdom w/o & w/dye Ct abd & pelvis Ct abd & pelvis Ct abd & pelvis Ct abd & pelv w/contrast Ct abd & pelv w/contrast Ct abd & pelv w/contrast Ct abd & pelv 1/> regns Ct abd & pelv 1/> regns Ct abd & pelv 1/> regns Mri abdomen w/o dye Mri abdomen w/o dye Mri abdomen w/o dye Mri abdomen w/dye Mri abdomen w/dye Mri abdomen w/dye Mri abdomen w/o & w/dye Mri abdomen w/o & w/dye Mri abdomen w/o & w/dye Mri angio abdom w orw/o dye Mri angio abdom w orw/o dye Mri angio abdom w orw/o dye X‐ray exam of peritoneum X‐ray exam of peritoneum X‐ray exam of peritoneum Contrst x‐ray exam of throat Contrst x‐ray exam of throat Contrst x‐ray exam of throat Contrast x‐ray esophagus Contrast x‐ray esophagus Contrast x‐ray esophagus Cine/vid x‐ray throat/esoph Cine/vid x‐ray throat/esoph Cine/vid x‐ray throat/esoph Remove esophagus obstruction Remove esophagus obstruction Remove esophagus obstruction X‐ray upper gi delay w/o kub X‐ray upper gi delay w/o kub X‐ray upper gi delay w/o kub X‐rayupper gi delay w/kub X‐rayupper gi delay w/kub X‐rayupper gi delay w/kub X‐ray upper gi&small intest X‐ray upper gi&small intest X‐ray upper gi&small intest Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract $320.16 $412.02 $91.86 $148.34 $232.38 $84.04 $261.98 $349.76 $87.78 $312.33 $409.64 $97.31 $312.33 $382.42 $70.09 $444.68 $528.04 $83.36 $479.38 $587.92 $108.53 $388.20 $474.62 $86.42 $23.48 $0.00 $0.00 $63.28 $80.29 $17.01 $71.45 $93.90 $22.46 $67.71 $93.22 $25.52 $65.32 $0.00 $0.00 $83.36 $117.04 $33.68 $89.48 $122.48 $33.00 $43.89 $166.71 $122.82 $98.67 $132.01 $283.78 $380.08 $96.30 $128.40 $216.49 $88.09 $231.11 $323.48 $92.37 $274.98 $376.98 $102.00 $262.50 $336.32 $73.83 $375.56 $463.29 $87.74 $404.09 $517.86 $113.77 $329.55 $420.14 $90.59 $24.25 $0.00 $0.00 $61.34 $79.18 $17.83 $69.19 $92.37 $23.18 $65.62 $92.37 $26.75 $58.85 $0.00 $0.00 $81.32 $116.27 $34.95 $86.31 $120.91 $34.60 $46.36 $180.47 $134.10 $95.58 $130.53 ‐11.40% ‐7.80% 4.80% ‐13.40% ‐6.80% 4.80% ‐11.80% ‐7.50% 5.20% ‐12.00% ‐8.00% 4.80% ‐16.00% ‐12.10% 5.30% ‐15.50% ‐12.30% 5.30% ‐15.70% ‐11.90% 4.80% ‐15.10% ‐11.50% 4.80% 3.30% ‐3.10% ‐1.40% 4.80% ‐3.20% ‐1.60% 3.20% ‐3.10% ‐0.90% 4.80% ‐9.90% ‐2.50% ‐0.70% 3.80% ‐3.50% ‐1.30% 4.80% 5.60% 8.30% 9.20% ‐3.10% ‐1.10% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 74246 74247 74247 74247 74249 74249 74249 74250 74250 74250 74251 74251 74251 74260 74260 74260 74261 74261 74261 74262 74262 74262 74263 74263 74263 74270 74270 74270 74280 74280 74280 74283 74283 74283 74290 74290 74290 74291 74291 74291 74300 74300 74300 74301 74301 74301 74305 74305 74305 74320 26 TC 26 26 TC TC 26 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 26 TC 26 TC 26 TC TC A A A A A A A A A A A A A A A A A A A A A A N N N A A A A A A A A A A A A A A A A C C A C C A C C A Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract Contrst x‐ray uppr gi tract X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel X‐ray exam of small bowel Ct colonography dx Ct colonography dx Ct colonography dx Ct colonography dx w/dye Ct colonography dx w/dye Ct colonography dx w/dye Ct colonography screening Ct colonography screening Ct colonography screening Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray exam of colon Contrast x‐ray gallbladder Contrast x‐ray gallbladder Contrast x‐ray gallbladder Contrast x‐rays gallbladder Contrast x‐rays gallbladder Contrast x‐rays gallbladder X‐ray bile ducts/pancreas X‐ray bile ducts/pancreas X‐ray bile ducts/pancreas X‐rays at surgery add‐on X‐rays at surgery add‐on X‐rays at surgery add‐on X‐ray bile ducts/pancreas X‐ray bile ducts/pancreas X‐ray bile ducts/pancreas Contrast x‐ray of bile ducts $33.34 $113.64 $146.98 $33.34 $43.89 $166.71 $122.82 $82.68 $105.47 $22.80 $33.34 $156.17 $122.82 $24.16 $106.83 $82.68 $173.52 $289.20 $115.68 $297.36 $417.46 $120.10 $674.00 $786.95 $112.96 $122.82 $156.17 $33.34 $47.63 $170.46 $122.82 $108.87 $204.48 $95.60 $56.48 $71.79 $15.31 $60.56 $70.43 $9.87 $17.69 $0.00 $0.00 $10.55 $0.00 $0.00 $20.75 $0.00 $0.00 $74.85 $34.95 $109.85 $144.80 $34.95 $46.36 $194.73 $148.37 $85.95 $109.85 $23.90 $34.95 $191.68 $156.73 $25.32 $129.77 $104.45 $114.94 $236.20 $121.26 $236.76 $363.02 $126.26 $634.84 $751.47 $116.63 $124.47 $159.42 $34.95 $49.93 $206.66 $156.73 $105.57 $205.79 $100.22 $54.21 $70.26 $16.05 $58.13 $68.12 $9.99 $18.55 $0.00 $0.00 $11.06 $0.00 $0.00 $21.40 $0.00 $0.00 $71.33 4.80% ‐3.30% ‐1.50% 4.80% 5.60% 16.80% 20.80% 4.00% 4.20% 4.80% 4.80% 22.70% 27.60% 4.80% 21.50% 26.30% ‐33.80% ‐18.30% 4.80% ‐20.40% ‐13.00% 5.10% ‐5.80% ‐4.50% 3.30% 1.30% 2.10% 4.80% 4.80% 21.20% 27.60% ‐3.00% 0.60% 4.80% ‐4.00% ‐2.10% 4.80% ‐4.00% ‐3.30% 1.20% 4.80% 4.80% 3.10% ‐4.70% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 74320 74320 74327 74327 74327 74328 74328 74328 74329 74329 74329 74330 74330 74330 74340 74340 74340 74355 74355 74355 74360 74360 74360 74363 74363 74363 74400 74400 74400 74410 74410 74410 74415 74415 74415 74420 74420 74420 74425 74425 74425 74430 74430 74430 74440 74440 74440 74445 74445 74445 26 TC 26 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC TC 26 TC 26 TC 26 26 TC 26 TC TC 26 TC 26 26 TC A A A A A A C C A C C A C C A C C A C C A C C A C C A A A A A A A A A A C C A C C A A A A A A A C C Contrast x‐ray of bile ducts Contrast x‐ray of bile ducts X‐ray bile stone removal X‐ray bile stone removal X‐ray bile stone removal X‐ray bile duct endoscopy X‐ray bile duct endoscopy X‐ray bile duct endoscopy X‐ray for pancreas endoscopy X‐ray for pancreas endoscopy X‐ray for pancreas endoscopy X‐ray bile/panc endoscopy X‐ray bile/panc endoscopy X‐ray bile/panc endoscopy X‐ray guide for gi tube X‐ray guide for gi tube X‐ray guide for gi tube X‐ray guide intestinal tube X‐ray guide intestinal tube X‐ray guide intestinal tube X‐ray guide gi dilation X‐ray guide gi dilation X‐ray guide gi dilation X‐ray bile duct dilation X‐ray bile duct dilation X‐ray bile duct dilation Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrst x‐ray urinary tract Contrast x‐ray bladder Contrast x‐ray bladder Contrast x‐ray bladder X‐ray male genital tract X‐ray male genital tract X‐ray male genital tract X‐ray exam of penis X‐ray exam of penis X‐ray exam of penis $100.71 $25.86 $107.51 $143.92 $36.40 $35.04 $0.00 $0.00 $35.38 $0.00 $0.00 $44.91 $0.00 $0.00 $26.54 $0.00 $0.00 $37.77 $0.00 $0.00 $28.24 $0.00 $0.00 $42.87 $0.00 $0.00 $92.20 $116.02 $23.82 $91.18 $114.66 $23.48 $118.40 $142.22 $23.82 $17.69 $0.00 $0.00 $17.35 $0.00 $0.00 $26.54 $41.51 $14.97 $67.37 $86.08 $18.71 $55.80 $0.00 $0.00 $98.08 $26.75 $104.50 $142.30 $37.81 $36.38 $0.00 $0.00 $36.74 $0.00 $0.00 $47.08 $0.00 $0.00 $27.46 $0.00 $0.00 $39.23 $0.00 $0.00 $28.89 $0.00 $0.00 $44.58 $0.00 $0.00 $89.52 $114.13 $24.61 $88.09 $112.70 $24.61 $114.13 $138.74 $24.61 $18.55 $0.00 $0.00 $18.19 $0.00 $0.00 $25.68 $41.37 $15.69 $64.55 $83.81 $19.26 $58.49 $0.00 $0.00 ‐2.60% 3.50% ‐2.80% ‐1.10% 3.90% 3.80% 3.80% 4.80% 3.50% 3.90% 2.30% 4.00% ‐2.90% ‐1.60% 3.30% ‐3.40% ‐1.70% 4.80% ‐3.60% ‐2.50% 3.30% 4.80% 4.80% ‐3.20% ‐0.30% 4.80% ‐4.20% ‐2.60% 2.90% 4.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 74450 74450 74450 74455 74455 74455 74470 74470 74470 74475 74475 74475 74480 74480 74480 74485 74485 74485 74710 74710 74710 74740 74740 74740 74742 74742 74742 74775 74775 74775 75557 75557 75557 75559 75559 75559 75561 75561 75561 75563 75563 75563 75565 75565 75565 75571 75571 75571 75572 75572 26 TC TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A C C A A A A C C A A A A A A A A A A A A A A A A C C A C C A A A A A A A A A A A A A A A A A A A A X‐ray urethra/bladder X‐ray urethra/bladder X‐ray urethra/bladder X‐ray urethra/bladder X‐ray urethra/bladder X‐ray urethra/bladder X‐ray exam of kidney lesion X‐ray exam of kidney lesion X‐ray exam of kidney lesion X‐ray control cath insert X‐ray control cath insert X‐ray control cath insert X‐ray control cath insert X‐ray control cath insert X‐ray control cath insert X‐ray guide gu dilation X‐ray guide gu dilation X‐ray guide gu dilation X‐ray measurement of pelvis X‐ray measurement of pelvis X‐ray measurement of pelvis X‐ray female genital tract X‐ray female genital tract X‐ray female genital tract X‐ray fallopian tube X‐ray fallopian tube X‐ray fallopian tube X‐ray exam of perineum X‐ray exam of perineum X‐ray exam of perineum Cardiac mri for morph Cardiac mri for morph Cardiac mri for morph Cardiac mri w/stress img Cardiac mri w/stress img Cardiac mri w/stress img Cardiac mri for morph w/dye Cardiac mri for morph w/dye Cardiac mri for morph w/dye Card mri w/stress img & dye Card mri w/stress img & dye Card mri w/stress img & dye Card mri veloc flow mapping Card mri veloc flow mapping Card mri veloc flow mapping Ct hrt w/o dye w/ca test Ct hrt w/o dye w/ca test Ct hrt w/o dye w/ca test Ct hrt w/3d image Ct hrt w/3d image $16.33 $0.00 $0.00 $71.11 $86.76 $15.65 $26.20 $0.00 $0.00 $73.49 $99.35 $25.86 $73.49 $99.35 $25.86 $73.83 $99.69 $25.86 $18.71 $33.68 $14.97 $61.24 $79.27 $18.03 $30.28 $0.00 $0.00 $30.62 $0.00 $0.00 $254.15 $366.77 $112.62 $338.53 $479.38 $140.86 $365.41 $489.59 $124.18 $435.49 $578.39 $142.90 $52.06 $63.96 $11.91 $49.67 $76.89 $27.22 $230.68 $313.69 $17.12 $0.00 $0.00 $68.48 $84.88 $16.41 $27.11 $0.00 $0.00 $70.26 $97.01 $26.75 $70.26 $97.01 $26.75 $70.62 $97.37 $26.75 $20.33 $37.09 $16.76 $58.85 $77.75 $18.90 $31.39 $0.00 $0.00 $31.74 $0.00 $0.00 $211.50 $328.48 $116.98 $283.19 $428.70 $145.51 $304.23 $433.33 $129.11 $363.07 $511.44 $148.37 $43.16 $55.64 $12.48 $18.79 $46.97 $28.18 $201.51 $287.82 4.80% ‐3.70% ‐2.20% 4.80% 3.50% ‐4.40% ‐2.40% 3.50% ‐4.40% ‐2.40% 3.50% ‐4.40% ‐2.30% 3.50% 8.60% 10.10% 12.00% ‐3.90% ‐1.90% 4.80% 3.70% 3.70% ‐16.80% ‐10.40% 3.90% ‐16.30% ‐10.60% 3.30% ‐16.70% ‐11.50% 4.00% ‐16.60% ‐11.60% 3.80% ‐17.10% ‐13.00% 4.80% ‐62.20% ‐38.90% 3.50% ‐12.60% ‐8.