radiology cpt codes list and description

Radiology CPT Codes List (2025)

by

Radiology CPT codes are standardized to identify specific radiology procedures and services. CPT full form, is Current Procedural Terminology, a medical code maintained and published by the American Medical Association (AMA). These CPT codes serve as a universal language between healthcare providers, Hospitals, and insurance companies to accurately communicate and bill for radiology services.

The list of 2025 Radiology CPT code is updated as below at the latest information and also add new updates as well. Please review the below mention list

List of Radiology CPT Codes

CPT
Code		CPT DescriptionModifier AllowedAllowed
Amount
70010MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION$196.68
70010MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$64.13
70010MYELOGRAPHY, POSTERIOR FOSSA, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$147.81
70015CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION$196.68
70015CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$64.13
70015CISTERNOGRAPHY, POSITIVE CONTRAST, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$46.34
70030RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY$49.20
70030RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY26$9.30
70030RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODY50$49.20
70030RADIOLOGIC EXAMINATION, EYE, FOR DETECTION OF FOREIGN BODYTC$14.44
70100RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS$49.20
70100RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWS26$9.83
70100RADIOLOGIC EXAMINATION, MANDIBLE; PARTIAL, LESS THAN FOUR VIEWSTC$18.13
70110RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS$49.20
70110RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWS26$13.37
70110RADIOLOGIC EXAMINATION, MANDIBLE; COMPLETE, MINIMUM OF FOUR VIEWSTC$21.38
70120RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE$49.20
70120RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDE26$9.83
70120RADIOLOGIC EXAMINATION, MASTOIDS; LESS THAN THREE VIEWS PER SIDETC$21.38
70130RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE
VIEWS PER SIDE		$49.20
70130RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE
VIEWS PER SIDE		26$17.92
70130RADIOLOGIC EXAMINATION, MASTOIDS; COMPLETE, MINIMUM OF THREE
VIEWS PER SIDE		TC$26.97
70134RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE$83.74
70134RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETE26$17.92
70134RADIOLOGIC EXAMINATION, INTERNAL AUDITORY MEATI, COMPLETETC$25.30
70140RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS$49.20
70140RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWS26$10.14
70140RADIOLOGIC EXAMINATION, FACIAL BONES; LESS THAN THREE VIEWSTC$21.38
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE
VIEWS		$49.20
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE
VIEWS		26$14.00
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE
VIEWS		LT$49.20
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE
VIEWS		RT$49.20
70150RADIOLOGIC EXAMINATION, FACIAL BONES; COMPLETE, MINIMUM OF THREE
VIEWS		TC$26.97
70160RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE
VIEWS		$49.20
70160RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE
VIEWS		26$9.15
70160RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE
VIEWS		LT$49.20
70160RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE
VIEWS		RT$49.20
70160RADIOLOGIC EXAMINATION, NASAL BONES, COMPLETE, MINIMUM OF THREE
VIEWS		TC$18.13
70170DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$232.98
70170DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$15.31
70170DACRYOCYSTOGRAPHY, NASOLACRIMAL DUCT, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$32.24
70190RADIOLOGIC EXAMINATION; OPTIC FORAMINA$49.20
70190RADIOLOGIC EXAMINATION; OPTIC FORAMINA26$11.44
70190RADIOLOGIC EXAMINATION; OPTIC FORAMINATC$21.38
70200RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS$49.20
70200RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWS26$14.98
70200RADIOLOGIC EXAMINATION; ORBITS, COMPLETE, MINIMUM OF FOUR VIEWSTC$26.97
70210RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS$49.20
70210RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWS26$9.15
70210RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, LESS THAN THREE VIEWSTC$21.38
70220RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF
THREE VIEWS		$49.20
70220RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF
THREE VIEWS		26$13.38
70220RADIOLOGIC EXAMINATION, SINUSES, PARANASAL, COMPLETE, MINIMUM OF
THREE VIEWS		TC$26.97
70240RADIOLOGIC EXAMINATION, SELLA TURCICA$49.20
70240RADIOLOGIC EXAMINATION, SELLA TURCICA26$10.39
70240RADIOLOGIC EXAMINATION, SELLA TURCICATC$14.44
70250RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR
WITHOUT STEREO		$49.20
70250RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR
WITHOUT STEREO		26$13.01
70250RADIOLOGIC EXAMINATION, SKULL; LESS THAN FOUR VIEWS, WITH OR
WITHOUT STEREO		TC$21.38
70260RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS,
WITH OR WITHOUT STEREO		$83.74
70260RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS,
WITH OR WITHOUT STEREO		26$17.92
70260RADIOLOGIC EXAMINATION, SKULL; COMPLETE, MINIMUM OF FOUR VIEWS,
WITH OR WITHOUT STEREO		TC$30.56
70300RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW$54.08
70300RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEW26$5.37
70300RADIOLOGIC EXAMINATION, TEETH; SINGLE VIEWTC$8.85
70310RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL
MOUTH		$54.08
70310RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL
MOUTH		26$8.33
70310RADIOLOGIC EXAMINATION, TEETH; PARTIAL EXAMINATION, LESS THAN FULL
MOUTH		TC$14.44
70320RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH$54.08
70320RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTH26$11.94
70320RADIOLOGIC EXAMINATION, TEETH; COMPLETE, FULL MOUTHTC$26.97
70328RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; UNILATERAL		$49.20
70328RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; UNILATERAL		26$9.83
70328RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; UNILATERAL		TC$17.12
70330RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; BILATERAL		$49.20
70330RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; BILATERAL		26$13.01
70330RADIOLOGIC EXAMINATION, TEMPOROMANDIBULAR JOINT, OPEN AND
CLOSED MOUTH; BILATERAL		TC$28.64
70332TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$235.57
70332TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$28.27
70332TEMPOROMANDIBULAR JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$71.73
70336MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR
JOINT		$343.96
70336MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR
JOINT		26$48.97
70336MAGNETIC RESONANCE (EG, PROTON) IMAGING, TEMPOROMANDIBULAR
JOINT		TC$382.71
70350CEPHALOGRAM, ORTHODONTIC$49.20
70350CEPHALOGRAM, ORTHODONTIC26$8.87
70350CEPHALOGRAM, ORTHODONTICTC$12.53
70355ORTHOPANTOGRAM$49.20
70355ORTHOPANTOGRAM26$10.69
70355ORTHOPANTOGRAMTC$19.70
70360RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE$49.20
70360RADIOLOGIC EXAMINATION; NECK, SOFT TISSUE26$9.07
70360RADIOLOGIC EXAMINATION; NECK, SOFT TISSUETC$14.44
70370RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY
AND/OR MAGNIFICATION TECHNIQUE		$89.64
70370RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY
AND/OR MAGNIFICATION TECHNIQUE		26$17.11
70370RADIOLOGIC EXAMINATION; PHARYNX OR LARYNX, INCLUDING FLUOROSCOPY
AND/OR MAGNIFICATION TECHNIQUE		TC$44.42
70371COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR
VIDEO RECORDING		$89.64
70371COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR
VIDEO RECORDING		26$45.45
70371COMPLEX DYNAMIC PHARYNGEAL AND SPEECH EVALUATION BY CINE OR
VIDEO RECORDING		TC$71.73
70373LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$114.52
70373LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$22.63
70373LARYNGOGRAPHY, CONTRAST, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$60.88
70380RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS$49.20
70380RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUS26$9.15
70380RADIOLOGIC EXAMINATION, SALIVARY GLAND FOR CALCULUSTC$23.05
70390SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION$114.52
70390SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$19.26
70390SIALOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$60.88
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		$213.19
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		26$46.13
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		59$213.19
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		76$213.19
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		ET$213.19
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		GA$213.19
70450COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL		TC$161.25
70460COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST
MATERIAL(S)		$289.49
70460COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST
MATERIAL(S)		26$60.94
70460COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITH CONTRAST
MATERIAL(S)		TC$193.15
70470COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		$344.34
70470COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		26$68.81
70470COMPUTERIZED AXIAL TOMOGRAPHY, HEAD OR BRAIN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		TC$241.50
70480COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		$213.19
70480COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		26$69.41
70480COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		59$212.87
70480COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		TC$161.25
70481COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST		$289.49
70481COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST		26$74.73
70481COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITH CONTRAST		TC$193.15
70482COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		$344.34
70482COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		26$78.51
70482COMPUTERIZED AXIAL TOMOGRAPHY, ORBIT, SELLA, OR POSTERIOR FOSSA
OR OUTER, MIDDLE, OR INNER EAR; WITHOUT CONTRA		TC$241.50
70486COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL		$213.19
70486COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL		26$61.48
70486COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL		TC$161.25
70487COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH
CONTRAST MATERIAL(S)		$289.49
70487COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH
CONTRAST MATERIAL(S)		26$70.18
70487COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITH
CONTRAST MATERIAL(S)		TC$193.15
70488COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S)		$344.34
70488COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S)		26$77.14
70488COMPUTERIZED AXIAL TOMOGRAPHY, MAXILLOFACIAL AREA; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S)		TC$241.50
70490COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL		$213.19
70490COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL		26$69.41
70490COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL		TC$161.25
70491COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST
MATERIAL(S)		$289.49
70491COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST
MATERIAL(S)		26$74.73
70491COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITH CONTRAST
MATERIAL(S)		TC$193.15
70492COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN		$344.34
70492COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN		26$78.51
70492COMPUTERIZED AXIAL TOMOGRAPHY, SOFT TISSUE NECK; WITHOUT
CONTRAST MATERIAL FOLLOWED BY CONTRAST MATERIAL(S) AN		TC$241.50
70496COMPUTED TOMOGRAPHIC ANGIOGRAPHY, HEAD, WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND		$336.85
70498COMPUTED TOMOGRAPHIC ANGIOGRAPHY, NECK, WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FUR		$336.85
70540MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK$395.76
70540MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECK26$80.09
70540MAGNETIC RESONANCE (EG, PROTON) IMAGING; ORBIT, FACE, AND NECKTC$382.71
70542MAGNETIC RESONANCE (EG, PROTON) IMAGING, ORBIT, FACE, AND NECK
WITH CONTRAST MATERIAL(S)		$420.48
70543MAGNETIC RESONANCE INAMGING, ORBIT, FACE AND NECK WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S)		$573.77
70544MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST
MATERIAL(S)		$395.76
70545MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITH CONTRAST MATERIAL(S)$420.48
70546MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH		$573.77
70546MAGNETIC RESONANCE ANGIOGRAPHY, HEAD; WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH		XS$573.77
70547MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITHOUT CONTRAST
MATERIAL(S)		$395.76
70548MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITH CONTRAST MATERIAL(S)$420.48
70549MAGNETIC RESONANCE ANGIOGRAPHY, NECK, WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND FURTH		$573.77
70551MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL		$395.76
70551MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL		26$80.09
70551MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL		TC$382.71
70552MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITH CONTRAST MATERIAL(S)		$420.48
70552MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITH CONTRAST MATERIAL(S)		26$91.88
70552MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITH CONTRAST MATERIAL(S)		TC$459.03
70553MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY		$573.77
70553MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY		26$122.18
70553MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY		52$573.77
70553MAGNETIC RESONANCE (EG, PROTON) IMAGING, BRAIN (INCLUDING BRAIN
STEM); WITHOUT CONTRAST MATERIAL, FOLLOWED BY		TC$850.02
70554MAGNETIC RESONANCE IMAGING, BRAIN FUNCATIONAL MRI; INCLUDING TEST
SELECTION AND ADMINISTRATION OF REPETITIVE		$382.73
70555MAGNETIC RESONANCE IMAGING, BRAIN FUNCATIONAL MRI; REQUIRING
PHYSICIAN OR PSYCHOLOGIST ADMINISTRATION OF ENTIR		$382.73
70557MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE;
WITHOUT CONTRAST MATERIAL		$395.76
70558MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE;
WITH CONTRAST MATERIAL		$420.48
70559MAGNETIC RESONANCE IMAGIN, BRAIN, DURING INTRACRANIAL PROCEDURE;
WITHOUT CONTRAST MATERIAL FOLLOWED		$573.77
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL$49.20
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL26$9.61
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL59$49.20
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTAL76$49.20
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTALRT$49.20
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTALTC$16.46
71010RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW, FRONTALXU$49.20
71015RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL$49.20
71015RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTAL26$11.19
71015RADIOLOGIC EXAMINATION, CHEST; STEREO, FRONTALTC$18.13
71020RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;$49.20
71020RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;26$11.74
71020RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;59$49.20
71020RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;GA$49.20
71020RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;TC$21.38
71021RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH APICAL LORDOTIC PROCEDURE		$49.20
71021RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH APICAL LORDOTIC PROCEDURE		26$14.21
71021RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH APICAL LORDOTIC PROCEDURE		TC$25.30
71022RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH OBLIQUE PROJECTIONS		$49.20
71022RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH OBLIQUE PROJECTIONS		26$16.50
71022RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH OBLIQUE PROJECTIONS		TC$25.30
71023RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH FLUOROSCOPY		$89.64
71023RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH FLUOROSCOPY		26$20.31
71023RADIOLOGIC EXAMINATION, CHEST, TWO VIEWS, FRONTAL AND LATERAL;
WITH FLUOROSCOPY		TC$26.97
71030RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;$49.20
71030RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;26$16.50
71030RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;TC$26.97
71034RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
WITH FLUOROSCOPY		$89.64
71034RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
WITH FLUOROSCOPY		26$25.12
71034RADIOLOGIC EXAMINATION, CHEST, COMPLETE, MINIMUM OF FOUR VIEWS;
WITH FLUOROSCOPY		TC$49.35
71035RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL
DECUBITUS, BUCKY STUDIES)		$49.20
71035RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL
DECUBITUS, BUCKY STUDIES)		26$9.61
71035RADIOLOGIC EXAMINATION, CHEST, SPECIAL VIEWS (EG, LATERAL
DECUBITUS, BUCKY STUDIES)		TC$18.13
71036NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS;
FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL		$82.21
71036NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS;
FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL		26$29.87
71036NEEDLE BIOPSY OF INTRATHORACIC LESION, INCLUDING FOLLOW-UP FILMS;
FLUOROSCOPIC LOCALIZATION ONLY, RADIOLOGICAL		TC$53.94
71038FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING$85.80
71038FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHING26$29.87
71038FLUOROSCOPIC LOCALIZATION FOR TRANSBRONCHIAL BIOPSY OR BRUSHINGTC$57.53
71040BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$114.52
71040BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$30.29
71040BRONCHOGRAPHY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$50.02
71045RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW$53.28
71045RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEW26$5.76
71045RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEWFY$53.28
71045RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEWTC$6.64
71045RADIOLOGIC EXAMINATION, CHEST; SINGLE VIEWUD$53.28
71046RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS$53.28
71046RADIOLOGIC EXAMINATION, CHEST; 2 VIEWS26$6.86
71046RADIOLOGIC EXAMINATION, CHEST; 2 VIEWSFY$53.28
71046RADIOLOGIC EXAMINATION, CHEST; 2 VIEWSPO$53.28
71046RADIOLOGIC EXAMINATION, CHEST; 2 VIEWSTC$12.17
71047RADIOLOGIC EXAMINATION, CHEST; 3 VIEWS$53.28
71047RADIOLOGIC EXAMINATION, CHEST; 3 VIEWS26$8.85
71047RADIOLOGIC EXAMINATION, CHEST; 3 VIEWSTC$15.49
71048RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWS$98.17
71048RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWS26$10.17
71048RADIOLOGIC EXAMINATION, CHEST; 4 OR MORE VIEWSTC$15.93
71060BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$114.52
71060BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$38.28
71060BRONCHOGRAPHY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$75.32
71090INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$89.64
71090INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
71090INSERTION PACEMAKER, FLUOROSCOPY AND RADIOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$57.53
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS$49.20
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS26$11.94
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWS59$49.20
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWSLT$49.20
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWSRT$49.20
71100RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; TWO VIEWSTC$19.70
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		$49.20
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		26$14.45
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		59$49.20
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		LT$49.20
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		RT$49.20
71101RADIOLOGIC EXAMINATION, RIBS, UNILATERAL; INCLUDING
POSTEROANTERIOR CHEST, MINIMUM OF THREE VIEWS		TC$23.05
71110RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS$49.20
71110RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWS26$14.45
71110RADIOLOGIC EXAMINATION, RIBS, BILATERAL; THREE VIEWSTC$26.97
71111RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR
CHEST, MINIMUM OF FOUR VIEWS		$83.74
71111RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR
CHEST, MINIMUM OF FOUR VIEWS		26$16.87
71111RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR
CHEST, MINIMUM OF FOUR VIEWS		59$83.74
71111RADIOLOGIC EXAMINATION, RIBS, BILATERAL; INCLUDING POSTEROANTERIOR
CHEST, MINIMUM OF FOUR VIEWS		TC$30.56
71120RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS$49.20
71120RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWS26$10.69
71120RADIOLOGIC EXAMINATION; STERNUM, MINIMUM OF TWO VIEWSTC$22.38
71130RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM
OF THREE VIEWS		$49.20
71130RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM
OF THREE VIEWS		26$11.74
71130RADIOLOGIC EXAMINATION; STERNOCLAVICULAR JOINT OR JOINTS, MINIMUM
OF THREE VIEWS		TC$24.06
71250COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL		$213.19
71250COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL		26$62.77
71250COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL		59$213.19
71250COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL		TC$201.42
71260COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)$289.49
71260COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)26$67.24
71260COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)59$289.49
71260COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITH CONTRAST MATERIAL(S)TC$241.50
71270COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		$344.34
71270COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		26$74.73
71270COMPUTERIZED AXIAL TOMOGRAPHY, THORAX; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		TC$301.80
71275COMPUTED TOMOGRAPHIC ANGIOGRAPHY, CHEST, WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S), FOLLO		$336.85
71550MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR
EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY)		$395.76
71550MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR
EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY)		26$86.81
71550MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR
EVALUATION OF HILAR AND MEDIASTINAL LYMPHADENOPATHY)		TC$382.71
71551MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG, FOR
EVALUATION OF HILAR AND MEDIASTINAL LYMPH WITH CONTRAS		$420.48
71552MAGNETIC RESONANCE (EG, PROTON) IMAGING, CHEST (EG,FOR EVALUATION
OF HILAR AND MEDIASTINAL LYMPH WITHOUT		$573.77
71555MAGNETIC RESONANCE IMAGING, CHEST$501.76
72010RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY,
ANTEROPOSTERIOR AND LATERAL		$49.20
72010RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY,
ANTEROPOSTERIOR AND LATERAL		26$23.97
72010RADIOLOGIC EXAMINATION, SPINE, ENTIRE, SURVEY STUDY,
ANTEROPOSTERIOR AND LATERAL		TC$34.90
72020RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL$49.20
72020RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL26$7.95
72020RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL59$49.20
72020RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVEL76$49.20
72020RADIOLOGIC EXAMINATION, SPINE, SINGLE VIEW, SPECIFY LEVELTC$14.44
72040RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND
LATERAL		$49.20
72040RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND
LATERAL		26$11.74
72040RADIOLOGIC EXAMINATION, SPINE, CERVICAL; ANTEROPOSTERIOR AND
LATERAL		TC$20.71
72050RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS$83.74
72050RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWS26$16.50
72050RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWSPO$83.74
72050RADIOLOGIC EXAMINATION, SPINE, CERVICAL; MINIMUM OF FOUR VIEWSTC$30.56
72052RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING
OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES		$83.74
72052RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING
OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES		26$18.99
72052RADIOLOGIC EXAMINATION, SPINE, CERVICAL; COMPLETE, INCLUDING
OBLIQUE AND FLEXION AND/OR EXTENSION STUDIES		TC$38.50
72069RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)$49.20
72069RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)26$11.02
72069RADIOLOGIC EXAMINATION, SPINE, THORACOLUMBAR, STANDING (SCOLIOSIS)TC$17.12
72070RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL		$49.20
72070RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL		26$11.75
72070RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL		TC$22.38
72072RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT		$49.20
72072RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT		26$11.74
72072RADIOLOGIC EXAMINATION, SPINE; THORACIC, ANTEROPOSTERIOR AND
LATERAL, INCLUDING SWIMMER’S VIEW OF THE CERVICOT		TC$25.30
72074RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING
OBLIQUES, MINIMUM OF FOUR VIEWS		$49.20
72074RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING
OBLIQUES, MINIMUM OF FOUR VIEWS		26$11.74
72074RADIOLOGIC EXAMINATION, SPINE; THORACIC, COMPLETE, INCLUDING
OBLIQUES, MINIMUM OF FOUR VIEWS		TC$31.23
72080RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR
AND LATERAL		$49.20
72080RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR
AND LATERAL		26$11.74
72080RADIOLOGIC EXAMINATION, SPINE; THORACOLUMBAR, ANTEROPOSTERIOR
AND LATERAL		TC$23.05
72081X-RAY OF SPINE, 1 VIEW$55.63
72082X-RAY OF SPINE, 2 OR 3 VIEWS$92.12
72083X-RAY OF SPINE, 4 OR 5 VIEWS$175.63
72084X-RAY OF SPINE, MINIMUM OF 6 VIEWS$175.63
72084X-RAY OF SPINE, MINIMUM OF 6 VIEWS$163.83
72090RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE
AND ERECT STUDIES		$83.74
72090RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE
AND ERECT STUDIES		26$14.74
72090RADIOLOGIC EXAMINATION, SPINE; SCOLIOSIS STUDY, INCLUDING SUPINE
AND ERECT STUDIES		TC$23.05
72100RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND
LATERAL		$49.20
72100RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND
LATERAL		26$11.75
72100RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND
LATERAL		59$49.20
72100RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND
LATERAL		FY$49.20
72100RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; ANTEROPOSTERIOR AND
LATERAL		TC$23.05
72110RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH
OBLIQUE VIEWS		$83.74
72110RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH
OBLIQUE VIEWS		26$16.50
72110RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, WITH
OBLIQUE VIEWS		TC$31.23
72114RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING
BENDING VIEWS		$83.74
72114RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING
BENDING VIEWS		26$18.99
72114RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL; COMPLETE, INCLUDING
BENDING VIEWS		TC$40.17
72120RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY,
MINIMUM OF FOUR VIEWS		$83.74
72120RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY,
MINIMUM OF FOUR VIEWS		26$11.74
72120RADIOLOGIC EXAMINATION, SPINE, LUMBOSACRAL, BENDING VIEWS ONLY,
MINIMUM OF FOUR VIEWS		TC$30.56
72125COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL		$213.19
72125COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL		26$62.77
72125COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL		59$213.19
72125COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL		TC$201.42
72126COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST
MATERIAL		$289.49
72126COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST
MATERIAL		26$65.87
72126COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITH CONTRAST
MATERIAL		TC$241.50
72127COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		$344.34
72127COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		26$68.81
72127COMPUTERIZED AXIAL TOMOGRAPHY, CERVICAL SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		TC$301.80
72128COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL		$213.19
72128COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL		26$62.77
72128COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL		TC$201.42
72129COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST
MATERIAL		$289.49
72129COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST
MATERIAL		26$65.87
72129COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITH CONTRAST
MATERIAL		TC$241.50
72130COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		$344.34
72130COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		26$68.81
72130COMPUTERIZED AXIAL TOMOGRAPHY, THORACIC SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND		TC$301.80
72131COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL		$213.19
72131COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL		26$62.77
72131COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL		TC$201.42
72132COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST
MATERIAL		$289.49
72132COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST
MATERIAL		26$65.87
72132COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITH CONTRAST
MATERIAL		TC$241.50
72133COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F		$344.34
72133COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F		26$68.81
72133COMPUTERIZED AXIAL TOMOGRAPHY, LUMBAR SPINE; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND F		TC$301.80
72141MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL		$395.76
72141MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL		26$86.81
72141MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITHOUT CONTRAST MATERIAL		TC$382.71
72142MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S)		$420.48
72142MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S)		26$99.20
72142MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, CERVICAL; WITH CONTRAST MATERIAL(S)		TC$459.03
72146MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL		$395.76
72146MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL		26$86.81
72146MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITHOUT CONTRAST MATERIAL		TC$424.89
72147MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S)		$420.48
72147MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S)		26$99.20
72147MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, THORACIC; WITH CONTRAST MATERIAL(S)		TC$459.03
72148MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL		$395.76
72148MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL		26$76.57
72148MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITHOUT CONTRAST MATERIAL		TC$424.89
72149MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S)		$420.48
72149MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S)		26$91.88
72149MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, LUMBAR; WITH CONTRAST MATERIAL(S)		TC$459.03
72156MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		$573.77
72156MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		26$132.52
72156MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		TC$850.02
72157MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		$573.77
72157MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		26$132.52
72157MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		TC$850.02
72158MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		$573.77
72158MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		26$122.18
72158MAGNETIC RESONANCE (EG, PROTON) IMAGING, SPINAL CANAL AND
CONTENTS, WITHOUT CONTRAST MATERIAL, FOLLOWED BY CON		TC$850.02
72159MAGNETIC RESONANCE IMAGING, SPINAL CANAL AND CONTENTS, WITH OR
WITHOUT CONTRAST MATERIAL(S)		$573.77
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY$49.20
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY26$12.04
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLY59$49.20
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLYFY$49.20
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLYLT$49.20
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLYRT$49.20
72170RADIOLOGIC EXAMINATION, PELVIS; ANTEROPOSTERIOR ONLYTC$18.13
72190RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS$49.20
72190RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWS26$10.69
72190RADIOLOGIC EXAMINATION, PELVIS; COMPLETE, MINIMUM OF THREE VIEWSTC$23.05
72191COMPUTED TOMOGRAPHIC ANGIOGRAPHY, PELVIS, WITHOUT CONTRAST
MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL(S) AND		$336.85
72192COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL		$213.19
72192COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL		26$55.96
72192COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL		TC$201.42
72193COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)$289.49
72193COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)26$59.90
72193COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)59$289.49
72193COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)GZ$289.49
72193COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITH CONTRAST MATERIAL(S)TC$233.65
72194COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		$344.34
72194COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		26$62.60
72194COMPUTERIZED AXIAL TOMOGRAPHY, PELVIS; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHER		TC$289.93
72195MAGNETIC RESONANCE (EG, PROTON)IMAGING, PELVIS; WITHOUT CONTRAST
MATERIAL(S)		$395.76
72196MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS$420.48
72196MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVIS26$82.88
72196MAGNETIC RESONANCE (EG, PROTON) IMAGING, PELVISTC$382.71
72197MAGNETIC RESONANCE (EG, PROTON)IMAGING, PELVIS; WITHOUTCONTRAST
MATERIAL(S) AND FURTHER SEQUENCES		$573.77
72198MAGNETIC RESONANCE ANGIOGRAPHY, PELVIS, WITH OR WITHOUT
CONTRAST MATERIAL(S)		$498.14
72200RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS$49.20
72200RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWS26$8.66
72200RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; LESS THAN THREE VIEWSTC$18.13
72202RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS$49.20