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 75572 75573 75573 75573 75574 75574 75574 75600 75600 75600 75605 75605 75605 75625 75625 75625 75630 75630 75630 75635 75635 75635 75658 75658 75658 75705 75705 75705 75710 75710 75710 75716 75716 75716 75726 75726 75726 75731 75731 75731 75733 75733 75733 75736 75736 75736 75741 75741 75741 75743 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Ct hrt w/3d image Ct hrt w/3d image congen Ct hrt w/3d image congen Ct hrt w/3d image congen Ct angio hrt w/3d image Ct angio hrt w/3d image Ct angio hrt w/3d image Contrast exam thoracic aorta Contrast exam thoracic aorta Contrast exam thoracic aorta Contrast exam thoracic aorta Contrast exam thoracic aorta Contrast exam thoracic aorta Contrast exam abdominl aorta Contrast exam abdominl aorta Contrast exam abdominl aorta X‐ray aorta leg arteries X‐ray aorta leg arteries X‐ray aorta leg arteries Ct angio abdominal arteries Ct angio abdominal arteries Ct angio abdominal arteries Artery x‐rays arm Artery x‐rays arm Artery x‐rays arm Artery x‐rays spine Artery x‐rays spine Artery x‐rays spine Artery x‐rays arm/leg Artery x‐rays arm/leg Artery x‐rays arm/leg Artery x‐rays arms/legs Artery x‐rays arms/legs Artery x‐rays arms/legs Artery x‐rays abdomen Artery x‐rays abdomen Artery x‐rays abdomen Artery x‐rays adrenal gland Artery x‐rays adrenal gland Artery x‐rays adrenal gland Artery x‐rays adrenals Artery x‐rays adrenals Artery x‐rays adrenals Artery x‐rays pelvis Artery x‐rays pelvis Artery x‐rays pelvis Artery x‐rays lung Artery x‐rays lung Artery x‐rays lung Artery x‐rays lungs $83.02 $267.08 $387.86 $120.78 $267.42 $381.40 $113.98 $193.59 $217.07 $23.48 $102.41 $156.85 $54.44 $102.75 $157.19 $54.44 $101.73 $186.45 $84.72 $339.21 $454.21 $115.00 $124.52 $185.77 $61.24 $144.94 $249.73 $104.79 $128.95 $182.36 $53.42 $155.83 $218.43 $62.60 $128.27 $183.04 $54.78 $54.44 $169.43 $115.00 $148.34 $210.60 $62.26 $123.84 $176.92 $53.08 $102.07 $164.67 $62.60 $112.62 $86.31 $231.93 $357.47 $125.54 $231.93 $350.34 $118.41 $186.17 $210.07 $23.90 $96.30 $152.65 $56.35 $95.58 $151.93 $56.35 $95.23 $182.61 $87.38 $283.78 $403.62 $119.84 $114.49 $177.61 $63.13 $137.31 $246.45 $109.14 $120.19 $175.47 $55.28 $145.16 $210.07 $64.91 $121.26 $178.33 $57.06 $57.06 $180.47 $123.40 $139.09 $203.65 $64.55 $116.98 $172.26 $55.28 $97.72 $162.63 $64.91 $106.64 4.00% ‐13.20% ‐7.80% 3.90% ‐13.30% ‐8.10% 3.90% ‐3.80% ‐3.20% 1.80% ‐6.00% ‐2.70% 3.50% ‐7.00% ‐3.30% 3.50% ‐6.40% ‐2.10% 3.10% ‐16.30% ‐11.10% 4.20% ‐8.10% ‐4.40% 3.10% ‐5.30% ‐1.30% 4.20% ‐6.80% ‐3.80% 3.50% ‐6.90% ‐3.80% 3.70% ‐5.50% ‐2.60% 4.20% 4.80% 6.50% 7.30% ‐6.20% ‐3.30% 3.70% ‐5.50% ‐2.60% 4.20% ‐4.30% ‐1.20% 3.70% ‐5.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 75743 75743 75746 75746 75746 75756 75756 75756 75774 75774 75774 75791 75791 75791 75801 75801 75801 75803 75803 75803 75805 75805 75805 75807 75807 75807 75809 75809 75809 75810 75810 75810 75820 75820 75820 75822 75822 75822 75825 75825 75825 75827 75827 75827 75831 75831 75831 75833 75833 75833 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A C C A C C A C C A C C A A A A C C A A A A A A A A A A A A A A A A A A Artery x‐rays lungs Artery x‐rays lungs Artery x‐rays lung Artery x‐rays lung Artery x‐rays lung Artery x‐rays chest Artery x‐rays chest Artery x‐rays chest Artery x‐ray each vessel Artery x‐ray each vessel Artery x‐ray each vessel Av dialysis shunt imaging Av dialysis shunt imaging Av dialysis shunt imaging Lymph vessel x‐ray arm/leg Lymph vessel x‐ray arm/leg Lymph vessel x‐ray arm/leg Lymph vessel x‐ray arms/legs Lymph vessel x‐ray arms/legs Lymph vessel x‐ray arms/legs Lymph vessel x‐ray trunk Lymph vessel x‐ray trunk Lymph vessel x‐ray trunk Lymph vessel x‐ray trunk Lymph vessel x‐ray trunk Lymph vessel x‐ray trunk Nonvascular shunt x‐ray Nonvascular shunt x‐ray Nonvascular shunt x‐ray Vein x‐ray spleen/liver Vein x‐ray spleen/liver Vein x‐ray spleen/liver Vein x‐ray arm/leg Vein x‐ray arm/leg Vein x‐ray arm/leg Vein x‐ray arms/legs Vein x‐ray arms/legs Vein x‐ray arms/legs Vein x‐ray trunk Vein x‐ray trunk Vein x‐ray trunk Vein x‐ray chest Vein x‐ray chest Vein x‐ray chest Vein x‐ray kidney Vein x‐ray kidney Vein x‐ray kidney Vein x‐ray kidneys Vein x‐ray kidneys Vein x‐ray kidneys $191.55 $78.93 $117.04 $172.16 $55.12 $134.73 $193.59 $58.86 $85.40 $102.75 $17.35 $261.30 $341.93 $80.63 $44.57 $0.00 $0.00 $57.84 $0.00 $0.00 $40.15 $0.00 $0.00 $57.84 $0.00 $0.00 $23.14 $93.90 $70.77 $56.14 $0.00 $0.00 $94.92 $128.61 $33.68 $109.21 $159.91 $50.69 $97.31 $151.40 $54.10 $101.05 $154.80 $53.76 $103.09 $162.97 $59.88 $120.10 $189.17 $69.07 $188.67 $82.03 $110.56 $167.98 $57.42 $123.76 $184.03 $60.27 $80.96 $98.79 $17.83 $246.80 $330.26 $83.46 $46.01 $0.00 $0.00 $60.63 $0.00 $0.00 $41.73 $0.00 $0.00 $60.63 $0.00 $0.00 $24.25 $104.14 $79.89 $59.20 $0.00 $0.00 $90.23 $124.83 $34.60 $103.43 $156.21 $52.78 $90.95 $147.30 $56.35 $93.44 $149.08 $55.64 $97.01 $158.71 $61.70 $109.49 $180.11 $70.62 ‐1.50% 3.90% ‐5.50% ‐2.40% 4.20% ‐8.10% ‐4.90% 2.40% ‐5.20% ‐3.90% 2.80% ‐5.60% ‐3.40% 3.50% 3.20% 4.80% 3.90% 4.80% 4.80% 10.90% 12.90% 5.50% ‐4.90% ‐2.90% 2.70% ‐5.30% ‐2.30% 4.10% ‐6.50% ‐2.70% 4.20% ‐7.50% ‐3.70% 3.50% ‐5.90% ‐2.60% 3.00% ‐8.80% ‐4.80% 2.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 75840 75840 75840 75842 75842 75842 75860 75860 75860 75870 75870 75870 75872 75872 75872 75880 75880 75880 75885 75885 75885 75887 75887 75887 75889 75889 75889 75891 75891 75891 75893 75893 75893 75894 75894 75894 75896 75896 75896 75896 75896 75896 75898 75898 75898 75898 75898 75898 75901 75901 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 26 TC TC 26 26 TC TC TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A C C C C A A C C C C A A Vein x‐ray adrenal gland Vein x‐ray adrenal gland Vein x‐ray adrenal gland Vein x‐ray adrenal glands Vein x‐ray adrenal glands Vein x‐ray adrenal glands Vein x‐ray neck Vein x‐ray neck Vein x‐ray neck Vein x‐ray skull Vein x‐ray skull Vein x‐ray skull Vein x‐ray skull epidural Vein x‐ray skull epidural Vein x‐ray skull epidural Vein x‐ray eye socket Vein x‐ray eye socket Vein x‐ray eye socket Vein x‐ray liver w/hemodynam Vein x‐ray liver w/hemodynam Vein x‐ray liver w/hemodynam Vein x‐ray liver w/o hemodyn Vein x‐ray liver w/o hemodyn Vein x‐ray liver w/o hemodyn Vein x‐ray liver w/hemodynam Vein x‐ray liver w/hemodynam Vein x‐ray liver w/hemodynam Vein x‐ray liver Vein x‐ray liver Vein x‐ray liver Venous sampling by catheter Venous sampling by catheter Venous sampling by catheter X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy X‐rays transcath therapy Follow‐up angiography Follow‐up angiography Follow‐up angiography Follow‐up angiography Follow‐up angiography Follow‐up angiography Remove cva device obstruct Remove cva device obstruct $102.07 $163.31 $61.24 $122.48 $194.61 $72.13 $102.41 $157.19 $54.78 $101.73 $156.85 $55.12 $55.12 $156.85 $101.73 $204.82 $241.56 $36.74 $103.09 $171.82 $68.73 $102.41 $170.12 $67.71 $103.77 $158.21 $54.44 $103.43 $158.21 $54.78 $103.43 $128.61 $25.18 $65.32 $0.00 $0.00 $64.98 $64.98 $0.00 $0.00 $0.00 $0.00 $83.02 $83.02 $0.00 $0.00 $0.00 $0.00 $155.14 $178.62 $99.51 $163.35 $63.84 $119.12 $194.73 $75.61 $97.37 $154.43 $57.06 $98.44 $156.57 $58.13 $52.07 $153.00 $100.93 $99.86 $135.17 $35.31 $98.08 $169.41 $71.33 $98.08 $168.70 $70.62 $98.79 $155.50 $56.71 $98.79 $156.21 $57.42 $99.51 $125.90 $26.39 $68.12 $0.00 $0.00 $67.41 $67.41 $0.00 $0.00 $0.00 $0.00 $85.95 $85.95 $0.00 $0.00 $0.00 $0.00 $153.36 $177.61 ‐2.50% 0.00% 4.20% ‐2.70% 0.10% 4.80% ‐4.90% ‐1.80% 4.20% ‐3.20% ‐0.20% 5.50% ‐5.50% ‐2.50% ‐0.80% ‐51.20% ‐44.00% ‐3.90% ‐4.90% ‐1.40% 3.80% ‐4.20% ‐0.80% 4.30% ‐4.80% ‐1.70% 4.20% ‐4.50% ‐1.30% 4.80% ‐3.80% ‐2.10% 4.80% 4.30% 3.70% 3.70% 3.50% 3.50% ‐1.20% ‐0.60% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 75901 75902 75902 75902 75945 75945 75945 75946 75946 75946 75952 75952 75952 75953 75953 75953 75954 75954 75954 75956 75956 75956 75957 75957 75957 75958 75958 75958 75959 75959 75959 75960 75960 75960 75962 75962 75962 75964 75964 75964 75966 75966 75966 75968 75968 75968 75970 75970 75970 75978 26 TC 26 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC A A A A A C C A C C A C C A C C A C C A C C A C C A C C A C C A A A A A A A A A A A A A A A A C C A Remove cva device obstruct Remove cva lumen obstruct Remove cva lumen obstruct Remove cva lumen obstruct Intravascular us Intravascular us Intravascular us Intravascular us add‐on Intravascular us add‐on Intravascular us add‐on Endovasc repair abdom aorta Endovasc repair abdom aorta Endovasc repair abdom aorta Abdom aneurysm endovas rpr Abdom aneurysm endovas rpr Abdom aneurysm endovas rpr Iliac aneurysm endovas rpr Iliac aneurysm endovas rpr Iliac aneurysm endovas rpr Xray endovasc thor ao repr Xray endovasc thor ao repr Xray endovasc thor ao repr Xray endovasc thor ao repr Xray endovasc thor ao repr Xray endovasc thor ao repr Xray place prox ext thor ao Xray place prox ext thor ao Xray place prox ext thor ao Xray place dist ext thor ao Xray place dist ext thor ao Xray place dist ext thor ao Transcath iv stent rs&i Transcath iv stent rs&i Transcath iv stent rs&i Repair arterial blockage Repair arterial blockage Repair arterial blockage Repair artery blockage each Repair artery blockage each Repair artery blockage each Repair arterial blockage Repair arterial blockage Repair arterial blockage Repair artery blockage each Repair artery blockage each Repair artery blockage each Vascular biopsy Vascular biopsy Vascular biopsy Repair venous blockage $23.48 $58.18 $77.23 $19.05 $19.39 $0.00 $0.00 $19.73 $0.00 $0.00 $226.93 $0.00 $0.00 $69.07 $0.00 $0.00 $113.30 $0.00 $0.00 $356.56 $0.00 $0.00 $304.17 $0.00 $0.00 $202.78 $0.00 $0.00 $176.24 $0.00 $0.00 $88.12 $126.91 $38.79 $127.59 $153.10 $25.52 $81.31 $99.01 $17.69 $118.06 $179.64 $61.58 $73.15 $89.82 $16.67 $40.15 $0.00 $0.00 $126.23 $24.25 $55.28 $74.90 $19.62 $19.97 $0.00 $0.00 $20.33 $0.00 $0.00 $232.54 $0.00 $0.00 $70.97 $0.00 $0.00 $115.56 $0.00 $0.00 $364.50 $0.00 $0.00 $312.07 $0.00 $0.00 $207.57 $0.00 $0.00 $184.75 $0.00 $0.00 $82.74 $122.69 $39.95 $119.48 $145.87 $26.39 $75.61 $93.80 $18.19 $110.56 $174.40 $63.84 $69.90 $87.02 $17.12 $41.73 $0.00 $0.00 $118.05 3.30% ‐5.00% ‐3.00% 3.00% 3.00% 3.00% Y Y Y Y Y Y Y Y Y Y 2.50% 2.80% Y Y Y 2.00% 2.20% 2.60% 2.40% 4.80% ‐6.10% ‐3.30% 3.00% ‐6.40% ‐4.70% 3.40% ‐7.00% ‐5.30% 2.80% ‐6.40% ‐2.90% 3.70% ‐4.40% ‐3.10% 2.70% 3.90% ‐6.50% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 75978 75978 75980 75980 75980 75982 75982 75982 75984 75984 75984 75989 75989 75989 76000 76000 76000 76001 76001 76001 76010 76010 76010 76080 76080 76080 76098 76098 76098 76100 76100 76100 76101 76101 76101 76102 76102 76102 76120 76120 76120 76125 76125 76125 76140 76376 76376 76376 76377 76377 26 26 TC 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC TC 26 TC A A A C C A C C A A A A A A A A A A C C A A A A A A A A A A A A A A A A A A A A A A C C I A A A A A Repair venous blockage Repair venous blockage Contrast xray exam bile duct Contrast xray exam bile duct Contrast xray exam bile duct Contrast xray exam bile duct Contrast xray exam bile duct Contrast xray exam bile duct Xray control catheter change Xray control catheter change Xray control catheter change Abscess drainage under x‐ray Abscess drainage under x‐ray Abscess drainage under x‐ray Fluoroscope examination Fluoroscope examination Fluoroscope examination Fluoroscope exam extensive Fluoroscope exam extensive Fluoroscope exam extensive X‐ray nose to rectum X‐ray nose to rectum X‐ray nose to rectum X‐ray exam of fistula X‐ray exam of fistula X‐ray exam of fistula X‐ray exam breast specimen X‐ray exam breast specimen X‐ray exam breast specimen X‐ray exam of body section X‐ray exam of body section X‐ray exam of body section Complex body section x‐ray Complex body section x‐ray Complex body section x‐ray Complex body section x‐rays Complex body section x‐rays Complex body section x‐rays Cine/video x‐rays Cine/video x‐rays Cine/video x‐rays Cine/video x‐rays add‐on Cine/video x‐rays add‐on Cine/video x‐rays add‐on X‐ray consultation 3d render w/intrp postproces 3d render w/intrp postproces 3d render w/intrp postproces 3d render w/intrp postproces 3d render w/intrp postproces $151.74 $25.52 $70.09 $0.00 $0.00 $70.09 $0.00 $0.00 $79.27 $113.64 $34.36 $70.09 $126.57 $56.48 $44.57 $53.08 $8.51 $35.04 $0.00 $0.00 $18.71 $27.56 $8.85 $35.72 $61.58 $25.86 $11.23 $19.05 $7.83 $70.77 $101.73 $30.96 $121.46 $156.51 $35.04 $173.52 $209.24 $35.72 $18.71 $77.23 $58.52 $13.95 $0.00 $0.00 $0.00 $50.69 $60.22 $9.53 $44.57 $82.68 $144.44 $26.39 $73.11 $0.00 $0.00 $72.76 $0.00 $0.00 $75.61 $111.28 $35.67 $67.05 $125.90 $58.85 $42.09 $50.64 $8.56 $36.02 $0.00 $0.00 $18.55 $27.46 $8.92 $34.60 $61.34 $26.75 $10.70 $18.90 $8.20 $69.90 $102.00 $32.10 $115.20 $151.93 $36.74 $165.49 $202.94 $37.45 $19.97 $93.09 $73.11 $14.62 $0.00 $0.00 $0.00 $18.90 $28.89 $9.99 $43.16 $82.74 ‐4.80% 3.40% 4.30% 3.80% ‐4.60% ‐2.10% 3.80% ‐4.30% ‐0.50% 4.20% ‐5.60% ‐4.60% 0.60% 2.80% ‐0.90% ‐0.40% 0.80% ‐3.20% ‐0.40% 3.50% ‐4.70% ‐0.80% 4.80% ‐1.20% 0.30% 3.70% ‐5.20% ‐2.90% 4.80% ‐4.60% ‐3.00% 4.80% 6.70% 20.50% 24.90% 4.80% ‐62.70% ‐52.00% 4.80% ‐3.20% 0.10% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 76377 76380 76380 76380 76390 76390 76390 76496 76496 76496 76497 76497 76497 76498 76498 76498 76499 76499 76499 76506 76506 76506 76510 76510 76510 76511 76511 76511 76512 76512 76512 76513 76513 76513 76514 76514 76514 76516 76516 76516 76519 76519 76519 76529 76529 76529 76536 76536 76536 76604 26 TC 26 TC 26 26 TC 26 TC 26 TC 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A N N N C C C C C C C C C C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A 3d render w/intrp postproces Cat scan follow‐up study Cat scan follow‐up study Cat scan follow‐up study Mr spectroscopy Mr spectroscopy Mr spectroscopy Fluoroscopic procedure Fluoroscopic procedure Fluoroscopic procedure Ct procedure Ct procedure Ct procedure Mri procedure Mri procedure Mri procedure Radiographic procedure Radiographic procedure Radiographic procedure Echo exam of head Echo exam of head Echo exam of head Ophth us b & quant a Ophth us b & quant a Ophth us b & quant a Ophth us quant a only Ophth us quant a only Ophth us quant a only Ophth us b w/non‐quant a Ophth us b w/non‐quant a Ophth us b w/non‐quant a Echo exam of eye water bath Echo exam of eye water bath Echo exam of eye water bath Echo exam of eye thickness Echo exam of eye thickness Echo exam of eye thickness Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Echo exam of eye Us exam of head and neck Us exam of head and neck Us exam of head and neck Us exam chest $38.11 $99.01 $145.96 $46.95 $396.71 $465.43 $68.73 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $30.96 $95.60 $64.64 $86.08 $182.36 $96.29 $51.03 $103.43 $52.40 $42.19 $95.94 $53.76 $63.96 $99.69 $35.72 $5.78 $15.31 $9.53 $50.35 $80.97 $30.62 $56.14 $87.78 $31.64 $49.33 $82.34 $33.00 $97.65 $124.86 $27.22 $63.28 $39.59 $74.72 $123.94 $49.22 $373.77 $445.10 $71.33 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $32.10 $123.40 $91.30 $80.96 $180.47 $99.51 $48.86 $103.43 $54.57 $39.59 $94.87 $55.28 $59.92 $97.01 $37.09 $5.35 $15.34 $9.99 $47.08 $78.82 $31.74 $52.43 $85.24 $32.81 $46.36 $80.60 $34.24 $93.80 $121.98 $28.18 $60.99 3.90% ‐24.50% ‐15.10% 4.80% ‐5.80% ‐4.40% 3.80% 3.70% 29.10% 41.20% ‐6.00% ‐1.00% 3.40% ‐4.30% 0.00% 4.20% ‐6.20% ‐1.10% 2.80% ‐6.30% ‐2.70% 3.80% ‐7.50% 0.20% 4.80% ‐6.50% ‐2.70% 3.70% ‐6.60% ‐2.90% 3.70% ‐6.00% ‐2.10% 3.80% ‐3.90% ‐2.30% 3.50% ‐3.60% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 76604 76604 76645 76645 76645 76700 76700 76700 76705 76705 76705 76770 76770 76770 76775 76775 76775 76776 76776 76776 76800 76800 76800 76801 76801 76801 76802 76802 76802 76805 76805 76805 76810 76810 76810 76811 76811 76811 76812 76812 76812 76813 76813 76813 76814 76814 76814 76815 76815 76815 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Us exam chest Us exam chest Us exam breast(s) Us exam breast(s) Us exam breast(s) Us exam abdom complete Us exam abdom complete Us exam abdom complete Echo exam of abdomen Echo exam of abdomen Echo exam of abdomen Us exam abdo back wall comp Us exam abdo back wall comp Us exam abdo back wall comp Us exam abdo back wall lim Us exam abdo back wall lim Us exam abdo back wall lim Us exam k transpl w/doppler Us exam k transpl w/doppler Us exam k transpl w/doppler Us exam spinal canal Us exam spinal canal Us exam spinal canal