72202RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWS26$9.68
72202RADIOLOGIC EXAMINATION, SACROILIAC JOINTS; THREE OR MORE VIEWSTC$21.38
72220RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS$49.20
72220RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWS26$9.30
72220RADIOLOGIC EXAMINATION, SACRUM AND COCCYX, MINIMUM OF TWO VIEWSTC$19.70
72240MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$196.68
72240MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$49.16
72240MYELOGRAPHY, CERVICAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$161.93
72255MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$196.68
72255MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$49.16
72255MYELOGRAPHY, THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$147.81
72265MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$196.68
72265MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$44.69
72265MYELOGRAPHY, LUMBOSACRAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$138.87
72270MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$196.68
72270MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$71.83
72270MYELOGRAPHY, ENTIRE SPINAL CANAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$208.02
72275EPIDUROGRAPHY, RADIOLOGICAL SUPERVISON AND INTERPRETATION$196.68
72285DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$820.92
72285DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$42.91
72285DISKOGRAPHY, CERVICAL OR THORACIC, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$286.59
72291RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS
VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING		$172.27
72291RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS
VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING		76$172.27
72292RADIOLOGICAL SUPERVISON AND INTERPRETATION, PERCUTANEOUS
VERTEBROPLASTY OR VERTEBRAL AUGMENTATION INCLUDING		$172.27
72295DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION$820.92
72295DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$42.91
72295DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATION59$820.92
72295DISKOGRAPHY, LUMBAR, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$268.23
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE$49.20
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE26$8.25
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETE50$49.20
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETELT$49.20
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETERT$49.20
73000RADIOLOGIC EXAMINATION; CLAVICLE, COMPLETETC$18.13
73010RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE$49.20
73010RADIOLOGIC EXAMINATION; SCAPULA, COMPLETE26$9.07
73010RADIOLOGIC EXAMINATION; SCAPULA, COMPLETELT$49.20
73010RADIOLOGIC EXAMINATION; SCAPULA, COMPLETERT$49.20
73010RADIOLOGIC EXAMINATION; SCAPULA, COMPLETETC$18.13
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW26$7.85
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW51$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW59$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEW76$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEWLT$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEWRT$49.20
73020RADIOLOGIC EXAMINATION, SHOULDER; ONE VIEWTC$16.46
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS26$9.54
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS50$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS59$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWS76$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWSLT$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWSRT$49.20
73030RADIOLOGIC EXAMINATION, SHOULDER; COMPLETE, MINIMUM OF TWO VIEWSTC$19.70
73040RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73040RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73040RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		LT$235.57
73040RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		RT$235.57
73040RADIOLOGIC EXAMINATION, SHOULDER, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$71.73
73050RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH
OR WITHOUT WEIGHTED DISTRACTION		$49.20
73050RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH
OR WITHOUT WEIGHTED DISTRACTION		26$10.53
73050RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH
OR WITHOUT WEIGHTED DISTRACTION		50$49.20
73050RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH
OR WITHOUT WEIGHTED DISTRACTION		RT$49.20
73050RADIOLOGIC EXAMINATION; ACROMIOCLAVICULAR JOINTS, BILATERAL, WITH
OR WITHOUT WEIGHTED DISTRACTION		TC$23.05
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS$49.20
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS26$8.79
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS59$49.20
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWS76$49.20
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWSLT$49.20
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWSRT$49.20
73060RADIOLOGIC EXAMINATION; HUMERUS, MINIMUM OF TWO VIEWSTC$19.70
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		$49.20
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		26$7.95
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		50$49.20
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		59$49.20
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		LT$49.20
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		RT$49.20
73070RADIOLOGIC EXAMINATION, ELBOW; ANTEROPOSTERIOR AND LATERAL
VIEWS		TC$18.13
73080RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS$49.20
73080RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWS26$9.30
73080RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWSLT$49.20
73080RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWSRT$49.20
73080RADIOLOGIC EXAMINATION, ELBOW; COMPLETE, MINIMUM OF THREE VIEWSTC$19.70
73085RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73085RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73085RADIOLOGIC EXAMINATION, ELBOW, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$71.73
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		$49.20
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		26$8.43
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		50$49.20
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		LT$49.20
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		RT$49.20
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		TC$18.13
73090RADIOLOGIC EXAMINATION; FOREARM, ANTEROPOSTERIOR AND LATERAL
VIEWS		XU$49.20
73092RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		$49.20
73092RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		26$8.10
73092RADIOLOGIC EXAMINATION; UPPER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		TC$17.12
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS26$8.10
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS50$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWS59$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWSLT$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWSPO$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWSRT$49.20
73100RADIOLOGIC EXAMINATION, WRIST; ANTEROPOSTERIOR AND LATERAL VIEWSTC$17.12
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS$49.20
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS26$9.30
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS50$49.20
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWS76$49.20
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWSLT$49.20
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWSRT$49.20
73110RADIOLOGIC EXAMINATION, WRIST; COMPLETE, MINIMUM OF THREE VIEWSTC$18.46
73115RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73115RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73115RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		RT$235.57
73115RADIOLOGIC EXAMINATION, WRIST, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$53.94
73120RADIOLOGIC EXAMINATION, HAND; TWO VIEWS$49.20
73120RADIOLOGIC EXAMINATION, HAND; TWO VIEWS26$8.10
73120RADIOLOGIC EXAMINATION, HAND; TWO VIEWSLT$49.20
73120RADIOLOGIC EXAMINATION, HAND; TWO VIEWSRT$49.20
73120RADIOLOGIC EXAMINATION, HAND; TWO VIEWSTC$17.12
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS26$9.30
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS50$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS59$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWS76$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWSLT$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWSRT$49.20
73130RADIOLOGIC EXAMINATION, HAND; MINIMUM OF THREE VIEWSTC$18.46
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS26$6.73
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS59$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWS76$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF1$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF3$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF4$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF5$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF6$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF7$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSF8$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSLT$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSRT$49.20
73140RADIOLOGIC EXAMINATION, FINGER OR FINGERS, MINIMUM OF TWO VIEWSTC$14.44
73200COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL		$213.19
73200COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL		26$58.48
73200COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL		LT$213.19
73200COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL		RT$213.19
73200COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL		TC$169.18
73201COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST
MATERIAL(S)		$289.49
73201COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST
MATERIAL(S)		26$62.77
73201COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITH CONTRAST
MATERIAL(S)		TC$201.42
73202COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		$344.34
73202COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		26$65.87
73202COMPUTERIZED AXIAL TOMOGRAPHY, UPPER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		TC$253.69
73206COMPUTED TOMOGRAPHIC ANGIOGRAPHY, UPPER EXTREMITY, WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL		$336.85
73218MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		$395.76
73218MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		LT$395.76
73218MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		RT$395.76
73219MAGNETIC RESONANCE (EG, PROTON)IMAGING, UPPER EXTREMITY0THER
THAN JOINT; WITH CONTRAST MATERIEL(S)		$420.48
73220MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER
THAN JOINT		$573.77
73220MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER
THAN JOINT		26$80.09
73220MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER
THAN JOINT		LT$573.77
73220MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER
THAN JOINT		RT$573.77
73220MAGNETIC RESONANCE (EG, PROTON) IMAGING, UPPER EXTREMITY, OTHER
THAN JOINT		TC$382.71
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		$395.76
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		26$48.97
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		50$395.76
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		LT$395.76
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		RT$395.76
73221MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY		TC$382.71
73222MAGNETIC RESONANCE (EG, PROTON)IMAGING, ANY JOINT OF UPPER
EXTREMITY WITH; CONTRAST MATERIAL(S)		$420.48
73223MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED		$573.77
73223MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED		LT$573.77
73223MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF UPPER
EXTREMITY; WITHOUT CONTRAST MATERIAL(S), FOLLOWED		RT$573.77
73225MAGNETIC RSONANCE ANGIOGRAPHY, UPPER EXTREMITY, WITH OR WITHOUT
CONTRAST MATERIAL(S)		$408.12
73500RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW$49.20
73500RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEW26$8.87
73500RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEWLT$49.20
73500RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEWRT$49.20
73500RADIOLOGIC EXAMINATION, HIP; UNILATERAL, ONE VIEWTC$16.46
73501X-RAY OF HIP WITH PELVIS, 1 VIEW$55.63
73501X-RAY OF HIP WITH PELVIS, 1 VIEWLT$55.63
73501X-RAY OF HIP WITH PELVIS, 1 VIEWRT$55.63
73502X-RAY OF HIP WITH PELVIS, 2-3 VIEWS$55.63
73502X-RAY OF HIP WITH PELVIS, 2-3 VIEWSLT$55.63
73502X-RAY OF HIP WITH PELVIS, 2-3 VIEWSRT$55.63
73503X-RAY OF HIP WITH PELVIS, MINIMUM OF 4 VIEWS$92.12
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS26$11.19
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS50$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS59$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWS76$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWSLT$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWSRT$49.20
73510RADIOLOGIC EXAMINATION, HIP; COMPLETE, MINIMUM OF TWO VIEWSTC$19.70
73520RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF
EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P		$83.74
73520RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF
EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P		26$13.95
73520RADIOLOGIC EXAMINATION, HIPS, BILATERAL, MINIMUM OF TWO VIEWS OF
EACH HIP, INCLUDING ANTEROPOSTERIOR VIEW OF P		TC$23.05
73521X-RAY OF BOTH HIPS WITH PELVIS, 2 VIEWS$92.12
73522X-RAY OF BOTH HIPS WITH PELVIS, 3-4 VIEWS$92.12
73523X-RAY OF BOTH HIPS WITH PELVIS, MINIMUM OF 5 VIEWS$175.63
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		59$235.57
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		LT$235.57
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		RT$235.57
73525RADIOLOGIC EXAMINATION, HIP, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$71.73
73530RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE$83.74
73530RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURE26$15.44
73530RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURERT$83.74
73530RADIOLOGIC EXAMINATION, HIP, DURING OPERATIVE PROCEDURETC$18.13
73540RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF
TWO VIEWS		$49.20
73540RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF
TWO VIEWS		26$10.89
73540RADIOLOGIC EXAMINATION, PELVIS AND HIPS, INFANT OR CHILD, MINIMUM OF
TWO VIEWS		TC$19.70
73542RADIOLOGICAL JOINT ARTHROGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$235.57
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS$49.20
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS26$9.15
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWS50$49.20
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWSLT$49.20
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWSRT$49.20
73550RADIOLOGIC EXAMINATION, FEMUR, ANTEROPOSTERIOR AND LATERAL VIEWSTC$19.70
73551X-RAY OF FEMUR, 1 VIEW$55.63
73551X-RAY OF FEMUR, 1 VIEWLT$55.63
73551X-RAY OF FEMUR, 1 VIEWRT$55.63
73552X-RAY OF FEMUR, MINIMUM 2 VIEWS$55.63
73552X-RAY OF FEMUR, MINIMUM 2 VIEWSLT$55.63
73552X-RAY OF FEMUR, MINIMUM 2 VIEWSRT$55.63
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS$49.20
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS26$8.55
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS50$49.20
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWS59$83.74
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWSLT$49.20
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWSRT$49.20
73560RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL VIEWSTC$18.13
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		26$9.83
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		50$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		59$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		76$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		LT$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		RT$49.20
73562RADIOLOGIC EXAMINATION, KNEE; ANTEROPOSTERIOR AND LATERAL, WITH
OBLIQUE(S), MINIMUM OF THREE VIEWS		TC$19.70
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		$49.20
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		26$11.94
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		50$49.20
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		76$49.20
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		LT$49.20
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		RT$49.20
73564RADIOLOGIC EXAMINATION, KNEE; COMPLETE, INCLUDING OBLIQUE(S), AND
TUNNEL, AND/OR PATELLAR AND/OR STANDING VIEW		TC$21.38
73565RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING,
ANTEROPOSTERIOR		$49.20
73565RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING,
ANTEROPOSTERIOR		26$11.43
73565RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING,
ANTEROPOSTERIOR		59$49.20
73565RADIOLOGIC EXAMINATION, KNEE; BOTH KNEES, STANDING,
ANTEROPOSTERIOR		TC$17.12
73580RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73580RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73580RADIOLOGIC EXAMINATION, KNEE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$89.77
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		$49.20
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		26$8.55
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		50$49.20
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		LT$49.20
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		RT$49.20
73590RADIOLOGIC EXAMINATION; TIBIA AND FIBULA, ANTEROPOSTERIOR AND
LATERAL VIEWS		TC$18.13
73592RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		$49.20
73592RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		26$8.10
73592RADIOLOGIC EXAMINATION; LOWER EXTREMITY, INFANT, MINIMUM OF TWO
VIEWS		TC$17.12
73600RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS$49.20
73600RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWS26$8.12
73600RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWSLT$49.20
73600RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWSRT$49.20
73600RADIOLOGIC EXAMINATION, ANKLE; ANTEROPOSTERIOR AND LATERAL VIEWSTC$17.12
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS26$9.30
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS50$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS59$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWS76$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWSLT$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWSRT$49.20
73610RADIOLOGIC EXAMINATION, ANKLE; COMPLETE, MINIMUM OF THREE VIEWSTC$18.46
73615RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$235.57
73615RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
73615RADIOLOGIC EXAMINATION, ANKLE, ARTHROGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$71.73
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS$49.20
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS26$8.10
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWS76$49.20
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWSLT$49.20
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWSRT$49.20
73620RADIOLOGIC EXAMINATION, FOOT; ANTEROPOSTERIOR AND LATERAL VIEWSTC$17.12
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS$49.20
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS26$9.30
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS50$49.20
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWS59$49.20
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWSLT$49.20
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWSRT$49.20
73630RADIOLOGIC EXAMINATION, FOOT; COMPLETE, MINIMUM OF THREE VIEWSTC$18.46
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS$49.20
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS26$8.10
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWS50$49.20
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWSLT$49.20
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWSRT$49.20
73650RADIOLOGIC EXAMINATION; CALCANEUS, MINIMUM OF TWO VIEWSTC$16.46
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS26$6.73
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS50$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS59$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWS76$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWSLT$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWSRT$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWST5$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWST6$49.20
73660RADIOLOGIC EXAMINATION; TOE OR TOES, MINIMUM OF TWO VIEWSTC$14.44
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		$213.19
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		26$58.48
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		50$213.19
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		59$213.19
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		LT$49.20
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		RT$49.20
73700COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL		TC$169.18
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		$289.49
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		26$62.77
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		59$289.49
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		LT$289.49
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		RT$289.49
73701COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITH CONTRAST
MATERIAL(S)		TC$201.42
73702COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		$344.34
73702COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		26$65.87
73702COMPUTERIZED AXIAL TOMOGRAPHY, LOWER EXTREMITY; WITHOUT
CONTRAST MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AN		TC$253.69
73706COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL		$336.85
73706COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL		59$336.85
73706COMPUTED TOMOGRAPHIC ANGIOGRAPHY, LOWER EXTREMITY, WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY CONTRAST MATERIAL		LT$336.85
73718MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		$395.76
73718MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		LT$395.76
73718MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER
THAN JOINT; WITHOUT CONTRAST MATERIAL(S)		RT$395.76
73719MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY OTHER
THAN JOINT; WITH CONTRAST MATERIAL(S)		$420.48
73720MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER
THAN JOINT		$573.77
73720MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER
THAN JOINT		26$80.09
73720MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER
THAN JOINT		LT$573.77
73720MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER
THAN JOINT		RT$573.77
73720MAGNETIC RESONANCE (EG, PROTON) IMAGING, LOWER EXTREMITY, OTHER
THAN JOINT		TC$382.71
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		$395.76
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		26$146.63
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		50$395.76
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		LT$395.76
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		RT$395.76
73721MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY		TC$382.71
73722MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY; WITH CONTRAST MATERIAL(S)		$420.48
73723MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY; WITHOUT CONTRAST MATERIAL(S)		$573.77
73723MAGNETIC RESONANCE (EG, PROTON) IMAGING, ANY JOINT OF LOWER
EXTREMITY; WITHOUT CONTRAST MATERIAL(S)		LT$573.77
73725MAGNETIC RESONANCE ANGIOGRAPHY, LOWER EXTREMITY, WITH OR
WITHOUT CONTRAST MATERIAL(S)		$498.94
74000RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW$49.20
74000RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW26$12.50
74000RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW59$49.20
74000RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEW76$49.20
74000RADIOLOGIC EXAMINATION, ABDOMEN; SINGLE ANTEROPOSTERIOR VIEWTC$18.13
74010RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL
OBLIQUE AND CONE VIEWS		$49.20
74010RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL
OBLIQUE AND CONE VIEWS		26$12.23
74010RADIOLOGIC EXAMINATION, ABDOMEN; ANTEROPOSTERIOR AND ADDITIONAL
OBLIQUE AND CONE VIEWS		TC$19.70
74018RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW$53.28
74018RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEW26$5.76
74018RADIOLOGIC EXAMINATION, ABDOMEN; 1 VIEWTC$11.29
74019RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS$98.17
74019RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWS26$7.30
74019RADIOLOGIC EXAMINATION, ABDOMEN; 2 VIEWSTC$13.50
74020RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS
AND/OR ERECT VIEWS		$49.20
74020RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS
AND/OR ERECT VIEWS		26$14.45
74020RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS
AND/OR ERECT VIEWS		59$49.20
74020RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE, INCLUDING DECUBITUS
AND/OR ERECT VIEWS		TC$21.38
74021RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWS$98.17
74021RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWS26$8.63
74021RADIOLOGIC EXAMINATION, ABDOMEN; 3 OR MORE VIEWSTC$15.70
74022RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES,
INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE		$83.74
74022RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES,
INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE		26$16.87
74022RADIOLOGIC EXAMINATION, ABDOMEN; COMPLETE ACUTE ABDOMEN SERIES,
INCLUDING SUPINE, ERECT, AND/ OR DECUBITUS VIE		TC$25.30
74150COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL		$213.19
74150COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL		26$64.13
74150COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL		TC$193.15
74160COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST
MATERIAL(S)		$289.49
74160COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST
MATERIAL(S)		26$68.81
74160COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST
MATERIAL(S)		59$289.49
74160COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST
MATERIAL(S)		GZ$289.49
74160COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITH CONTRAST
MATERIAL(S)		TC$233.65
74170COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE		$344.34
74170COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE		26$75.84
74170COMPUTERIZED AXIAL TOMOGRAPHY, ABDOMEN; WITHOUT CONTRAST
MATERIAL, FOLLOWED BY CONTRAST MATERIAL(S) AND FURTHE		TC$289.93
74174COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN AND PELVIS, WITH
CONTRAST MATERIAL(S), INCLUDING NONCONTRAST IMAGES		$365.52
74175COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMEN, WITHOUT CONTRAST
MATERIAL(S),FOLLOWED BY CONTRAST MATERIAL(S) AND		$336.85
74176COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST
MATERIAL		$189.83
74177COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST
MATERIAL		$293.59
74177COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST
MATERIAL		PO$293.59
74177COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST
MATERIAL		TC$136.74
74177COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITH CONTRAST
MATERIAL		XP$293.59
74178COMPUTED TOMOGRAPHY, ABDOMEN AND PELVIS; WITHOUT CONTRAST
MATERIAL IN ONE OR BOTH BODY REGIONS, FOLLOWED BY		$327.30
74181MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN$395.76
74181MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN26$86.81
74181MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN59$395.76
74181MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMENTC$382.71
74182MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITH CONTRAST
MATERIAL(S)		$420.48
74183MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATE		$573.77
74183MAGNETIC RESONANCE (EG, PROTON) IMAGING, ABDOMEN; WITHOUT
CONTRAST MATERIAL(S), FOLLOWED BY WITH CONTRAST MATE		59$573.77
74185MAGNETIC RESONANCE ANGIOGRAPHY, ABDOMEN, WITH OR WITHOUT
CONTRAST MATERIAL(S)		$498.54
74190PERITONEOGRAM, RADIOLOGICAL SUPERVISION AND INTERPRETATION$232.98
74210RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS$99.10
74210RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUS26$18.77
74210RADIOLOGIC EXAMINATION; PHARYNX AND/OR CERVICAL ESOPHAGUSTC$40.17
74220RADIOLOGIC EXAMINATION; ESOPHAGUS$96.42
74220RADIOLOGIC EXAMINATION; ESOPHAGUS26$25.34
74220RADIOLOGIC EXAMINATION; ESOPHAGUSTC$40.17
74230SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH
CINERADIOGRAPHY AND/OR VIDEO		$96.42
74230SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH
CINERADIOGRAPHY AND/OR VIDEO		26$29.33
74230SWALLOWING FUNCTION, PHARYNX AND/OR ESOPHAGUS, WITH
CINERADIOGRAPHY AND/OR VIDEO		TC$44.42
74235REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON
CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT		$153.00
74235REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON
CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT		26$64.13
74235REMOVAL OF FOREIGN BODY(S), ESOPHAGEAL, WITH USE OF BALLOON
CATHETER, RADIOLOGICAL SUPERVISION AND INTERPRETAT		TC$89.77
74240RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITHOUT KUB		$99.10
74240RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITHOUT KUB		26$37.41
74240RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITHOUT KUB		TC$50.02
74241RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITH KUB		$99.10
74241RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITH KUB		26$37.41
74241RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH OR
WITHOUT DELAYED FILMS, WITH KUB		TC$51.03
74245RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL
BOWEL, INCLUDES MULTIPLE SERIAL FILMS		$154.80
74245RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL
BOWEL, INCLUDES MULTIPLE SERIAL FILMS		26$49.32
74245RADIOLOGIC EXAMINATION, GASTROINTESTINAL TRACT, UPPER; WITH SMALL
BOWEL, INCLUDES MULTIPLE SERIAL FILMS		TC$81.59
74246RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		$99.10
74246RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		26$37.41
74246RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		TC$56.28
74247RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		$99.10
74247RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		26$37.41
74247RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		TC$57.53
74249RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		$154.80
74249RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		26$49.32
74249RADIOLOGICAL EXAMINATION, GASTROINTESTINAL TRACT, UPPER, AIR
CONTRAST, WITH SPECIFIC HIGH DENSITY BARIUM, EFFE		TC$87.85
74250RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL
FILMS		$99.10
74250RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL
FILMS		26$25.49
74250RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL
FILMS		TC$44.42
74251RADIOLOGIC EXAMINATION, SMALL BOWEL, INCLUDES MULTIPLE SERIAL
FILMS; VIA ENTEROCLYSIS TUBE		$154.80
74260DUODENOGRAPHY, HYPOTONIC$154.80
74260DUODENOGRAPHY, HYPOTONIC26$27.46
74260DUODENOGRAPHY, HYPOTONICTC$51.03
74261COMPUTED TOMOGRAPHIC (CT) COLONOGRAPHY, DIAGNOSTIC, INCLUDING
IMAGE POSTPROCESSING; WITHOUT CONTRAST MATERIAL		$189.83
74270RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA$99.10
74270RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMA26$37.41
74270RADIOLOGIC EXAMINATION, COLON; BARIUM ENEMATC$58.20
74280RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH
DENSITY BARIUM, WITH OR WITHOUT GLUCAGON		$154.80
74280RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH
DENSITY BARIUM, WITH OR WITHOUT GLUCAGON		26$53.46
74280RADIOLOGIC EXAMINATION, COLON; AIR CONTRAST WITH SPECIFIC HIGH
DENSITY BARIUM, WITH OR WITHOUT GLUCAGON		TC$76.33
74283THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF
INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION		$99.10
74283THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF
INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION		26$104.17
74283THERAPEUTIC ENEMA, CONTRAST OR AIR, FOR REDUCTION OF
INTUSSUSCEPTION OR OTHER INTRALUNIMAL OBSTRUCTION		TC$87.52
74290CHOLECYSTOGRAPHY, ORAL CONTRAST;$99.10
74290CHOLECYSTOGRAPHY, ORAL CONTRAST;26$16.87
74290CHOLECYSTOGRAPHY, ORAL CONTRAST;TC$25.30
74291CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT
EXAMINATION OR MULTIPLE DAY EXAMINATION		$99.10
74291CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT
EXAMINATION OR MULTIPLE DAY EXAMINATION		26$10.69
74291CHOLECYSTOGRAPHY, ORAL CONTRAST; ADDITIONAL OR REPEAT
EXAMINATION OR MULTIPLE DAY EXAMINATION		TC$14.44
74300CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; DURING SURGERY$114.52
74300CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; DURING SURGERY26$19.24
74301CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET DURING
SURGERY		$114.52
74301CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; ADDITIONAL SET DURING
SURGERY		26$11.19
74305CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE$114.52
74305CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVE26$22.67
74305CHOLANGIOGRAPHY AND/OR PANCREATOGRAPHY; POSTOPERATIVETC$26.97
74320CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
74320CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
74320CHOLANGIOGRAPHY, PERCUTANEOUS, TRANSHEPATIC, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$107.31
74327POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T-
TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ		$153.00
74327POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T-
TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ		26$37.97
74327POSTOPERATIVE BILIARY DUCT STONE REMOVAL, PERCUTANEOUS VIA T-
TUBE TRACT, BASKET OR SNARE (EG, BURHENNE TECHNIQ		TC$60.20
74328ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$143.57
74328ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$37.97
74328ENDOSCOPIC CATHETERIZATION OF THE BILIARY DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$107.31
74329ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$143.57
74329ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$37.97
74329ENDOSCOPIC CATHETERIZATION OF THE PANCREATIC DUCTAL SYSTEM,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$107.31