Ob us < 14 wks single fetus Ob us < 14 wks single fetus Ob us < 14 wks single fetus Ob us < 14 wks addl fetus Ob us < 14 wks addl fetus Ob us < 14 wks addl fetus Ob us >/= 14 wks sngl fetus Ob us >/= 14 wks sngl fetus Ob us >/= 14 wks sngl fetus Ob us >/= 14 wks addl fetus Ob us >/= 14 wks addl fetus Ob us >/= 14 wks addl fetus Ob us detailed sngl fetus Ob us detailed sngl fetus Ob us detailed sngl fetus Ob us detailed addl fetus Ob us detailed addl fetus Ob us detailed addl fetus Ob us nuchal meas 1 gest Ob us nuchal meas 1 gest Ob us nuchal meas 1 gest Ob us nuchal meas add‐on Ob us nuchal meas add‐on Ob us nuchal meas add‐on Ob us limited fetus(s) Ob us limited fetus(s) Ob us limited fetus(s) $89.82 $26.54 $26.54 $91.18 $64.64 $99.35 $138.47 $39.13 $82.00 $110.23 $28.24 $99.35 $135.07 $35.72 $83.02 $110.92 $27.90 $120.10 $156.51 $36.40 $78.93 $133.37 $54.44 $80.97 $128.95 $47.97 $26.54 $67.03 $40.49 $99.35 $147.66 $48.31 $50.69 $98.33 $47.63 $95.94 $189.51 $93.56 $88.12 $152.76 $64.64 $66.00 $124.18 $58.18 $31.64 $80.63 $48.99 $60.90 $91.86 $30.96 $88.45 $27.46 $27.46 $98.44 $70.97 $100.22 $140.88 $40.66 $78.82 $108.42 $29.60 $95.94 $133.03 $37.09 $36.38 $65.62 $29.25 $104.50 $142.66 $38.16 $82.39 $139.81 $57.42 $77.39 $127.33 $49.93 $25.68 $68.12 $42.44 $97.72 $148.01 $50.29 $48.15 $98.08 $49.93 $91.30 $188.31 $97.01 $91.30 $212.92 $121.62 $62.77 $123.40 $60.63 $29.96 $80.96 $51.00 $58.49 $90.59 $32.10 ‐1.50% 3.50% 3.50% 8.00% 9.80% 0.90% 1.70% 3.90% ‐3.90% ‐1.60% 4.80% ‐3.40% ‐1.50% 3.80% ‐56.20% ‐40.80% 4.80% ‐13.00% ‐8.90% 4.80% 4.40% 4.80% 5.50% ‐4.40% ‐1.30% 4.10% ‐3.20% 1.60% 4.80% ‐1.60% 0.20% 4.10% ‐5.00% ‐0.30% 4.80% ‐4.80% ‐0.60% 3.70% 3.60% 39.40% 88.10% ‐4.90% ‐0.60% 4.20% ‐5.30% 0.40% 4.10% ‐4.00% ‐1.40% 3.70% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 76816 76816 76816 76817 76817 76817 76818 76818 76818 76819 76819 76819 76820 76820 76820 76821 76821 76821 76825 76825 76825 76826 76826 76826 76827 76827 76827 76828 76828 76828 76830 76830 76830 76831 76831 76831 76856 76856 76856 76857 76857 76857 76870 76870 76870 76872 76872 76872 76873 76873 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Ob us follow‐up per fetus Ob us follow‐up per fetus Ob us follow‐up per fetus Transvaginal us obstetric Transvaginal us obstetric Transvaginal us obstetric Fetal biophys profile w/nst Fetal biophys profile w/nst Fetal biophys profile w/nst Fetal biophys profil w/o nst Fetal biophys profil w/o nst Fetal biophys profil w/o nst Umbilical artery echo Umbilical artery echo Umbilical artery echo Middle cerebral artery echo Middle cerebral artery echo Middle cerebral artery echo Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Echo exam of fetal heart Transvaginal us non‐ob Transvaginal us non‐ob Transvaginal us non‐ob Echo exam uterus Echo exam uterus Echo exam uterus Us exam pelvic complete Us exam pelvic complete Us exam pelvic complete Us exam pelvic limited Us exam pelvic limited Us exam pelvic limited Us exam scrotum Us exam scrotum Us exam scrotum Us transrectal Us transrectal Us transrectal Echograp trans r pros study Echograp trans r pros study $41.85 $106.49 $64.64 $64.64 $101.39 $36.74 $74.17 $125.89 $51.71 $53.76 $91.52 $37.77 $24.50 $40.83 $16.33 $62.26 $96.97 $34.70 $140.86 $221.83 $80.97 $93.22 $133.71 $40.49 $32.66 $60.56 $27.90 $17.69 $44.91 $27.22 $42.53 $76.21 $33.68 $93.22 $128.95 $35.72 $93.90 $126.91 $33.00 $64.64 $83.36 $18.71 $95.94 $126.91 $30.96 $40.49 $73.49 $33.00 $97.31 $173.18 $43.87 $118.77 $74.90 $64.20 $102.36 $38.16 $70.26 $124.12 $53.85 $50.64 $89.88 $39.23 $25.32 $49.57 $24.25 $59.20 $95.23 $36.02 $133.39 $217.20 $83.81 $87.38 $129.11 $41.73 $31.03 $59.92 $28.89 $16.76 $44.94 $28.18 $40.66 $75.61 $34.95 $88.81 $125.90 $37.09 $90.23 $124.83 $34.60 $35.31 $54.57 $19.26 $41.37 $73.83 $32.46 $38.52 $73.11 $34.60 $93.80 $173.33 4.80% 11.50% 15.90% ‐0.70% 1.00% 3.90% ‐5.30% ‐1.40% 4.10% ‐5.80% ‐1.80% 3.90% 3.40% 21.40% 48.50% ‐4.90% ‐1.80% 3.80% ‐5.30% ‐2.10% 3.50% ‐6.30% ‐3.40% 3.10% ‐5.00% ‐1.10% 3.60% ‐5.30% 0.10% 3.50% ‐4.40% ‐0.80% 3.80% ‐4.70% ‐2.40% 3.80% ‐3.90% ‐1.60% 4.80% ‐45.40% ‐34.50% 2.90% ‐56.90% ‐41.80% 4.80% ‐4.90% ‐0.50% 4.80% ‐3.60% 0.10% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 76873 76881 76881 76881 76882 76882 76882 76885 76885 76885 76886 76886 76886 76930 76930 76930 76932 76932 76932 76936 76936 76936 76937 76937 76937 76940 76940 76940 76941 76941 76941 76942 76942 76942 76945 76945 76945 76946 76946 76946 76948 76948 76948 76950 76950 76950 76965 76965 76965 76970 26 TC 26 TC 26 26 TC 26 TC TC 26 26 TC 26 TC TC 26 26 TC 26 TC TC 26 26 TC TC 26 TC 26 TC 26 TC 26 26 A A A A A A A A A A A A A A A A A C C A A A A A A A C C A C C A A A A C C A A A A A A A A A A A A A Echograp trans r pros study Us xtr non‐vasc complete Us xtr non‐vasc complete Us xtr non‐vasc complete Us xtr non‐vasc lmtd Us xtr non‐vasc lmtd Us xtr non‐vasc lmtd Us exam infant hips dynamic Us exam infant hips dynamic Us exam infant hips dynamic Us exam infant hips static Us exam infant hips static Us exam infant hips static Echo guide cardiocentesis Echo guide cardiocentesis Echo guide cardiocentesis Echo guide for heart biopsy Echo guide for heart biopsy Echo guide for heart biopsy Echo guide for artery repair Echo guide for artery repair Echo guide for artery repair Us guide vascular access Us guide vascular access Us guide vascular access Us guide tissue ablation Us guide tissue ablation Us guide tissue ablation Echo guide for transfusion Echo guide for transfusion Echo guide for transfusion Echo guide for biopsy Echo guide for biopsy Echo guide for biopsy Echo guide villus sampling Echo guide villus sampling Echo guide villus sampling Echo guide for amniocentesis Echo guide for amniocentesis Echo guide for amniocentesis Echo guide ova aspiration Echo guide ova aspiration Echo guide ova aspiration Echo guidance radiotherapy Echo guidance radiotherapy Echo guidance radiotherapy Echo guidance radiotherapy Echo guidance radiotherapy Echo guidance radiotherapy Ultrasound exam follow‐up $75.87 $93.56 $124.52 $30.96 $11.57 $35.38 $23.82 $35.72 $100.37 $64.64 $29.26 $93.90 $64.64 $54.44 $85.74 $31.30 $32.32 $0.00 $0.00 $96.63 $205.50 $108.87 $21.77 $36.40 $14.63 $102.75 $0.00 $0.00 $68.73 $0.00 $0.00 $175.90 $208.56 $32.66 $34.02 $0.00 $0.00 $13.95 $32.66 $18.71 $14.29 $33.68 $19.39 $22.11 $51.03 $28.92 $24.50 $89.82 $65.32 $20.07 $79.53 $87.38 $119.48 $32.10 $10.70 $35.67 $24.97 $37.45 $130.58 $93.13 $30.32 $106.28 $75.97 $51.00 $83.46 $32.46 $33.17 $0.00 $0.00 $98.79 $235.42 $136.63 $21.04 $36.02 $14.98 $106.28 $0.00 $0.00 $71.33 $0.00 $0.00 $39.59 $73.47 $33.88 $34.95 $0.00 $0.00 $13.20 $32.46 $19.26 $13.55 $33.53 $19.97 $21.40 $51.36 $29.96 $23.54 $92.02 $68.48 $20.69 4.80% ‐6.60% ‐4.10% 3.70% ‐7.50% 0.80% 4.80% 4.80% 30.10% 44.10% 3.60% 13.20% 17.50% ‐6.30% ‐2.70% 3.70% 2.60% 2.20% 14.60% 25.50% ‐3.40% ‐1.10% 2.40% 3.40% 3.80% ‐77.50% ‐64.80% 3.70% 2.70% ‐5.40% ‐0.60% 2.90% ‐5.20% ‐0.50% 3.00% ‐3.20% 0.60% 3.60% ‐3.90% 2.40% 4.80% 3.10% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 76970 76970 76975 76975 76975 76977 76977 76977 76998 76998 76998 76999 76999 76999 77001 77001 77001 77002 77002 77002 77003 77003 77003 77011 77011 77011 77012 77012 77012 77013 77013 77013 77014 77014 77014 77021 77021 77021 77022 77022 77022 77031 77031 77031 77032 77032 77032 77051 77051 77051 TC 26 TC TC 26 26 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 26 TC TC 26 TC 26 TC 26 A A A C C A A A A C C C C C A A A A A A A A A A A A A A A A C C A A A A A A A C C A A A A A A A A A Ultrasound exam follow‐up Ultrasound exam follow‐up Gi endoscopic ultrasound Gi endoscopic ultrasound Gi endoscopic ultrasound Us bone density measure Us bone density measure Us bone density measure Us guide intraop Us guide intraop Us guide intraop Echo examination procedure Echo examination procedure Echo examination procedure Fluoroguide for vein device Fluoroguide for vein device Fluoroguide for vein device Needle localization by xray Needle localization by xray Needle localization by xray Fluoroguide for spine inject Fluoroguide for spine inject Fluoroguide for spine inject Ct scan for localization Ct scan for localization Ct scan for localization Ct scan for needle biopsy Ct scan for needle biopsy Ct scan for needle biopsy Ct guide for tissue ablation Ct guide for tissue ablation Ct guide for tissue ablation Ct scan for therapy guide Ct scan for therapy guide Ct scan for therapy guide Mr guidance for needle place Mr guidance for needle place Mr guidance for needle place Mri for tissue ablation Mri for tissue ablation Mri for tissue ablation Stereotact guide for brst bx Stereotact guide for brst bx Stereotact guide for brst bx Guidance for needle breast Guidance for needle breast Guidance for needle breast Computer dx mammogram add‐on Computer dx mammogram add‐on Computer dx mammogram add‐on $84.72 $64.64 $43.21 $0.00 $0.00 $4.42 $7.14 $2.72 $63.96 $0.00 $0.00 $0.00 $0.00 $0.00 $102.75 $121.12 $18.37 $52.74 $79.95 $27.22 $65.66 $95.94 $30.28 $166.71 $226.59 $59.88 $73.83 $128.61 $54.78 $195.29 $0.00 $0.00 $82.68 $124.52 $41.85 $318.12 $391.26 $73.15 $206.52 $0.00 $0.00 $52.06 $129.97 $77.91 $25.52 $52.40 $26.88 $7.14 $10.21 $3.06 $95.23 $74.54 $44.58 $0.00 $0.00 $4.28 $7.13 $2.85 $65.98 $0.00 $0.00 $0.00 $0.00 $0.00 $97.72 $116.98 $19.26 $49.93 $78.11 $28.18 $60.27 $91.30 $31.03 $162.28 $224.69 $62.41 $70.97 $128.40 $57.42 $202.94 $0.00 $0.00 $79.89 $124.12 $44.22 $317.06 $394.10 $77.04 $215.42 $0.00 $0.00 $49.57 $131.25 $81.67 $24.61 $52.78 $28.18 $7.13 $10.34 $3.21 12.40% 15.30% 3.20% ‐3.20% ‐0.20% 4.80% 3.20% ‐4.90% ‐3.40% 4.80% ‐5.30% ‐2.30% 3.50% ‐8.20% ‐4.80% 2.50% ‐2.70% ‐0.80% 4.20% ‐3.90% ‐0.20% 4.80% 3.90% ‐3.40% ‐0.30% 5.70% ‐0.30% 0.70% 5.30% 4.30% ‐4.80% 1.00% 4.80% ‐3.60% 0.70% 4.80% ‐0.20% 1.30% 4.