74330COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND
PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND		$143.57
74330COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND
PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND		26$37.97
74330COMBINED ENDOSCOPIC CATHETERIZATION OF THE BILIARY AND
PANCREATIC DUCTAL SYSTEMS, RADIOLOGICAL SUPERVISION AND		TC$107.31
74340INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT),
WITH MULTIPLE FLUOROSCOPIES AND FILMS		$89.64
74340INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT),
WITH MULTIPLE FLUOROSCOPIES AND FILMS		26$29.87
74340INTRODUCTION OF LONG GASTROINTESTINAL TUBE (EG, MILLER-ABBOTT),
WITH MULTIPLE FLUOROSCOPIES AND FILMS		TC$89.77
74350PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$114.52
74350PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$41.15
74350PERCUTANEOUS PLACEMENT OF GASTROSTOMY TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$107.31
74355PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$114.52
74355PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$41.15
74355PERCUTANEOUS PLACEMENT OF ENTEROCLYSIS TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$89.77
74360INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG,
ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE		$153.00
74360INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG,
ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE		26$29.87
74360INTRALUMINAL DILATION OF STRICTURES AND/OR OBSTRUCTIONS (EG,
ESOPHAGUS), RADIOLOGICAL SUPERVISION AND INTERPRE		TC$107.31
74363PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE
WITH OR WITHOUT PLACEMENT OF STENT, RADIOLOGICA		$343.82
74363PERCUTANEOUS TRANSHEPATIC DILATATION OF BILIARY DUCT STRICTURE
WITH OR WITHOUT PLACEMENT OF STENT, RADIOLOGICA		26$45.60
74400UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY;		$172.39
74400UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY;		26$26.64
74400UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY;		TC$57.53
74405UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI		$93.38
74405UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI		26$26.64
74405UROGRAPHY (PYELOGRAPHY), INTRAVENOUS, WITH OR WITHOUT KUB, WITH
OR WITHOUT TOMOGRAPHY; WITH SPECIAL HYPERTENSI		TC$68.05
74410UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;$172.39
74410UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;26$26.64
74410UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE;TC$66.47
74415UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH
NEPHROTOMOGRAPHY		$172.39
74415UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH
NEPHROTOMOGRAPHY		26$26.64
74415UROGRAPHY, INFUSION, DRIP TECHNIQUE AND/OR BOLUS TECHNIQUE; WITH
NEPHROTOMOGRAPHY		TC$72.40
74420UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB$172.39
74420UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB26$18.77
74420UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUB76$172.39
74420UROGRAPHY, RETROGRADE, WITH OR WITHOUT KUBTC$89.77
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		$172.39
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$18.01
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		59$172.39
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		LT$172.39
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		RT$172.39
74425UROGRAPHY, ANTEGRADE, (PYELOSTOGRAM, NEPHROSTOGRAM,
LOOPOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$44.42
74430CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$172.39
74430CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$16.33
74430CYSTOGRAPHY, MINIMUM OF THREE VIEWS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$35.83
74440VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$172.39
74440VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$19.26
74440VASOGRAPHY, VESICULOGRAPHY, OR EPIDIDYMOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$38.50
74445CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$172.39
74445CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$58.90
74445CORPORA CAVERNOSOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$38.50
74450URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$172.39
74450URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$16.66
74450URETHROCYSTOGRAPHY, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$50.02
74455URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$172.39
74455URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$16.66
74455URETHROCYSTOGRAPHY, VOIDING, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$53.94
74470RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST
VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN		$114.52
74470RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST
VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN		26$28.27
74470RADIOLOGIC EXAMINATION, RENAL CYST STUDY, TRANSLUMBAR, CONTRAST
VISUALIZATION, RADIOLOGICAL SUPERVISION AND IN		TC$42.75
74475INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR
DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO		$343.82
74475INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR
DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO		26$29.87
74475INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR
DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO		LT$343.82
74475INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR
DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO		RT$343.82
74475INTRODUCTION OF INTRACATHETER OR CATHETER INTO RENAL PELVIS FOR
DRAINAGE AND/OR INJECTION, PERCUTANEOUS, RADIO		TC$138.87
74480INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH
RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER		$153.00
74480INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH
RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER		26$29.87
74480INTRODUCTION OF URETERAL CATHETER OR STENT INTO URETER THROUGH
RENAL PELVIS FOR DRAINAGE AND/OR INJECTION, PER		TC$138.87
74485DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$153.00
74485DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
74485DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		LT$153.00
74485DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		RT$153.00
74485DILATION OF NEPHROSTOMY, URETERS, OR URETHRA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$107.31
74710PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION$83.74
74710PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATION26$18.17
74710PELVIMETRY, WITH OR WITHOUT PLACENTAL LOCALIZATIONTC$35.83
74712MAGNETIC RESONANCE IMAGING OF FETUS, SINGLE OR FIRST PREGNANCY$250.25
74740HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$232.98
74740HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$20.05
74740HYSTEROSALPINGOGRAPHY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$44.42
74742TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
74742TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$30.64
74742TRANSCERVICAL CATHETERIZATION OF FALLOPIAN TUBE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$107.31
74775PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF
ANOMALIES)		$172.39
74775PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF
ANOMALIES)		26$33.89
74775PERINEOGRAM (EG, VAGINOGRAM, FOR SEX DETERMINATION OR EXTENT OF
ANOMALIES)		TC$50.02
75500ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$453.13
75500ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$61.70
75500ANGIOCARDIOGRAPHY BY CINERADIOGRAPHY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$394.24
75505ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$453.13
75505ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75505ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, SINGLE PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$394.24
75507ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$461.80
75507ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75507ANGIOCARDIOGRAPHY BY SERIALOGRAPHY, MULTI-PLANE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$394.24
75519CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT
SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		$437.82
75519CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT
SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		26$45.45
75519CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT
SIDE, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		TC$394.24
75523CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$437.82
75523CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$45.45
75523CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, LEFT SIDE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$394.24
75527CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND
LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE		$471.82
75527CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND
LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE		26$81.00
75527CARDIAC RADIOGRAPHY, SELECTIVE CARDIAC CATHETERIZATION, RIGHT AND
LEFT SIDE, RADIOLOGICAL SUPERVISION AND INTE		TC$394.24
75552MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUM$395.76
75552MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUM26$86.81
75552MAGNETIC RESONANCE (EG, PROTON) IMAGING, MYOCARDIUMTC$382.71
75553CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY; WITHOUT
CONTRAST MATERIAL		$420.48
75554CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR
WITHOUT MORPHOLOGY; COMPLETE STUDY		$395.76
75555CARDIAC MAGNETIC RESONANCE IMAGING FOR FUNCTION, WITH OR
WITHOUT MORPHOLOGY; LIMITED STUDY		$395.76
75556CARDIAC MAGNETIC RESONANCE IMAGING FOR VELOCITY FLOW MAPPING$395.76
75557CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND
FUNCTION WITHOUT CONTRAST MATERIAL;		$320.14
75561CARDIAC MAGNETIC RESONANCE IMAGING FOR MORPHOLOGY AND
FUNCTION WITHOUT CONTRAST MATERIAL(S), FOLLOWED BY CONTR		$582.37
75600AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75600AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$26.64
75600AORTOGRAPHY, THORACIC, WITHOUT SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75605AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75605AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75605AORTOGRAPHY, THORACIC, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75625AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75625AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75625AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		59$1,377.18
75625AORTOGRAPHY, ABDOMINAL, BY SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75630AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER
EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU		$1,377.18
75630AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER
EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU		26$70.93
75630AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER
EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU		59$1,377.18
75630AORTOGRAPHY, ABDOMINAL PLUS BILATERAL ILIOFEMORAL LOWER
EXTREMITY, CATHETER, BY SERIALOGRAPHY, RADIOLOGICAL SU		TC$448.51
75635COMPUTED TOMOGRAPHIC ANGIOGRAPHY, ABDOMINAL AORTA AND
BILATERAL ILIOFEMORAL LOWER EXTREMITY RUNOFF, RADIOLOGIC		$336.85
75650ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$1,377.18
75650ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$80.40
75650ANGIOGRAPHY, CERVICOCEREBRAL, CATHETER, INCLUDING VESSEL ORIGIN,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75658ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$586.71
75658ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$70.93
75658ANGIOGRAPHY, BRACHIAL, RETROGRADE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75660ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$425.62
75660ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$70.93
75660ANGIOGRAPHY, EXTERNAL CAROTID, UNILATERAL, SELECTIVE,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75662ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75662ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$89.70
75662ANGIOGRAPHY, EXTERNAL CAROTID, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75665ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75665ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75665ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		RT$1,377.18
75665ANGIOGRAPHY, CAROTID, CEREBRAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75671ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75671ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$89.70
75671ANGIOGRAPHY, CAROTID, CEREBRAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75676ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75676ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75676ANGIOGRAPHY, CAROTID, CERVICAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75680ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75680ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$89.70
75680ANGIOGRAPHY, CAROTID, CERVICAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75685ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$1,377.18
75685ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$70.93
75685ANGIOGRAPHY, VERTEBRAL, CERVICAL, AND/OR INTRACRANIAL,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75705ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$425.62
75705ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$117.76
75705ANGIOGRAPHY, SPINAL, SELECTIVE, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75710ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$1,377.18
75710ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$61.70
75710ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		59$1,377.18
75710ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		LT$1,377.18
75710ANGIOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75716ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$1,377.18
75716ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$70.93
75716ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		59$1,377.18
75716ANGIOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75722ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA		$1,377.18
75722ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA		26$61.70
75722ANGIOGRAPHY, RENAL, UNILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM), RADIOLOGICAL SUPERVISION AND INTERPRETA		TC$430.15
75724ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM),		$1,377.18
75724ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM),		26$80.40
75724ANGIOGRAPHY, RENAL, BILATERAL, SELECTIVE (INCLUDING FLUSH
AORTOGRAM),		TC$430.15
75726ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR
WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION		$1,377.18
75726ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR
WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION		26$61.70
75726ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR
WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION		59$1,377.18
75726ANGIOGRAPHY, VISCERAL, SELECTIVE OR SUPRASELECTIVE, (WITH OR
WITHOUT FLUSH AORTOGRAM) RADIOLOGICAL SUPERVISION		TC$430.15
75731ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75731ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75731ANGIOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75733ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$425.62
75733ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75733ANGIOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75736ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75736ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75736ANGIOGRAPHY, PELVIC, SELECTIVE OR SUPRASELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75741ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$586.71
75741ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75741ANGIOGRAPHY, PULMONARY, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75743ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75743ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$89.70
75743ANGIOGRAPHY, PULMONARY, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75746ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS
INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		$586.71
75746ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS
INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		26$61.70
75746ANGIOGRAPHY, PULMONARY, BY NONSELECTIVE CATHETER OR VENOUS
INJECTION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		TC$430.15
75750ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$489.05
75750ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$61.70
75750ANGIOGRAPHY, CORONARY, ROOT INJECTION, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$430.15
75752ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM		$489.05
75752ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM		26$61.70
75752ANGIOGRAPHY, CORONARY, UNILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM		TC$430.15
75754ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A		$498.05