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 77052 77052 77052 77053 77053 77053 77054 77054 77054 77055 77055 77055 77056 77056 77056 77057 77057 77057 77058 77058 77058 77059 77059 77059 77071 77072 77072 77072 77073 77073 77073 77074 77074 77074 77075 77075 77075 77076 77076 77076 77077 77077 77077 77078 77078 77078 77080 77080 77080 77081 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 26 TC TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Comp screen mammogram add‐on Comp screen mammogram add‐on Comp screen mammogram add‐on X‐ray of mammary duct X‐ray of mammary duct X‐ray of mammary duct X‐ray of mammary ducts X‐ray of mammary ducts X‐ray of mammary ducts Mammogram one breast Mammogram one breast Mammogram one breast Mammogram both breasts Mammogram both breasts Mammogram both breasts Mammogram screening Mammogram screening Mammogram screening Mri one breast Mri one breast Mri one breast Mri both breasts Mri both breasts Mri both breasts X‐ray stress view X‐rays for bone age X‐rays for bone age X‐rays for bone age X‐rays bone length studies X‐rays bone length studies X‐rays bone length studies X‐rays bone survey limited X‐rays bone survey limited X‐rays bone survey limited X‐rays bone survey complete X‐rays bone survey complete X‐rays bone survey complete X‐rays bone survey infant X‐rays bone survey infant X‐rays bone survey infant Joint survey single view Joint survey single view Joint survey single view Ct bone density axial Ct bone density axial Ct bone density axial Dxa bone density axial Dxa bone density axial Dxa bone density axial Dxa bone density/peripheral $7.14 $10.21 $3.06 $42.87 $59.88 $17.01 $58.86 $80.63 $21.77 $55.46 $89.14 $33.68 $72.47 $114.66 $42.19 $47.63 $81.66 $34.02 $549.47 $628.06 $78.59 $547.43 $626.02 $78.59 $52.40 $14.63 $23.82 $9.19 $24.84 $39.47 $14.63 $49.67 $71.45 $21.77 $26.20 $96.97 $70.77 $70.77 $104.45 $33.68 $24.84 $41.51 $16.67 $11.91 $86.08 $74.17 $40.49 $50.35 $9.87 $17.69 $7.13 $10.34 $3.21 $41.37 $59.20 $17.83 $57.06 $79.89 $22.83 $53.50 $88.81 $35.31 $70.62 $114.49 $43.87 $46.01 $81.32 $35.31 $463.65 $546.39 $82.74 $461.87 $544.61 $82.74 $51.71 $14.27 $23.90 $9.63 $23.18 $38.52 $15.34 $48.15 $70.97 $22.83 $27.46 $107.00 $79.53 $72.04 $107.35 $35.31 $23.54 $40.66 $17.12 $12.48 $106.49 $94.01 $38.52 $48.50 $9.99 $16.76 ‐0.20% 1.30% 4.80% ‐3.50% ‐1.10% 4.80% ‐3.10% ‐0.90% 4.80% ‐3.50% ‐0.40% 4.80% ‐2.60% ‐0.20% 4.00% ‐3.40% ‐0.40% 3.80% ‐15.60% ‐13.00% 5.30% ‐15.60% ‐13.00% 5.30% ‐1.30% ‐2.50% 0.30% 4.80% ‐6.70% ‐2.40% 4.80% ‐3.10% ‐0.70% 4.80% 4.80% 10.30% 12.40% 1.80% 2.80% 4.80% ‐5.20% ‐2.10% 2.70% 4.80% 23.70% 26.70% ‐4.90% ‐3.70% 1.20% ‐5.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 77081 77081 77082 77082 77082 77084 77084 77084 77261 77262 77263 77280 77280 77280 77285 77285 77285 77290 77290 77290 77295 77295 77295 77299 77299 77299 77300 77300 77300 77301 77301 77301 77305 77305 77305 77310 77310 77310 77315 77315 77315 77321 77321 77321 77326 77326 77326 77327 77327 77327 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A A A A A A A A A A A A Dxa bone density/peripheral Dxa bone density/peripheral Dxa bone density vert fx Dxa bone density vert fx Dxa bone density vert fx Magnetic image bone marrow Magnetic image bone marrow Magnetic image bone marrow Radiation therapy planning Radiation therapy planning Radiation therapy planning Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Set radiation therapy field Radiation therapy planning Radiation therapy planning Radiation therapy planning Radiation therapy dose plan Radiation therapy dose plan Radiation therapy dose plan Radiotherapy dose plan imrt Radiotherapy dose plan imrt Radiotherapy dose plan imrt Teletx isodose plan simple Teletx isodose plan simple Teletx isodose plan simple Teletx isodose plan intermed Teletx isodose plan intermed Teletx isodose plan intermed Teletx isodose plan complex Teletx isodose plan complex Teletx isodose plan complex Special teletx port plan Special teletx port plan Special teletx port plan Brachytx isodose calc simp Brachytx isodose calc simp Brachytx isodose calc simp Brachytx isodose calc interm Brachytx isodose calc interm Brachytx isodose calc interm $28.58 $10.89 $20.07 $28.58 $8.51 $338.53 $416.10 $77.57 $71.45 $107.51 $158.89 $146.64 $181.00 $34.36 $268.44 $320.16 $51.71 $454.55 $531.44 $76.89 $219.11 $445.36 $226.25 $0.00 $0.00 $0.00 $36.06 $66.69 $30.62 $1,594.32 $1,990.35 $396.03 $24.16 $58.52 $34.36 $32.66 $84.38 $51.71 $56.82 $133.71 $76.89 $43.89 $90.84 $46.95 $100.37 $146.30 $45.93 $135.07 $203.80 $68.73 $27.82 $11.06 $18.90 $27.46 $8.56 $283.19 $364.86 $81.67 $75.61 $113.06 $166.20 $115.56 $151.58 $36.02 $258.57 $313.14 $54.57 $305.29 $385.90 $80.60 $211.14 $447.60 $236.46 $0.00 $0.00 $0.00 $35.31 $67.41 $32.10 $1,039.64 $1,453.36 $413.72 $23.54 $59.56 $36.02 $31.74 $86.31 $54.57 $54.57 $135.17 $80.60 $42.09 $91.30 $49.22 $96.65 $144.80 $48.15 $130.53 $202.94 $72.40 ‐2.70% 1.60% ‐5.80% ‐3.90% 0.60% ‐16.30% ‐12.30% 5.30% 5.80% 5.20% 4.60% ‐21.20% ‐16.30% 4.80% ‐3.70% ‐2.20% 5.50% ‐32.80% ‐27.40% 4.80% ‐3.60% 0.50% 4.50% ‐2.10% 1.10% 4.80% ‐34.80% ‐27.00% 4.50% ‐2.60% 1.80% 4.80% ‐2.80% 2.30% 5.50% ‐4.00% 1.10% 4.80% ‐4.10% 0.50% 4.80% ‐3.70% ‐1.00% 4.80% ‐3.40% ‐0.40% 5.40% Y Y Y Y Y Y Y Y 77328 77328 77328 77331 77331 77331 77332 77332 77332 77333 77333 77333 77334 77334 77334 77336 77338 77338 77338 77370 77371 77372 77373 77399 77399 77399 77401 77402 77403 77404 77406 77407 77408 77409 77411 77412 77413 77414 77416 77417 77418 77421 77421 77421 77422 77423 77424 77425 77427 77431 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 A A A A A A A A A A A A A A A A A A A A C A A C C C A A A A A A A A A A A A A A A A A A A A X X A A Brachytx isodose plan compl Brachytx isodose plan compl Brachytx isodose plan compl Special radiation dosimetry Special radiation dosimetry Special radiation dosimetry Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation treatment aid(s) Radiation physics consult Design mlc device for imrt Design mlc device for imrt Design mlc device for imrt Radiation physics consult Srs multisource Srs linear based Sbrt delivery External radiation dosimetry External radiation dosimetry External radiation dosimetry Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiation treatment delivery Radiology port film(s) Radiation tx delivery imrt Stereoscopic x‐ray guidance Stereoscopic x‐ray guidance Stereoscopic x‐ray guidance Neutron beam tx simple Neutron beam tx complex Io rad tx delivery by x‐ray Io rad tx deliver by elctrns Radiation tx management x5 Radiation therapy management $169.09 $272.52 $103.43 $19.05 $61.92 $42.87 $53.42 $80.29 $26.88 $9.53 $51.03 $41.51 $89.14 $150.04 $60.90 $43.89 $288.17 $501.16 $212.98 $118.06 $0.00 $784.91 $1,268.72 $0.00 $0.00 $0.00 $20.75 $155.14 $127.93 $142.22 $142.22 $225.91 $176.24 $196.31 $197.33 $240.20 $231.36 $260.28 $259.94 $14.29 $405.55 $55.46 $74.51 $19.05 $282.73 $288.17 $0.00 $0.00 $178.28 $97.99 $162.99 $271.06 $108.07 $18.55 $63.84 $45.29 $51.71 $79.89 $28.18 $9.27 $53.14 $43.87 $85.95 $150.15 $64.20 $42.44 $277.48 $500.03 $222.55 $113.77 $0.00 $759.67 $1,222.96 $0.00 $0.00 $0.00 $20.69 $139.81 $100.58 $100.58 $100.58 $259.64 $169.41 $188.31 $187.24 $188.67 $188.67 $188.67 $188.67 $13.91 $392.67 $53.14 $73.11 $19.97 $188.67 $188.67 $0.00 $0.00 $185.46 $102.36 ‐3.60% ‐0.50% 4.50% ‐2.70% 3.10% 5.70% ‐3.20% ‐0.50% 4.80% ‐2.70% 4.10% 5.70% ‐3.60% 0.10% 5.40% ‐3.30% ‐3.70% ‐0.20% 4.50% ‐3.60% ‐3.20% ‐3.60% ‐0.30% ‐9.90% ‐21.40% ‐29.30% ‐29.30% 14.90% ‐3.90% ‐4.10% ‐5.10% ‐21.50% ‐18.50% ‐27.50% ‐27.40% ‐2.70% ‐3.20% ‐4.20% ‐1.90% 4.80% ‐33.30% ‐34.50% 4.00% 4.50% Y Y Y Y 77432 77435 77469 77470 77470 77470 77499 77499 77499 77520 77522 77523 77525 77600 77600 77600 77605 77605 77605 77610 77610 77610 77615 77615 77615 77620 77620 77620 77750 77750 77750 77761 77761 77761 77762 77762 77762 77763 77763 77763 77776 77776 77776 77777 77777 77777 77778 77778 77778 77785 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A C C C C C C C R R R R R R R R R R R R R R R A A A A A A A A A A A A A A A A A A A A A A Stereotactic radiation trmt Sbrt management Io radiation tx management Special radiation treatment Special radiation treatment Special radiation treatment Radiation therapy management Radiation therapy management Radiation therapy management Proton trmt simple w/o comp Proton trmt simple w/comp Proton trmt intermediate Proton treatment complex Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Hyperthermia treatment Infuse radioactive materials Infuse radioactive materials Infuse radioactive materials Apply intrcav radiat simple Apply intrcav radiat simple Apply intrcav radiat simple Apply intrcav radiat interm Apply intrcav radiat interm Apply intrcav radiat interm Apply intrcav radiat compl Apply intrcav radiat compl Apply intrcav radiat compl Apply interstit radiat simpl Apply interstit radiat simpl Apply interstit radiat simpl Apply interstit radiat inter Apply interstit radiat inter Apply interstit radiat inter Apply interstit radiat compl Apply interstit radiat compl Apply interstit radiat compl Hdr brachytx 1 channel $401.13 $605.61 $301.10 $47.97 $151.40 $103.43 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $354.52 $431.41 $76.89 $1,048.93 $1,161.21 $112.28 $1,017.97 $1,094.52 $76.55 $915.56 $1,018.99 $103.43 $512.05 $587.58 $75.53 $112.96 $360.64 $247.69 $193.59 $383.44 $189.85 $222.51 $507.28 $284.77 $286.81 $715.50 $428.69 $194.27 $429.71 $235.44 $207.88 $581.79 $373.91 $293.28 $853.64 $560.36 $180.32 $418.71 $632.35 $312.78 $46.01 $154.43 $108.42 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $342.03 $422.99 $80.96 $412.29 $529.27 $116.98 $412.29 $491.47 $79.18 $413.72 $522.14 $108.42 $283.90 $363.43 $79.53 $108.78 $368.07 $259.29 $187.96 $385.54 $197.59 $213.28 $511.08 $297.81 $275.69 $724.72 $449.03 $187.24 $433.33 $246.09 $191.17 $584.55 $393.39 $282.47 $868.09 $585.62 $174.05 4.40% 4.40% 3.90% ‐4.10% 2.00% 4.80% ‐3.50% ‐2.00% 5.30% ‐60.70% ‐54.40% 4.20% ‐59.50% ‐55.10% 3.40% ‐54.80% ‐48.80% 4.80% ‐44.60% ‐38.10% 5.30% ‐3.70% 2.10% 4.70% ‐2.90% 0.50% 4.10% ‐4.20% 0.70% 4.60% ‐3.90% 1.30% 4.70% ‐3.60% 0.80% 4.50% ‐8.00% 0.50% 5.20% ‐3.70% 1.70% 4.50% ‐3.50% 77785 77785 77786 77786 77786 77787 77787 77787 77789 77789 77789 77790 77790 77790 77799 77799 77799 78012 78012 78012 78013 78013 78013 78014 78014 78014 78015 78015 78015 78016 78016 78016 78018 78018 78018 78020 78020 78020 78070 78070 78070 78070 78070 78070 78071 78071 78071 78072 78072 78072 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 26 TC TC TC 26 26 TC A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C Hdr brachytx 1 channel Hdr brachytx 1 channel Hdr brachytx 2‐12 channel Hdr brachytx 2‐12 channel Hdr brachytx 2‐12 channel Hdr brachytx over 12 chan Hdr brachytx over 12 chan Hdr brachytx over 12 chan Apply surface radiation Apply surface radiation Apply surface radiation Radiation handling Radiation handling Radiation handling Radium/radioisotope therapy Radium/radioisotope therapy Radium/radioisotope therapy Thyroid uptake measurement Thyroid uptake measurement Thyroid uptake measurement Thyroid imaging w/blood flow Thyroid imaging w/blood flow Thyroid imaging w/blood flow Thyroid imaging w/blood flow Thyroid imaging w/blood flow Thyroid imaging w/blood flow Thyroid met imaging Thyroid met imaging Thyroid met imaging Thyroid met imaging/studies Thyroid met imaging/studies Thyroid met imaging/studies Thyroid met imaging body Thyroid met imaging body Thyroid met imaging body Thyroid met uptake Thyroid met uptake Thyroid met uptake Parathyroid planar imaging Parathyroid planar imaging Parathyroid planar imaging Parathyroid planar imaging Parathyroid planar imaging Parathyroid planar imaging Parathyrd planar w/wo subtrj Parathyrd planar w/wo subtrj Parathyrd planar w/wo subtrj Parathyrd planar w/spect&ct Parathyrd planar w/spect&ct Parathyrd planar w/spect&ct $250.75 $70.43 $396.03 $556.96 $160.93 $712.78 $955.71 $242.92 $61.24 $118.06 $56.82 $43.21 $94.58 $51.37 $0.00 $0.00 $0.00 $73.83 $83.02 $9.19 $192.23 $209.92 $17.69 $218.77 $242.58 $23.82 $191.55 $222.85 $31.30 $255.51 $289.20 $33.68 $282.39 $322.20 $39.81 $57.84 $84.72 $26.88 $37.43 $37.43 $270.48 $270.48 $233.06 $233.06 $305.19 $361.66 $56.48 $78.25 $0.00 $0.00 $247.87 $73.83 $382.33 $550.67 $168.34 $686.56 $940.49 $253.94 $58.49 $117.70 $59.20 $41.73 $95.58 $53.85 $0.00 $0.00 $0.00 $68.48 $77.75 $9.27 $177.61 $195.80 $18.19 $211.14 $235.75 $24.61 $185.82 $218.98 $33.17 $249.30 $284.61 $35.31 $273.20 $314.92 $41.73 $55.28 $83.46 $28.18 $39.23 $39.23 $299.23 $299.23 $260.00 $260.00 $293.17 $352.37 $59.20 $80.96 $0.00 $0.00 ‐1.20% 4.80% ‐3.50% ‐1.10% 4.60% ‐3.70% ‐1.60% 4.50% ‐4.50% ‐0.30% 4.20% ‐3.40% 1.10% 4.80% ‐7.30% ‐6.30% 0.90% ‐7.60% ‐6.70% 2.80% ‐3.50% ‐2.80% 3.30% ‐3.00% ‐1.70% 6.00% ‐2.40% ‐1.60% 4.80% ‐3.30% ‐2.30% 4.80% ‐4.40% ‐1.50% 4.80% 4.80% 4.80% 10.60% 10.60% 11.60% 11.60% ‐3.90% ‐2.60% 4.80% 3.50% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78075 78075 78075 78099 78099 78099 78102 78102 78102 78103 78103 78103 78104 78104 78104 78110 78110 78110 78111 78111 78111 78120 78120 78120 78121 78121 78121 78122 78122 78122 78130 78130 78130 78135 78135 78135 78140 78140 78140 78185 78185 78185 78190 78190 78190 78191 78191 78191 78195 78195 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 26 TC TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 26 A A A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A Adrenal cortex & medulla img Adrenal cortex & medulla img Adrenal cortex & medulla img Endocrine nuclear procedure Endocrine nuclear procedure Endocrine nuclear procedure Bone marrow imaging ltd Bone marrow imaging ltd Bone marrow imaging ltd Bone marrow imaging mult Bone marrow imaging mult Bone marrow imaging mult Bone marrow imaging body Bone marrow imaging body Bone marrow imaging body Plasma volume single Plasma volume single Plasma volume single Plasma volume multiple Plasma volume multiple Plasma volume multiple Red cell mass single Red cell mass single Red cell mass single Red cell mass multiple Red cell mass multiple Red cell mass multiple Blood volume Blood volume Blood volume Red cell survival study Red cell survival study Red cell survival study Red cell survival kinetics Red cell survival kinetics Red cell survival kinetics Red cell sequestration Red cell sequestration Red cell sequestration Spleen imaging Spleen imaging Spleen imaging Platelet survival kinetics Platelet survival kinetics Platelet survival kinetics Platelet survival Platelet survival Platelet survival Lymph system imaging Lymph system imaging $407.60 $441.28 $33.68 $0.00 $0.00 $0.00 $149.02 $174.54 $25.52 $188.49 $222.85 $34.36 $218.09 $255.51 $37.43 $85.74 $94.92 $9.19 $9.53 $86.76 $77.23 $82.68 $93.56 $10.89 $12.93 $79.27 $66.34 $80.63 $101.05 $20.41 $135.07 $165.01 $29.94 $336.49 $367.79 $31.30 $108.87 $138.47 $29.60 $199.37 $218.43 $19.05 $53.42 $250.07 $196.65 $135.41 $165.35 $29.94 $56.82 $336.83 $392.32 $427.98 $35.67 $0.00 $0.00 $0.00 $143.37 $170.12 $26.75 $188.67 $225.40 $36.74 $205.79 $244.31 $38.52 $85.60 $95.23 $9.63 $11.06 $102.00 $90.95 $84.53 $96.30 $11.77 $16.05 $102.00 $85.95 $78.11 $99.51 $21.40 $140.88 $172.26 $31.39 $319.92 $352.37 $32.46 $105.57 $136.60 $31.03 $192.59 $212.21 $19.62 $55.64 $332.05 $276.41 $140.88 $172.26 $31.39 $59.56 $359.15 ‐3.80% ‐3.00% 5.90% Y Y Y ‐3.80% ‐2.50% 4.80% 0.10% 1.20% 6.90% ‐5.60% ‐4.40% 2.90% ‐0.20% 0.30% 4.80% 16.10% 17.60% 17.80% 2.20% 2.90% 8.10% 24.10% 28.70% 29.60% ‐3.10% ‐1.50% 4.80% 4.30% 4.40% 4.80% ‐4.90% ‐4.20% 3.70% ‐3.00% ‐1.40% 4.80% ‐3.40% ‐2.90% 3.00% 4.20% 32.80% 40.60% 4.00% 4.20% 4.80% 4.80% 6.60% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78195 78199 78199 78199 78201 78201 78201 78202 78202 78202 78205 78205 78205 78206 78206 78206 78215 78215 78215 78216 78216 78216 78226 78226 78226 78227 78227 78227 78230 78230 78230 78231 78231 78231 78232 78232 78232 78258 78258 78258 78261 78261 78261 78262 78262 78262 78264 78264 78264 78267 TC 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A A X Lymph system imaging Blood/lymph nuclear exam Blood/lymph nuclear exam Blood/lymph nuclear exam Liver imaging Liver imaging Liver imaging Liver imaging with flow Liver imaging with flow Liver imaging with flow Liver imaging (3d) Liver imaging (3d) Liver imaging (3d) Liver image (3d) with flow Liver image (3d) with flow Liver image (3d) with flow Liver and spleen imaging Liver and spleen imaging Liver and spleen imaging Liver & spleen image/flow Liver & spleen image/flow Liver & spleen