75754ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A		26$71.25
75754ANGIOGRAPHY, CORONARY, BILATERAL SELECTIVE INJECTION, INCLUDING
LEFT VENTRICULAR AND SUPRAVALVULAR ANGIOGRAM A		TC$430.15
75756ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$586.71
75756ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$61.70
75756ANGIOGRAPHY, INTERNAL MAMMARY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75762ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$489.05
75762ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$61.70
75762ANGIOGRAPHY, CORONARY BYPASS, UNILATERAL SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75766ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$497.71
75766ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$70.93
75766ANGIOGRAPHY, CORONARY BYPASS, MULTIPLE SELECTIVE INJECTION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75774ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC
EXAMINATION, RADIOLOGICAL SUPERVISION AND I		$586.71
75774ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC
EXAMINATION, RADIOLOGICAL SUPERVISION AND I		26$18.01
75774ANGIOGRAPHY, SELECTIVE, EACH ADDITIONAL VESSEL STUDIED AFTER BASIC
EXAMINATION, RADIOLOGICAL SUPERVISION AND I		TC$430.15
75790ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT),
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$586.71
75790ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT),
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$99.33
75790ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT),
RADIOLOGICAL SUPERVISION AND INTERPRETATION		LT$586.71
75790ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT),
RADIOLOGICAL SUPERVISION AND INTERPRETATION		RT$586.71
75790ANGIOGRAPHY, ARTERIOVENOUS SHUNT (EG, DIALYSIS PATIENT),
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$46.34
75801LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
75801LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$43.75
75801LYMPHANGIOGRAPHY, EXTREMITY ONLY, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$184.97
75803LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
75803LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$62.99
75803LYMPHANGIOGRAPHY, EXTREMITY ONLY, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$184.97
75805LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
75805LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$43.75
75805LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, UNILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$208.02
75807LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$232.98
75807LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$62.99
75807LYMPHANGIOGRAPHY, PELVIC/ABDOMINAL, BILATERAL, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$208.02
75809SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING
NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE		$114.52
75809SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING
NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE		26$23.65
75809SHUNTOGRAM FOR INVESTIGATION OF PREVIOUSLY PLACED INDWELLING
NONVASCULAR SHUNT (EG, LEVEEN SHUNT, VENTRICULOPE		TC$26.97
75810SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION$586.71
75810SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$61.70
75810SPLENOPORTOGRAPHY, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$430.15
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$425.62
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$37.97
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		59$425.62
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		LT$425.62
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		RT$425.62
75820VENOGRAPHY, EXTREMITY, UNILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$32.24
75822VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$425.62
75822VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$56.96
75822VENOGRAPHY, EXTREMITY, BILATERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$50.68
75825VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$586.71
75825VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75825VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		59$586.71
75825VENOGRAPHY, CAVAL, INFERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75827VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$586.71
75827VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75827VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		59$586.71
75827VENOGRAPHY, CAVAL, SUPERIOR, WITH SERIALOGRAPHY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75831VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$586.71
75831VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75831VENOGRAPHY, RENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75833VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$586.71
75833VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$80.40
75833VENOGRAPHY, RENAL, BILATERAL, SELECTIVE, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$430.15
75840VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75840VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$61.70
75840VENOGRAPHY, ADRENAL, UNILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75842VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$1,377.18
75842VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$80.40
75842VENOGRAPHY, ADRENAL, BILATERAL, SELECTIVE, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$430.15
75860VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$425.62
75860VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$61.70
75860VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		59$425.62
75860VENOGRAPHY, SINUS OR JUGULAR, CATHETER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$430.15
75870VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$425.62
75870VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$61.70
75870VENOGRAPHY, SUPERIOR SAGITTAL SINUS, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75872VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$586.71
75872VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$61.70
75872VENOGRAPHY, EPIDURAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$430.15
75880VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION$425.62
75880VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATION26$37.97
75880VENOGRAPHY, ORBITAL, RADIOLOGICAL SUPERVISION AND INTERPRETATIONTC$32.24
75885PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$1,377.18
75885PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$77.97
75885PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75887PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		$586.71
75887PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		26$77.97
75887PERCUTANEOUS TRANSHEPATIC PORTOGRAPHY WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETAT		TC$430.15
75889HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$1,377.18
75889HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$61.70
75889HEPATIC VENOGRAPHY, WEDGED OR FREE, WITH HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$430.15
75891HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		$586.71
75891HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		26$61.70
75891HEPATIC VENOGRAPHY, WEDGED OR FREE, WITHOUT HEMODYNAMIC
EVALUATION, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		TC$430.15
75893VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY
(EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC		$458.42
75893VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY
(EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC		26$29.87
75893VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY
(EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC		59$458.42
75893VENOUS SAMPLING THROUGH CATHETER, WITH OR WITHOUT ANGIOGRAPHY
(EG, FOR PARATHYROID HORMONE, RENIN), RADIOLOGIC		TC$430.15
75894TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$343.82
75894TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$70.93
75894TRANSCATHETER THERAPY, EMBOLIZATION, ANY METHOD, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$824.38
75896TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS
OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A		$343.82
75896TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS
OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A		26$70.93
75896TRANSCATHETER THERAPY, INFUSION, ANY METHOD (EG, THROMBOLYSIS
OTHER THAN CORONARY), RADIOLOGICAL SUPERVISION A		TC$716.49
75898ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR
TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION		$114.52
75898ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR
TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION		26$89.40
75898ANGIOGRAM THROUGH EXISTING CATHETER FOR FOLLOW-UP STUDY FOR
TRANSCATHETER THERAPY, EMBOLIZATION OR INFUSION		TC$35.83
75901MECHANICAL REMOVAL OF PERICATHETER OBSTRUCTIVE MATERIAL FROM
CENTRAL VENOUS DEVICE VIA SEPERATE VENOUS ACCESS		$114.52
75902MECHANICAL REMOVAL OF INTRALUMINAL OBSTRUCTIVE MATERIAL FROM
CENTRAL VENOUS DEVICE THROUGH DEVICE LUMEN, RADIO		$114.52
75940PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$343.82
75940PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$28.27
75940PERCUTANEOUS PLACEMENT OF IVC FILTER, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$430.15
75945INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL
SUPERVISION AND INTERPRETATION; INTIAL VESSEL		$172.28
75946INTRAVASCULAR ULTRASOUND (NON-CORONARY VESSEL), RADIOLOGICAL
SUPERVISION AND INTERPRETATION; EACH ADDITIONAL		$107.12
75960TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON-
CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO		$425.62
75960TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON-
CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO		26$42.24
75960TRANSCATHETER INTRODUCTION OF INTRAVASCULAR STENT(S), (NON-
CORONARY VESSEL), PERCUTANEOUS AND/OR OPEN, RADIOLO		TC$508.57
75961TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR
FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE		$425.62
75961TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR
FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE		26$230.07
75961TRANSCATHETER RETRIEVAL, PERCUTANEOUS, OF INTRAVASCULAR
FOREIGN BODY (EG, FRACTURED VENOUS OR ARTERIAL CATHETE		TC$358.41
75962TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$425.62
75962TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$28.27
75962TRANSLUMINAL BALLOON ANGIOPLASTY, PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$537.46
75964TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI		$425.62
75964TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI		26$18.01
75964TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL PERIPHERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATI		TC$286.93
75966TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$425.62
75966TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$67.57
75966TRANSLUMINAL BALLOON ANGIOPLASTY, RENAL OR OTHER VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$537.46
75968TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$425.62
75968TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$18.01
75968TRANSLUMINAL BALLOON ANGIOPLASTY, EACH ADDITIONAL VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$286.93
75970TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$425.62
75970TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$44.69
75970TRANSCATHETER BIOPSY, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$394.24
75978TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN
STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO		$425.62
75978TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN
STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO		26$36.63
75978TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN
STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO		59$425.62
75978TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN
STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO		LT$425.62
75978TRANSLUMINAL BALLOON ANGIOPLASTY, VENOUS (EG, SUBCLAVIAN
STENOSIS), RADIOLOGICAL SUPERVISION AND INTERPRETATIO		RT$425.62
75980PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST
MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI		$343.82
75980PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST
MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI		26$77.97
75980PERCUTANEOUS TRANSHEPATIC BILIARY DRAINAGE WITH CONTRAST
MONITORING, RADIOLOGICAL SUPERVISION AND INTERPRETATI		TC$184.97
75982PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED
INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA		$343.82
75982PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED
INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA		26$77.97
75982PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED
INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA		52$343.82
75982PERCUTANEOUS PLACEMENT OF DRAINAGE CATHETER FOR COMBINED
INTERNAL AND EXTERNAL BILIARY DRAINAGE OR OF A DRAINA		TC$208.02
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		$114.52
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		26$37.27
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		50$114.52
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		59$114.52
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		LT$114.52
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		RT$114.52
75984CHANGE OF PERCUTANEOUS DRAINAGE CATHETER WITH CONTRAST
MONITORING (IE, BILIARY TRACT, URINARY TRACT), RADIOLOG		TC$66.47
75989RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR
SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN		$126.26
75989RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR
SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN		26$52.49
75989RADIOLOGICAL GUIDANCE FOR PERCUTANEOUS DRAINAGE OF ABSCESS, OR
SPECIMEN COLLECTION (IE, FLUOROSCOPY, ULTRASOUN		TC$107.31
75992TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$586.71
75992TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$28.27
75992TRANSLUMINAL ATHERECTOMY, PERIPHERAL ARTERY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$537.46
75993TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$586.71
75993TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$18.01
75993TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL PERIPHERAL ARTERY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$286.93
75994TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$586.71
75994TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$67.57
75994TRANSLUMINAL ATHERECTOMY, RENAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$537.46
75995TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		$586.71
75995TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		26$67.57
75995TRANSLUMINAL ATHERECTOMY, VISCERAL, RADIOLOGICAL SUPERVISION AND
INTERPRETATION		TC$537.46
75996TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		$586.71
75996TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		26$18.01
75996TRANSLUMINAL ATHERECTOMY, EACH ADDITIONAL RENAL OR VISCERAL
ARTERY, RADIOLOGICAL SUPERVISION AND INTERPRETATIO		TC$286.93
76000FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME,
OTHER THAN 71023 OR 71034		$89.64
76000FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME,
OTHER THAN 71023 OR 71034		26$8.55
76000FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME,
OTHER THAN 71023 OR 71034		59$89.64
76000FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME,
OTHER THAN 71023 OR 71034		TC$44.42
76000FLUOROSCOPY (SEPARATE PROCEDURE), UP TO ONE HOUR PHYSICIAN TIME,
OTHER THAN 71023 OR 71034		XU$89.64
76001FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-
RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY,		$124.68
76001FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-
RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY,		26$36.60
76001FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-
RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY,		59$124.68
76001FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-
RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY,		76$124.68
76001FLUOROSCOPY, PHYSICIAN TIME MORE THAN ONE HOUR, ASSISTING A NON-
RADIOLOGIC PHYSICIAN (EG, NEPHROSTOLITHOTOMY,		TC$89.77
76003FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE
ASPIRATION		$72.69
76003FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE
ASPIRATION		26$29.87
76003FLUOROSCOPIC LOCALIZATION FOR NEEDLE BIOPSY OR FINE NEEDLE
ASPIRATION		TC$44.42
76006MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN FOR JOINT
RADIOLOGY, INCLUDING CONTRALATERAL JOINT IF IND		$49.20
76010RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY,
SINGLE FILM, CHILD		$49.20
76010RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY,
SINGLE FILM, CHILD		26$9.61
76010RADIOLOGIC EXAMINATION FROM NOSE TO RECTUM FOR FOREIGN BODY,
SINGLE FILM, CHILD		TC$18.13
76012RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS
VERTEBROPLASTY, PER VERTEBRAL BODY; UNDER FLUOROSCOP		$196.68
76013RADIOLOGICAL SUPERVISION AND INTERPRETATION, PERCUTANEOUS
VERTEBROPLASTY; UNDER CT GUIDANCE		$196.68
76020BONE AGE STUDIES$49.20
76020BONE AGE STUDIES26$10.39
76020BONE AGE STUDIESTC$18.13
76040BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)$83.74
76040BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)26$14.45
76040BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)TC$26.97
76061RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR
METASTASES)		$83.74
76061RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR
METASTASES)		26$24.29
76061RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED (EG, FOR
METASTASES)		TC$33.91
76062RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND
APPENDICULAR SKELETON)		$83.74
76062RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND
APPENDICULAR SKELETON)		26$29.87
76062RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND
APPENDICULAR SKELETON)		TC$49.35
76065RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANT$83.74
76065RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANT26$14.74
76065RADIOLOGIC EXAMINATION OSSEOUS SURVEY; INFANTTC$25.30
76066JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY)$49.20
76066JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY)26$16.50
76066JOINT SURVEY, SINGLE VIEW, ONE OR MORE JOINTS (SPECIFY)TC$37.83
76070COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR
MORE SITES		$82.39
76070COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR
MORE SITES		26$13.37
76070COMPUTERIZED TOMOGRAPHY BONE MINERAL DENSITY STUDY, ONE OR
MORE SITES		TC$100.71
76071COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, ONE OR MORE
SITES;APPENDICULAR SKELETON		$107.47
76075DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE
OR MORE SITES; AXIAL SKELETON (EG, HIPS, PEL		$82.39
76076DUAL ENERGY X-RAY ABSORPTIOMETRY (DEXA), BONE DENSITY STUDY, ONE
OR MORE SITES; APPENDICULAR SKELETON		$43.04
76077DUAL ENERGY X-RAY ABSORPTIOMETRY (DXA), BONE DENSITY STUDY, ONE
OR MORE SITES; VERTEBRAL FRACTURE ASSESSMENT		$49.20
76078RADIOGRAPHIC ABSORPTIOMETRY (PHOTODENSITOMETRY), ONE OR MORE
SITES		$49.20
76080RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$114.52
76080RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$28.27
76080RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		59$114.52
76080RADIOLOGIC EXAMINATION, ABSCESS, FISTULA OR SINUS TRACT STUDY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$35.83
76082COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR
INTERPRETATION, WITH OR WITHOUT DIGITIZATION		$17.25
76082COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR
INTERPRETATION, WITH OR WITHOUT DIGITIZATION		LT$17.25
76082COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR
INTERPRETATION, WITH OR WITHOUT DIGITIZATION		RT$17.25
76083COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEW FOR
INTERPRETATION, WITH OR WITHOUT DIGITIZATION		$17.25
76086MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$114.52
76086MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$18.34
76086MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$89.77
76088MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$114.52
76088MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$22.97
76088MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$125.09
76090MAMMOGRAPHY; UNILATERAL$44.40
76090MAMMOGRAPHY; UNILATERAL26$13.37
76090MAMMOGRAPHY; UNILATERALLT$44.40
76090MAMMOGRAPHY; UNILATERALRT$44.40
76090MAMMOGRAPHY; UNILATERALTC$35.83
76091MAMMOGRAPHY; BILATERAL$55.22
76091MAMMOGRAPHY; BILATERAL26$21.93
76091MAMMOGRAPHY; BILATERALTC$44.42
76092SCREENING MAMMOGRAPHY, BILATERAL (TWO VIEW FILM STUDY OF EACH
BREAST)		$52.00
76095STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$232.98
76095STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		LT$232.98
76095STEREOTACTIC LOCALIZATION FOR BREAST BIOPSY, EACH LESION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		RT$232.98
76096PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$114.52
76096PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$29.28
76096PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		LT$114.52
76096PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		RT$114.52
76096PREOPERATIVE PLACEMENT OF NEEDLE LOCALIZATION WIRE, BREAST,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$44.42
76098RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN$49.20
76098RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMEN26$8.10
76098RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMENLT$49.20
76098RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMENRT$49.20
76098RADIOLOGICAL EXAMINATION, BREAST SURGICAL SPECIMENTC$14.44
76100RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG,
TOMOGRAPHY), OTHER THAN WITH UROGRAPHY		$83.74
76100RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG,
TOMOGRAPHY), OTHER THAN WITH UROGRAPHY		26$32.00
76100RADIOLOGIC EXAMINATION, SINGLE PLANE BODY SECTION (EG,
TOMOGRAPHY), OTHER THAN WITH UROGRAPHY		TC$42.75
76101RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		$114.52
76101RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		26$32.00
76101RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		TC$48.35
76102RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		$232.98
76102RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		26$32.00
76102RADIOLOGIC EXAMINATION, COMPLEX MOTION (IE, HYPERCYCLOIDAL) BODY
SECTION (EG, MASTOID POLYTOMOGRAPHY), OTHER T		TC$59.21
76120CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED$89.64
76120CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDED26$20.31
76120CINERADIOGRAPHY, EXCEPT WHERE SPECIFICALLY INCLUDEDTC$35.83
76125CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION$49.20
76125CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATION26$14.21
76125CINERADIOGRAPHY TO COMPLEMENT ROUTINE EXAMINATIONTC$26.97
76150XERORADIOGRAPHY$49.20
76355COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC
LOCALIZATION		$289.49
76355COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC
LOCALIZATION		26$65.56
76355COMPUTERIZED TOMOGRAPHY GUIDANCE FOR STEREOTACTIC
LOCALIZATION		TC$282.00
76360COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$289.49
76360COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$59.57
76360COMPUTERIZED TOMOGRAPHY GUIDANCE FOR NEEDLE BIOPSY,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$282.00
76362COMPUTERIZED AXIAL TOMOGRAPHIC GUIDANCE FOR, AND MONITORING OF,
TISSUE ABLATION		$344.34
76365COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$341.57
76365COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$59.57
76365COMPUTERIZED TOMOGRAPHY GUIDANCE FOR CYST ASPIRATION,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$282.00
76370COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION
THERAPY FIELDS		$107.47
76370COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION
THERAPY FIELDS		26$46.13
76370COMPUTERIZED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION
THERAPY FIELDS		TC$100.71
76375CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR
HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO		$128.50
76375CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR
HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO		26$8.10
76375CORONAL, SAGITTAL, MULTIPLANAR, OBLIQUE, 3-DIMENSIONAL AND/OR
HOLOGRAPHIC RECONSTRUCTION OF COMPUTERIZED TOMO		TC$120.50
763763D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		$41.39
763763D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		59$41.39
763763D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		LT$41.39
763763D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		RT$41.39
763773D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		$107.47
763773D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		59$107.47
763773D REDERING WITH INTERPRETATION AND REPORTING OF COMPUTED
TOMOGRAPHY, MAGNETIC RESONANCE IMAGING, ULTRASOUND,		ET$107.47
76380COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY$107.47
76380COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY26$50.57
76380COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDY59$107.47
76380COMPUTERIZED TOMOGRAPHY, LIMITED OR LOCALIZED FOLLOW-UP STUDYTC$119.50
76393MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT (EG, FOR
BIOPSY)RADIOLOGICAL SUPERVISION AND INTERPRETATION		$343.96
76394MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF, TISSUE
ABLATION		$343.96
76400MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD
SUPPLY		$343.96
76400MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD
SUPPLY		26$82.88
76400MAGNETIC RESONANCE (EG, PROTON) IMAGING, BONE MARROW BLOOD
SUPPLY		TC$382.71
76496UNLISTED FLUOROSCOPIC PROCEDURE (EG, DIAGNOSTIC, INTERVENTIONAL)$89.64
76497UNLISTED COMPUTED TOMOGRAPHY PROCEDURE (EG, DIAGNOSTIC
INTERVENTIONAL)		$107.47
76498UNLISTED MAGNETIC RESONANCE PROCEDURE (EG, DIAGNOSTIC,
INTERVENTIONAL)		$343.96
76499UNLISTED DIAGNOSTIC RADIOLOGIC PROCEDURE$49.20
76506ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR		$66.98
76506ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR		26$34.43
76506ECHOENCEPHALOGRAPHY, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION (GRAY SCALE) (FOR DETERMINATION OF VENTR		TC$48.35
76510OPHTHALMIC ULTRASOUND, DIAGNOSTIC; B-SCAN AND QUANTITATIVE A-SCAN
PERFORMED DURING THE SAME PATIENT ENCOUNTER		$107.12
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		$107.12
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		26$33.25
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		50$107.12
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		LT$107.12
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		RT$107.12
76511OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; A-SCAN ONLY, WITH
AMPLITUDE QUANTIFICATION		TC$42.75
76512OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN
(WITH OR WITHOUT SIMULTANEOUS A-SCAN)		$107.12
76512OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN
(WITH OR WITHOUT SIMULTANEOUS A-SCAN)		26$36.00
76512OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN
(WITH OR WITHOUT SIMULTANEOUS A-SCAN)		LT$107.12
76512OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN
(WITH OR WITHOUT SIMULTANEOUS A-SCAN)		RT$107.12
76512OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CONTACT B-SCAN
(WITH OR WITHOUT SIMULTANEOUS A-SCAN)		TC$52.27
76513OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR
SEGMENT ULTRASOUND,		$107.12
76513OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR
SEGMENT ULTRASOUND,		26$36.00
76513OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; ANTERIOR
SEGMENT ULTRASOUND,		TC$52.27
76514OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL
PACHYMETRY, UNILATERAL OR BILATERAL		$41.39
76514OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL
PACHYMETRY, UNILATERAL OR BILATERAL		50$41.39
76514OPHTHALMIC ULTRASOUND, ECHOGRAPHY, DIAGNOSTIC; CORNEAL
PACHYMETRY, UNILATERAL OR BILATERAL		PO$0.01
76516OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;$66.98
76516OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;26$29.63
76516OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN;TC$42.75
76519OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH
INTRAOCULAR LENS POWER CALCULATION		$107.12
76519OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH
INTRAOCULAR LENS POWER CALCULATION		26$29.63
76519OPHTHALMIC BIOMETRY BY ULTRASOUND ECHOGRAPHY, A-SCAN; WITH
INTRAOCULAR LENS POWER CALCULATION		TC$42.75
76529OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION$66.98
76529OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATION26$31.40
76529OPHTHALMIC ULTRASONIC FOREIGN BODY LOCALIZATIONTC$46.67
76536ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID,
PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM		$107.12
76536ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID,
PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM		26$30.69
76536ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID,
PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM		59$107.12
76536ECHOGRAPHY, SOFT TISSUES OF HEAD AND NECK (EG, THYROID,
PARATHYROID, PAROTID), B-SCAN AND/OR REAL TIME WITH IM		TC$48.35
76604ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME
WITH IMAGE DOCUMENTATION		$107.12
76604ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME
WITH IMAGE DOCUMENTATION		26$30.40
76604ECHOGRAPHY, CHEST, B-SCAN (INCLUDES MEDIASTINUM) AND/OR REAL TIME
WITH IMAGE DOCUMENTATION		TC$44.42
76641ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE		$95.46
76641ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE		26$22.57
76641ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE		50$95.46
76641ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; COMPLETE		TC$44.25
76642ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED		$83.38
76642ULTRASOUND, BREAST, UNILATERAL, REALTIME WITH IMAGE
DOCUMENTATION, INCLUDING AXILLA WHEN PERFORMED; LIMITED		XS$83.38
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		$66.98
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		26$29.63
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		50$66.98
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		LT$66.98
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		RT$66.98
76645ECHOGRAPHY, BREAST(S) (UNILATERAL OR BILATERAL), B-SCAN AND/ OR
REAL TIME WITH IMAGE DOCUMENTATION		TC$35.83
76700ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE		$107.12
76700ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE		26$43.59
76700ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE		59$107.12
76700ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE		TC$67.14
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		$107.12
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		26$32.29
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		59$107.12
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		GA$107.12
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		TC$48.35
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		XS$107.12
76705ECHOGRAPHY, ABDOMINAL, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (EG, SINGLE ORGAN, QUADRANT,		XU$107.12
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		$107.12
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		26$40.09
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		59$107.12
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		GA$107.12
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		TC$67.14
76770ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; COMPL		XU$107.12
76775ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT		$107.12
76775ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT		26$32.00
76775ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT		59$107.12
76775ECHOGRAPHY, RETROPERITONEAL (EG, RENAL, AORTA, NODES), B-SCAN
AND/OR REAL TIME WITH IMAGE DOCUMENTATION; LIMIT		TC$48.35
76776ULTRASOUND, TRANSPLANTED KIDNEY, REAL TIME AND DUPLEX DOPPLER
WITH IMAGE DOCUMENTATION		$105.26
76778ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO		$107.12
76778ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO		26$38.28
76778ECHOGRAPHY OF TRANSPLANTED KIDNEY, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION, WITH OR WITHOUT DUPLEX DO		TC$67.14
76800ECHOGRAPHY, SPINAL CANAL AND CONTENTS$107.12
76800ECHOGRAPHY, SPINAL CANAL AND CONTENTS26$58.56
76800ECHOGRAPHY, SPINAL CANAL AND CONTENTSTC$48.35
76801ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FETAL AND MATERNAL EVALUATION, FIR		$107.12
76802ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FETAL AND MATERNAL EVALUATION, EACH ADDITIONA		$66.98
76805ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		$107.12
76805ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		26$53.46
76805ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		TC$71.73
76810ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		$107.12
76810ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		26$101.56
76810ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; COMPLETE (COMPLETE FETAL AND MA		TC$142.89
76811ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FETAL AND MATERNAL EVALUATION, SINGLE OR FIRS		$172.28
76811ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FETAL AND MATERNAL EVALUATION, SINGLE OR FIRS		TC$172.28
76812ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FETAL AND MATERNAL EVALUATION, EACH ADDITIONA		$107.12
76813ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY		$105.26
76813ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY		55$105.26
76813ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY		PO$105.26
76814ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, FIRST TRIMESTER FETAL NUCHAL TRANSLUCENCY		$105.26
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		$66.98
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		22$66.98
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		25$66.98