image/flow Hepatobiliary system imaging Hepatobiliary system imaging Hepatobiliary system imaging Hepatobil syst image w/drug Hepatobil syst image w/drug Hepatobil syst image w/drug Salivary gland imaging Salivary gland imaging Salivary gland imaging Serial salivary imaging Serial salivary imaging Serial salivary imaging Salivary gland function exam Salivary gland function exam Salivary gland function exam Esophageal motility study Esophageal motility study Esophageal motility study Gastric mucosa imaging Gastric mucosa imaging Gastric mucosa imaging Gastroesophageal reflux exam Gastroesophageal reflux exam Gastroesophageal reflux exam Gastric emptying study Gastric emptying study Gastric emptying study Breath tst attain/anal c‐14 $280.01 $0.00 $0.00 $0.00 $171.14 $191.89 $20.75 $187.81 $210.60 $22.80 $185.77 $218.77 $33.00 $304.85 $349.42 $44.57 $177.60 $201.08 $23.48 $100.37 $126.57 $26.20 $314.37 $351.12 $36.74 $44.23 $358.60 $314.37 $156.51 $178.28 $21.77 $107.85 $132.35 $24.50 $80.29 $99.69 $19.39 $196.31 $231.02 $34.70 $226.93 $260.28 $33.34 $226.25 $258.23 $31.98 $256.87 $294.64 $37.77 $0.00 $299.59 $0.00 $0.00 $0.00 $166.20 $187.96 $21.76 $179.75 $203.65 $23.90 $179.75 $214.35 $34.60 $294.60 $340.96 $46.36 $171.55 $196.16 $24.61 $96.30 $123.76 $27.46 $296.38 $333.11 $36.74 $44.58 $419.68 $375.10 $118.77 $138.38 $19.62 $104.50 $130.18 $25.68 $80.25 $100.93 $20.69 $186.53 $222.91 $36.38 $219.34 $254.29 $34.95 $213.28 $245.73 $32.46 $250.01 $289.60 $39.59 $0.00 7.00% Y ‐2.90% ‐2.10% 4.80% ‐4.30% ‐3.30% 4.80% ‐3.20% ‐2.00% 4.80% ‐3.40% ‐2.40% 4.00% ‐3.40% ‐2.50% 4.80% ‐4.10% ‐2.20% 4.80% ‐5.70% ‐5.10% 0.00% 0.80% 17.00% 19.30% ‐24.10% ‐22.40% ‐9.90% ‐3.10% ‐1.60% 4.80% ‐0.10% 1.30% 6.70% ‐5.00% ‐3.50% 4.80% ‐3.40% ‐2.30% 4.80% ‐5.70% ‐4.80% 1.50% ‐2.70% ‐1.70% 4.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78268 78270 78270 78270 78271 78271 78271 78272 78272 78272 78278 78278 78278 78282 78282 78282 78290 78290 78290 78291 78291 78291 78299 78299 78299 78300 78300 78300 78305 78305 78305 78306 78306 78306 78315 78315 78315 78320 78320 78320 78350 78350 78350 78351 78399 78399 78399 78414 78414 78414 TC 26 TC 26 TC 26 26 TC 26 TC 26 TC TC 26 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 26 TC 26 TC X A A A A A A A A A A A A A C C A A A A A A C C C A A A A A A A A A A A A A A A N N N N C C C A C C Breath test analysis c‐14 Vit b‐12 absorption exam Vit b‐12 absorption exam Vit b‐12 absorption exam Vit b‐12 absrp exam int fac Vit b‐12 absrp exam int fac Vit b‐12 absrp exam int fac Vit b‐12 absorp combined Vit b‐12 absorp combined Vit b‐12 absorp combined Acute gi blood loss imaging Acute gi blood loss imaging Acute gi blood loss imaging Gi protein loss exam Gi protein loss exam Gi protein loss exam Meckels divert exam Meckels divert exam Meckels divert exam Leveen/shunt patency exam Leveen/shunt patency exam Leveen/shunt patency exam Gi nuclear procedure Gi nuclear procedure Gi nuclear procedure Bone imaging limited area Bone imaging limited area Bone imaging limited area Bone imaging multiple areas Bone imaging multiple areas Bone imaging multiple areas Bone imaging whole body Bone imaging whole body Bone imaging whole body Bone imaging 3 phase Bone imaging 3 phase Bone imaging 3 phase Bone imaging (3d) Bone imaging (3d) Bone imaging (3d) Bone mineral single photon Bone mineral single photon Bone mineral single photon Bone mineral dual photon Musculoskeletal nuclear exam Musculoskeletal nuclear exam Musculoskeletal nuclear exam Non‐imaging heart function Non‐imaging heart function Non‐imaging heart function $0.00 $78.25 $87.78 $9.53 $86.08 $95.94 $9.87 $83.70 $96.63 $12.93 $46.95 $303.49 $256.53 $18.71 $0.00 $0.00 $32.32 $288.86 $256.53 $221.83 $263.34 $41.51 $0.00 $0.00 $0.00 $155.83 $185.43 $29.60 $204.48 $243.94 $39.47 $217.75 $258.23 $40.49 $48.31 $310.29 $261.98 $184.74 $233.06 $48.31 $22.80 $33.68 $10.89 $14.63 $0.00 $0.00 $0.00 $22.46 $0.00 $0.00 $0.00 $80.96 $91.30 $10.34 $80.96 $91.30 $10.34 $89.52 $103.43 $13.91 $49.57 $351.30 $301.73 $19.62 $0.00 $0.00 $33.88 $335.61 $301.73 $209.71 $252.51 $42.80 $0.00 $0.00 $0.00 $150.86 $181.89 $31.03 $190.81 $231.82 $41.02 $210.07 $252.51 $42.44 $50.64 $350.59 $299.95 $178.68 $229.33 $50.64 $21.76 $32.81 $11.06 $14.98 $0.00 $0.00 $0.00 $22.83 $0.00 $0.00 3.50% 4.00% 8.60% ‐6.00% ‐4.80% 4.80% 7.00% 7.00% 7.60% 5.60% 15.80% 17.60% 4.80% 4.80% 16.20% 17.60% ‐5.50% ‐4.10% 3.10% ‐3.20% ‐1.90% 4.80% ‐6.70% ‐5.00% 3.90% ‐3.50% ‐2.20% 4.80% 4.80% 13.00% 14.50% ‐3.30% ‐1.60% 4.80% ‐4.60% ‐2.60% 1.60% 2.40% 1.70% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78428 78428 78428 78445 78445 78445 78451 78451 78451 78452 78452 78452 78453 78453 78453 78454 78454 78454 78456 78456 78456 78457 78457 78457 78458 78458 78458 78459 78459 78459 78466 78466 78466 78468 78468 78468 78469 78469 78469 78472 78472 78472 78473 78473 78473 78481 78481 78481 78483 78483 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC A A A A A A A A A A A A A A A A A A A A A A A A A A A A C C A A A A A A A A A A A A A A A A A A A A Cardiac shunt imaging Cardiac shunt imaging Cardiac shunt imaging Vascular flow imaging Vascular flow imaging Vascular flow imaging Ht muscle image spect sing Ht muscle image spect sing Ht muscle image spect sing Ht muscle image spect mult Ht muscle image spect mult Ht muscle image spect mult Ht muscle image planar sing Ht muscle image planar sing Ht muscle image planar sing Ht musc image planar mult Ht musc image planar mult Ht musc image planar mult Acute venous thrombus image Acute venous thrombus image Acute venous thrombus image Venous thrombosis imaging Venous thrombosis imaging Venous thrombosis imaging Ven thrombosis images bilat Ven thrombosis images bilat Ven thrombosis images bilat Heart muscle imaging (pet) Heart muscle imaging (pet) Heart muscle imaging (pet) Heart infarct image Heart infarct image Heart infarct image Heart infarct image (ef) Heart infarct image (ef) Heart infarct image (ef) Heart infarct image (3d) Heart infarct image (3d) Heart infarct image (3d) Gated heart planar single Gated heart planar single Gated heart planar single Gated heart multiple Gated heart multiple Gated heart multiple Heart first pass single Heart first pass single Heart first pass single Heart first pass multiple Heart first pass multiple $153.10 $189.51 $36.40 $155.49 $177.60 $22.11 $294.98 $360.30 $65.32 $425.63 $502.18 $76.55 $265.38 $313.01 $47.63 $386.50 $450.12 $63.62 $318.12 $365.41 $47.29 $173.18 $209.92 $36.74 $152.42 $192.57 $40.15 $70.09 $0.00 $0.00 $168.41 $202.44 $34.02 $167.73 $205.84 $38.11 $189.51 $233.74 $44.23 $192.23 $238.50 $46.27 $233.06 $302.46 $69.41 $141.54 $187.81 $46.27 $181.00 $250.75 $146.23 $184.39 $38.16 $150.15 $172.98 $22.83 $279.26 $347.02 $67.76 $402.30 $481.84 $79.53 $257.86 $308.15 $50.29 $373.06 $439.75 $66.69 $274.98 $324.20 $49.22 $158.35 $196.52 $38.16 $125.90 $164.77 $38.88 $73.47 $0.00 $0.00 $149.79 $184.39 $34.60 $159.78 $199.01 $39.23 $181.89 $227.90 $46.01 $183.68 $232.18 $48.50 $221.48 $293.53 $72.04 $130.89 $179.04 $48.15 $171.55 $243.95 ‐4.50% ‐2.70% 4.80% ‐3.40% ‐2.60% 3.20% ‐5.30% ‐3.70% 3.70% ‐5.50% ‐4.10% 3.90% ‐2.80% ‐1.60% 5.60% ‐3.50% ‐2.30% 4.80% ‐13.60% ‐11.30% 4.10% ‐8.60% ‐6.40% 3.90% ‐17.40% ‐14.40% ‐3.20% 4.80% ‐11.10% ‐8.90% 1.70% ‐4.70% ‐3.30% 3.00% ‐4.00% ‐2.50% 4.00% ‐4.50% ‐2.70% 4.80% ‐5.00% ‐3.00% 3.80% ‐7.50% ‐4.70% 4.10% ‐5.20% ‐2.70% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78483 78491 78491 78491 78492 78492 78492 78494 78494 78494 78496 78496 78496 78499 78499 78499 78579 78579 78579 78580 78580 78580 78582 78582 78582 78597 78597 78597 78598 78598 78598 78599 78599 78599 78600 78600 78600 78601 78601 78601 78605 78605 78605 78606 78606 78606 78607 78607 78607 78608 26 26 TC 26 TC TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 26 A A C C A C C A A A A A A C C C A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A A A A Heart first pass multiple Heart image (pet) single Heart image (pet) single Heart image (pet) single Heart image (pet) multiple Heart image (pet) multiple Heart image (pet) multiple Heart image spect Heart image spect Heart image spect Heart first pass add‐on Heart first pass add‐on Heart first pass add‐on Cardiovascular nuclear exam Cardiovascular nuclear exam Cardiovascular nuclear exam Lung ventilation imaging Lung ventilation imaging Lung ventilation imaging Lung perfusion imaging Lung perfusion imaging Lung perfusion imaging Lung ventilat&perfus imaging Lung ventilat&perfus imaging Lung ventilat&perfus imaging Lung perfusion differential Lung perfusion differential Lung perfusion differential Lung perf&ventilat diferentl Lung perf&ventilat diferentl Lung perf&ventilat diferentl Respiratory nuclear exam Respiratory nuclear exam Respiratory nuclear exam Brain image < 4 views Brain image < 4 views Brain image < 4 views Brain image w/flow < 4 views Brain image w/flow < 4 views Brain image w/flow < 4 views Brain image 4+ views Brain image 4+ views Brain image 4+ views Brain image w/flow 4 + views Brain image w/flow 4 + views Brain image w/flow 4 + views Brain imaging (3d) Brain imaging (3d) Brain imaging (3d) Brain imaging (pet) $69.75 $71.45 $0.00 $0.00 $88.80 $0.00 $0.00 $180.32 $236.46 $56.14 $21.77 $45.25 $23.48 $0.00 $0.00 $0.00 $198.35 $222.85 $24.50 $209.92 $244.63 $34.70 $336.49 $389.22 $52.74 $207.54 $243.94 $36.40 $322.54 $364.05 $41.51 $0.00 $0.00 $0.00 $168.07 $188.83 $20.75 $198.69 $222.85 $24.16 $177.94 $203.46 $25.52 $313.01 $342.61 $29.60 $305.87 $362.00 $56.14 $70.43 $72.40 $74.18 $0.00 $0.00 $92.37 $0.00 $0.00 $171.19 $229.68 $58.49 $20.69 $44.94 $24.25 $0.00 $0.00 $0.00 $163.70 $187.60 $23.90 $204.36 $240.74 $36.38 $284.61 $337.75 $53.14 $167.98 $203.29 $35.31 $267.85 $309.22 $41.37 $0.00 $0.00 $0.00 $161.92 $183.68 $21.76 $191.88 $217.20 $25.32 $172.26 $199.01 $26.75 $300.30 $331.33 $31.03 $292.10 $351.30 $59.20 $74.18 3.80% 3.80% ‐5.10% ‐2.90% 4.20% ‐5.00% ‐0.70% 3.30% Y Y Y Y Y Y Y Y Y Y Y Y Y ‐17.50% ‐15.80% ‐2.50% ‐2.70% ‐1.60% 4.80% ‐15.40% ‐13.20% 0.80% ‐19.10% ‐16.70% ‐3.00% ‐17.00% ‐15.10% ‐0.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y ‐3.70% ‐2.70% 4.80% ‐3.40% ‐2.50% 4.80% ‐3.20% ‐2.20% 4.80% ‐4.10% ‐3.30% 4.80% ‐4.50% ‐3.00% 5.50% 5.30% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 4.00% 78608 78608 78609 78609 78609 78610 78610 78610 78630 78630 78630 78635 78635 78635 78645 78645 78645 78647 78647 78647 78650 78650 78650 78660 78660 78660 78699 78699 78699 78700 78700 78700 78701 78701 78701 78707 78707 78707 78708 78708 78708 78709 78709 78709 78710 78710 78710 78725 78725 78725 TC 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 C C N N N A A A A A A A A A A A A A A A A A A A A A C C C A A A A A A A A A A A A A A A A A A A A A Brain imaging (pet) Brain imaging (pet) Brain imaging (pet) Brain imaging (pet) Brain imaging (pet) Brain flow imaging only Brain flow imaging only Brain flow imaging only Cerebrospinal fluid scan Cerebrospinal fluid scan Cerebrospinal fluid scan Csf ventriculography Csf ventriculography Csf ventriculography Csf shunt evaluation Csf shunt evaluation Csf shunt evaluation Cerebrospinal fluid scan Cerebrospinal fluid scan Cerebrospinal fluid scan Csf leakage imaging Csf leakage imaging Csf leakage imaging Nuclear exam of tear flow Nuclear exam of tear flow Nuclear exam of tear flow Nervous system nuclear exam Nervous system nuclear exam Nervous system nuclear exam Kidney imaging morphol Kidney imaging morphol Kidney imaging morphol Kidney imaging with flow Kidney imaging with flow Kidney imaging with flow K flow/funct image w/o drug K flow/funct image w/o drug K flow/funct image w/o drug K flow/funct image w/drug K flow/funct image w/drug K flow/funct image w/drug K flow/funct image multiple K flow/funct image multiple K flow/funct image multiple Kidney imaging (3d) Kidney imaging (3d) Kidney imaging (3d) Kidney function study Kidney function study Kidney function study $0.00 $0.00 $75.19 $75.19 $0.00 $167.73 $182.02 $14.29 $323.56 $355.88 $32.32 $320.16 $348.74 $28.58 $26.54 $290.90 $264.36 $334.79 $377.32 $42.53 $315.05 $343.97 $28.92 $168.07 $194.61 $26.54 $0.00 $0.00 $0.00 $160.59 $182.36 $21.77 $196.31 $219.79 $23.48 $192.57 $237.14 $44.57 $118.74 $175.22 $56.48 $312.33 $378.34 $66.00 $181.34 $210.26 $28.92 $96.29 $113.98 $17.69 $0.00 $0.00 $0.00 $77.75 $0.00 $160.49 $175.12 $14.62 $306.36 $339.89 $33.53 $310.64 $340.60 $29.96 $27.82 $324.55 $296.74 $181.25 $226.90 $45.65 $307.79 $338.11 $30.32 $160.85 $188.31 $27.46 $0.00 $0.00 $0.00 $153.36 $175.83 $22.47 $191.17 $215.42 $24.25 $186.17 $232.89 $46.72 $114.49 $174.05 $59.56 $299.23 $368.42 $69.19 $170.48 $200.44 $29.96 $92.37 $110.56 $18.19 Y Y ‐100.00% 3.40% ‐4.30% ‐3.80% 2.30% ‐5.30% ‐4.50% 3.70% ‐3.00% ‐2.30% 4.80% 4.80% 11.60% 12.20% ‐45.90% ‐39.90% 7.30% ‐2.30% ‐1.70% 4.80% ‐4.30% ‐3.20% 3.50% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y ‐4.50% ‐3.60% 3.20% ‐2.60% ‐2.00% 3.30% ‐3.30% ‐1.80% 4.80% ‐3.60% ‐0.70% 5.50% ‐4.20% ‐2.60% 4.80% ‐6.00% ‐4.70% 3.60% ‐4.10% ‐3.00% 2.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 78730 78730 78730 78740 78740 78740 78761 78761 78761 78799 78799 78799 78800 78800 78800 78801 78801 78801 78802 78802 78802 78803 78803 78803 78804 78804 78804 78805 78805 78805 78806 78806 78806 78807 78807 78807 78808 78811 78811 78811 78812 78812 78812 78813 78813 78813 78814 78814 78814 78815 TC 26 TC 26 TC 26 26 TC TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 TC 26 26 TC 26 TC 26 TC 26 TC 26 A A A A A A A A A C C C A A A A A A A A A A A A A A A A A A A A A A A A A A C C A C C A C C A C C A Urinary bladder retention Urinary bladder retention Urinary bladder retention Ureteral reflux study Ureteral reflux study Ureteral reflux study Testicular imaging w/flow Testicular imaging w/flow Testicular imaging w/flow Genitourinary nuclear exam Genitourinary nuclear exam Genitourinary nuclear exam Tumor imaging limited area Tumor imaging limited area Tumor imaging limited area Tumor imaging mult areas Tumor imaging mult areas Tumor imaging mult areas Tumor imaging whole body Tumor imaging whole body Tumor imaging whole body Tumor imaging (3d) Tumor imaging (3d) Tumor imaging (3d) Tumor imaging whole body Tumor imaging whole body Tumor imaging whole body Abscess imaging ltd area Abscess imaging ltd area Abscess imaging ltd area Abscess imaging whole body Abscess imaging whole body Abscess imaging whole body Nuclear localization/abscess Nuclear localization/abscess Nuclear localization/abscess Iv inj ra drug dx study Pet image ltd area Pet image ltd area Pet image ltd area Pet image skull‐thigh Pet image skull‐thigh Pet image skull‐thigh Pet image full body Pet image full body Pet image full body Pet image w/ct lmtd Pet image w/ct lmtd Pet image w/ct lmtd Pet image w/ct skull‐thigh $60.90 $68.05 $7.14 $210.94 $238.50 $27.56 $188.15 $222.17 $34.02 $0.00 $0.00 $0.00 $163.31 $195.29 $31.98 $213.32 $250.75 $37.43 $292.60 $332.74 $40.15 $300.42 $350.44 $50.01 $536.20 $586.22 $50.01 $153.10 $187.81 $34.70 $301.10 $341.25 $40.15 $298.04 $347.37 $49.33 $45.93 $76.55 $0.00 $0.00 $92.88 $0.00 $0.00 $96.63 $0.00 $0.00 $106.83 $0.00 $0.00 $118.06 $58.85 $66.34 $7.49 $195.45 $223.62 $28.18 $175.83 $211.85 $36.02 $0.00 $0.00 $0.00 $159.07 $192.59 $33.53 $212.57 $251.80 $39.23 $281.76 $323.84 $42.09 $289.60 $342.39 $52.78 $518.57 $571.00 $52.43 $147.65 $183.68 $36.02 $290.67 $332.76 $42.09 $288.89 $340.96 $52.07 $46.72 $80.96 $0.00 $0.00 $97.37 $0.00 $0.00 $102.00 $0.00 $0.00 $112.35 $0.00 $0.00 $123.40 ‐3.40% ‐2.50% 4.80% ‐7.40% ‐6.20% 2.20% ‐6.60% ‐4.60% 5.90% Y Y Y Y Y Y Y Y Y ‐2.60% ‐1.40% 4.80% ‐0.40% 0.40% 4.80% ‐3.70% ‐2.70% 4.80% ‐3.60% ‐2.30% 5.50% ‐3.30% ‐2.60% 4.80% ‐3.60% ‐2.20% 3.80% ‐3.50% ‐2.50% 4.80% ‐3.10% ‐1.90% 5.60% 1.70% 5.80% Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y Y 4.80% 5.60% 5.20% 4.50% Y Y Y Y Y Y Y Y Y Y Y Y Y 78815 78815 78816 78816 78816 78999 78999 78999 79005 79005 79005 79101 79101 79101 79200 79200 79200 79300 79300 79300 79403 79403 79403 79440 79440 79440 79445 79445 79445 79999 79999 79999 TC 26 TC 26 TC TC 26 TC 26 TC 26 26 TC TC 26 TC 26 26 TC 26 TC C C A C C C C C A A A A A A A A A A C C A A A A A A A C C C C C Pet image w/ct skull‐thigh Pet image w/ct skull‐thigh Pet image w/ct full body Pet image w/ct full body Pet image w/ct full body Nuclear diagnostic exam Nuclear diagnostic exam Nuclear diagnostic exam Nuclear rx oral admin Nuclear rx oral admin Nuclear rx oral admin Nuclear rx iv admin Nuclear rx iv admin Nuclear rx iv admin Nuclear rx intracav admin Nuclear rx intracav admin Nuclear rx intracav admin Nuclr rx interstit colloid Nuclr rx interstit colloid Nuclr rx interstit colloid Hematopoietic nuclear tx Hematopoietic nuclear tx Hematopoietic nuclear tx Nuclear rx intra‐articular Nuclear rx intra‐articular Nuclear rx intra‐articular Nuclear rx intra‐arterial Nuclear rx intra‐arterial Nuclear rx intra‐arterial Nuclear medicine therapy Nuclear medicine therapy Nuclear medicine therapy $0.00 $0.00 $119.08 $0.00 $0.00 $0.00 $0.00 $0.00 $49.67 $134.05 $84.38 $51.37 $142.90 $91.52 $56.82 $155.83 $99.01 $79.27 $0.00 $0.00 $82.00 $189.85 $107.85 $48.31 $142.90 $94.58 $112.96 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $124.47 $0.00 $0.00 $0.00 $0.00 $0.00 $47.43 $135.88 $88.45 $48.50 $144.09 $95.58 $54.92 $158.35 $103.43 $83.10 $0.00 $0.00 $80.60 $194.02 $113.42 $46.72 $145.87 $99.15 $118.77 $0.00 $0.00 $0.00 $0.00 $0.00 4.50% ‐4.50% 1.40% 4.80% ‐5.60% 0.80% 4.40% ‐3.30% 1.60% 4.50% 4.80% ‐1.70% 2.20% 5.20% ‐3.30% 2.10% 4.80% 5.10% Y Y Y Y Y
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