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		26$35.26
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		52$66.98
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		59$66.98
76815ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; LIMITED (FETAL SIZE, HEART		TC$48.35
76816ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; FOLLOW-UP OR REPEAT		$66.98
76816ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; FOLLOW-UP OR REPEAT		26$31.40
76816ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; FOLLOW-UP OR REPEAT		PO$66.98
76816ECHOGRAPHY, PREGNANT UTERUS, B-SCAN AND/OR REAL TIME WITH IMAGE
DOCUMENTATION; FOLLOW-UP OR REPEAT		TC$37.83
76817ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, TRANSVAGINAL		$107.12
76817ULTRASOUND, PREGNANT UTERUS, REAL TIME WITH IMAGE
DOCUMENTATION, TRANSVAGINAL		25$107.12
76818FETAL BIOPHYSICAL PROFILE$107.12
76818FETAL BIOPHYSICAL PROFILE26$41.45
76818FETAL BIOPHYSICAL PROFILE59$107.12
76818FETAL BIOPHYSICAL PROFILETC$55.28
76819FETAL BIOPHYSICAL PROFILE; WITHOUT STRESS OR NON-STRESS TESTING$107.12
76820DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY$108.05
76820DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY51$108.05
76820DOPPLER VELOCIMETRY, FETAL; UMBILICAL ARTERY59$108.05
76821DOPPLER VELOCIMETRY, FETAL; MIDDLE CEREBRAL ARTERY$108.05
76825ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		$113.06
76825ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		26$41.15
76825ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		TC$67.14
76826ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		$101.99
76826ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		26$53.10
76826ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, REAL TIME WITH
IMAGE DOCUMENTATION (2D) WITH OR WITHOUT M-MODE		TC$24.30
76827DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		$113.06
76827DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		26$38.51
76827DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		TC$59.37
76828DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		$101.99
76828DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		26$26.41
76828DOPPLER ECHOCARDIOGRAPHY, FETAL, CARDIOVASCULAR SYSTEM, PULSED
WAVE AND/OR CONTINUOUS WAVE WITH SPECTRAL DISPL		TC$5.60
76830ECHOGRAPHY, TRANSVAGINAL$107.12
76830ECHOGRAPHY, TRANSVAGINAL25$107.12
76830ECHOGRAPHY, TRANSVAGINAL26$37.66
76830ECHOGRAPHY, TRANSVAGINAL59$107.12
76830ECHOGRAPHY, TRANSVAGINALTC$52.27
76831HYSTEROSONOGRAPHY, WITH OR WITHOUT COLOR FLOW DOPPLER$172.28
76856ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; COMPLETE		$107.12
76856ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; COMPLETE		26$37.66
76856ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; COMPLETE		59$107.12
76856ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; COMPLETE		TC$52.27
76856ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; COMPLETE		XU$107.12
76857ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG,		$66.98
76857ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG,		26$20.05
76857ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG,		LT$66.98
76857ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG,		RT$66.98
76857ECHOGRAPHY, PELVIC (NONOBSTETRIC), B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION; LIMITED OR FOLLOW-UP (EG,		TC$35.83
76870ECHOGRAPHY, SCROTUM AND CONTENTS$107.12
76870ECHOGRAPHY, SCROTUM AND CONTENTS26$34.64
76870ECHOGRAPHY, SCROTUM AND CONTENTS59$107.12
76870ECHOGRAPHY, SCROTUM AND CONTENTSTC$52.27
76872ECHOGRAPHY, TRANSRECTAL$107.12
76872ECHOGRAPHY, TRANSRECTAL26$37.66
76872ECHOGRAPHY, TRANSRECTALTC$52.27
76873ECHOGRAPHY, TRANSRECTAL; PROSTATE VOLUME STUDY FOR
BRACHYTHERAPY TREATMENT PLANNING		$107.12
76880ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION		$107.12
76880ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION		26$32.29
76880ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION		LT$107.12
76880ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION		RT$107.12
76880ECHOGRAPHY, EXTREMITY, NON-VASCULAR, B-SCAN AND/OR REAL TIME WITH
IMAGE DOCUMENTATION		TC$48.35
76881ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; COMPLETE		$94.28
76881ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; COMPLETE		LT$94.28
76881ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; COMPLETE		RT$94.28
76882ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC		$60.95
76882ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC		LT$60.95
76882ULTRASOUND, EXTREMITY, NONVASCULAR, REAL-TIME WITH IMAGE
DOCUMENTATION; LIMITED, ANATOMIC SPECIFIC		RT$60.95
76885ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION;
DYNAMIC (EG, REQUIRING MANIPULATION)		$66.98
76886ECHOGRAPHY OF INFANT HIPS, REAL TIME WITH IMAGING DOCUMENTATION;
LIMITED, STATIC (EG, NOT REQUIRING MANIPULATO		$107.12
76930ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$70.55
76930ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$34.92
76930ULTRASONIC GUIDANCE FOR PERICARDIOCENTESIS, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$52.27
76932ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$70.55
76932ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$34.92
76932ULTRASONIC GUIDANCE FOR ENDOMYOCARDIAL BIOPSY, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$52.27
76934ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL
PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$87.19
76934ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL
PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION		26$34.92
76934ULTRASONIC GUIDANCE FOR THORACENTESIS OR ABDOMINAL
PARACENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRETATION		TC$52.27
76936ULTRASOUND GUIDED COMPRESSION REPAIR OF ARTERIAL PSEUDO-
ANEURYSM OR ARTERIOVENOUS FISTULAE (INCLUDES DIAGNOSTI		$70.55
76937ULTRASOUND GUIDANCE FOR VASCULAR ACCESS REQUIRING ULTRASOUND
EVALUATION OF POTENTIAL ACCESS SITES,		$20.14
76938ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS
ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE		$87.19
76938ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS
ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE		26$34.92
76938ULTRASONIC GUIDANCE FOR CYST (ANY LOCATION), OR RENAL PELVIS
ASPIRATION, RADIOLOGICAL SUPERVISION AND INTERPRE		TC$52.27
76940ULTRASOUND GUIDANCE FOR, AND MONITORING OF VISCERAL TISSUE
ABLATION		$70.55
76941ULTRSONIC GUIDANCE FOR INTRAUTERINE FETAL TRANSFUSION OR
CORDOCENTESIS, RADIOLOGICAL SUPERVISION AND INTERPRET		$70.55
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$70.55
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$34.92
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		59$70.55
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		LT$70.55
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		RT$70.55
76942ULTRASONIC GUIDANCE FOR NEEDLE BIOPSY, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$52.27
76945ULTRASONIC GUIDANCE FOR CHORIONIC VILLUS SAMPLING, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$70.55
76946ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		$70.55
76946ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		26$19.26
76946ULTRASONIC GUIDANCE FOR AMNIOCENTESIS, RADIOLOGICAL SUPERVISION
AND INTERPRETATION		TC$52.27
76948ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$70.55
76948ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		26$20.05
76948ULTRASONIC GUIDANCE FOR ASPIRATION OF OVA, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		TC$52.27
76950ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN$70.55
76950ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCAN26$32.00
76950ECHOGRAPHY FOR PLACEMENT OF RADIATION THERAPY FIELDS, B-SCANTC$44.42
76960ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS,
EXCEPT FOR B-SCAN ECHOGRAPHY		$74.72
76960ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS,
EXCEPT FOR B-SCAN ECHOGRAPHY		26$32.00
76960ULTRASONIC GUIDANCE FOR PLACEMENT OF RADIATION THERAPY FIELDS,
EXCEPT FOR B-SCAN ECHOGRAPHY		TC$44.42
76965ULTRASONIC GUIDANCE FOR INTERSTITIAL RADIOELEMENT APPLICATION$70.55
76970ULTRASOUND STUDY FOLLOW-UP (SPECIFY)$66.98
76970ULTRASOUND STUDY FOLLOW-UP (SPECIFY)26$20.61
76970ULTRASOUND STUDY FOLLOW-UP (SPECIFY)TC$35.83
76975GASTROINTESTINAL ENDOSCOPIC ULTRASOUND, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$107.12
76977ULTRASOUND BONE DENSITY MEASUREMENT AND
INTERPRETATION,PERIPHERAL SITE(S), ANY METHOD		$41.39
76978ULTRASOUND USING TARGETED MICROBUBBLE CONTRAST OF FIRST LESION$171.18
76978ULTRASOUND USING TARGETED MICROBUBBLE CONTRAST OF FIRST LESIONXS$171.18
76986ECHOGRAPHY, INTRAOPERATIVE$107.12
76986ECHOGRAPHY, INTRAOPERATIVE26$65.27
76986ECHOGRAPHY, INTRAOPERATIVETC$89.77
76998ULTRASONIC GUIDANCE, INTRAOPERATIVE$105.26
76999UNLISTED ULTRASOUND PROCEDURE$66.98
77001FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE
PLACEMENT, REPLACEMENT, OR REMOVAL		$68.05
77001FLUOROSCOPIC GUIDANCE FOR CENTRAL VENOUS ACCESS DEVICE
PLACEMENT, REPLACEMENT, OR REMOVAL		59$68.05
77002FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENT$52.46
77002FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENT59$52.46
77002FLUOROSCOPIC GUIDANCE FOE NEEDLE PLACEMENTLT$52.46
77003FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP
FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT		$48.04
77003FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP
FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT		50$48.04
77003FLUOROSCOPIC GUIDANCE AND LOCALIZATION OF NEEDLE OR CATHETER TIP
FOR SPINE PARASPINOUS DIAGNOSTIC OR THERAPEUT		59$48.04
77011COMPUTED TOMOGRAPHY GUIDANCE FOR STEROTACTIC$275.35
77012COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		$275.36
77012COMPUTED TOMOGRAPHY GUIDANCE FOR NEEDLE PLACEMENT,
RADIOLOGICAL SUPERVISION AND INTERPRETATION		59$275.36
77013COMPUTERIZED TOMOGRAPHY GUIDANCE FOR, AND MONITORING OF
PARENCHYMAL TISSUE ABLATION		$326.48
77014COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION
THERAPY FIELDS		$103.73
77014COMPUTED TOMOGRAPHY GUIDANCE FOR PLACEMENT OF RADIATION
THERAPY FIELDS		59$103.73
77021MAGNETIC RESONANCE GUIDANCE FOR NEEDLE PLACEMENT RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$307.04
77022MAGNETIC RESONANCE GUIDANCE FOR, AND MONITORING OF PARENCHYMAL
TISSUE ABLATION		$307.04
77031STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE
PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON		$199.55
77031STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE
PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON		50$199.55
77031STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE
PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON		59$199.55
77031STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE
PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON		LT$199.55
77031STEREOTACTIC LOCALIZATION GUIDANCE FOR BREAST BIOPSY OR NEEDLE
PLACEMENT, EACH LESION, RADIOLOGICAL SUPERVISON		RT$199.55
77032MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH
LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		$114.36
77032MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH
LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		59$114.36
77032MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH
LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		LT$114.36
77032MAMMOGRAPHIC GUIDANCE FOR NEEDLE PLACEMENT, BREAST, EACH
LESION, RADIOLOGICAL SUPERVISION AND INTERPRETATION		RT$114.36
77051COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR
INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY		$14.86
77051COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR
INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY		LT$14.86
77051COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR
INTERPRETATION; DIAGNOSTIC MAMMOGRAPHY		RT$14.86
77052COMPUTER AIDED DETECTION WITH FURTHER PHYSICIAN REVIEWFOR
INTERPRETATION; SCREENING MAMMOGRAPHY		$14.86
77053MAMMARY DUCTOGRAM OR GALACTOGRAM, SINGLE DUCT, RADIOLOGICAL
SUPERVISION AND INTERPRETATION		$114.36
77054MAMMARY DUCTOGRAM OR GALACTOGRAM, MULTIPLE DUCTS,
RADIOLOGICAL SUPERVISON AND INTERPRETATION		$114.36
77055MAMMOGRAPHY, UNILATERAL$36.69
77055MAMMOGRAPHY, UNILATERAL59$36.69
77055MAMMOGRAPHY, UNILATERALLT$36.69
77055MAMMOGRAPHY, UNILATERALRT$36.69
77056MAMMOGRAPHY; BILATERAL$59.31
77057SCREENING MAMMOGRAPHY, BILATERAL, 2 VIEW FILM STUDY OF EACH
BREAST		$51.26
77058MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH
CONTRAST MATERIALS, UNILATERAL		$768.21
77059MAGNETIC RESONANCE IMAGING, BREAST, WITHOUT AND/OR WITH
CONTRAST MATERIALS, BILATERAL		$969.07
77065DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; UNILATERAL		$108.18
77065DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; UNILATERAL		26$1.20
77065DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; UNILATERAL		LT$108.18
77065DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; UNILATERAL		RT$108.18
77065DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; UNILATERAL		TC$2.86
77066DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; BILATERAL		$138.16
77066DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; BILATERAL		26$1.49
77066DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; BILATERAL		LT$138.16
77066DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; BILATERAL		RT$138.16
77066DIAGNOSTIC MAMMORGRAPHY, INCLUDING COMPUTER-AIDED DETECTION
(CAD) WHEN PREFORMED; BILATERAL		TC$3.66
77067SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST),
INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED		$114.25
77067SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST),
INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED		26$1.14
77067SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST),
INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED		LT$114.25
77067SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST),
INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED		RT$114.25
77067SCREENING MAMMOGRAPHY, BILATERAL (2-VIEW STUDY OF EACH BREAST),
INCLUDING COMPUTER-AIDED DETECTION (CAD) WHEN PERFORMED		TC$3.02
77071MANUAL APPLICATION OF STRESS PERFORMED BY PHYSICIAN FOR JOINT
RADIOLOGY, INCLUDING CONTRALATERAL JOINT IF		$47.84
77072BONE AGE STUDIES$47.84
77073BONE LENGTH STUDIES (ORTHOROENTGENOGRAM, SCANOGRAM)$47.84
77074RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; LIMITED$82.45
77075RADIOLOGIC EXAMINATION, OSSEOUS SURVEY; COMPLETE (AXIAL AND
APPENDICULAR SKELETON)		$82.45
77076RADIOLOGIC EXAMINATION , OSSEOUS SURVEY, INFANT$47.84
77077JOINT SURVEY, SINGLE VIEW, 2 OR MORE JOINTS (SPECIFY)$47.84
77078COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1 OR MORE
SITES; AXIAL SKELETON (EG, HIPS, PELVIS, SPINE)		$79.29
77079COMPUTED TOMOGRAPHY, BONE MINERAL DENSITY STUDY, 1 OR MORE
SITES; APPENDICULAR SKELETON		$103.73
77080DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR
MORE SITES; AXIAL SKELETON		$79.29
77080DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR
MORE SITES; AXIAL SKELETON		59$79.29
77080DUAL ENERGY X-RAY ABSORPTIOMETRY, DXA, BONE DENSITY STUDY, 1 OR
MORE SITES; AXIAL SKELETON		GA$79.29
77081DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE
SITE; APPENDICULAR SKELETON		$37.08
77081DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE
SITE; APPENDICULAR SKELETON		59$37.08
77082DUAL- ENERGY X-RAY ABSORPTIOMETRY, BONE DENSITY STUDY, 1 OR MORE
SITE; VERTEBRAL FRACTURE ASSESSMENT		$47.84
77083RADIOGRAPHIC ABSORPTIOMETRY, 1 OR MORE SITES$82.45
77084MAGNETIC RESONANCE IMAGING, BONE MARROW BLOOD SUPPLY$307.04
77261THERAPEUTIC RADIOLOGY TREATMENT PLANNING; SIMPLE$75.50
77262THERAPEUTIC RADIOLOGY TREATMENT PLANNING; INTERMEDIATE$113.77
77263THERAPEUTIC RADIOLOGY TREATMENT PLANNING; COMPLEX$169.52
77280THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE$275.53
77280THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLE26$37.81
77280THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; SIMPLETC$118.50
77285THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE$265.30
77285THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATE26$56.34
77285THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; INTERMEDIATETC$190.23
77290THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX$275.53
77290THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEX26$84.54
77290THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; COMPLEXTC$222.13
77295THERAPEUTIC RADIOLOGY SIMULATION-AIDED FIELD SETTING; BY THREE
DIMENSIONAL RECONSTRUCTION OF TUMOR VOLUME		$936.28
77299UNLISTED PROCEDURE, THERAPEUTIC RADIOLOGY CLINICAL TREATMENT
PLANNING		$116.84
77300BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE,
TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI		$116.84
77300BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE,
TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI		26$33.74
77300BASIC RADIATION DOSIMETRY CALCULATION, CENTRAL AXIS DEPTH DOSE,
TDF, NSD, GAP CALCULATION, OFF AXIS FACTOR, TI		TC$45.76
77301INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE- VOLUME
HISTOGRAMS FOR TARGET AND CRITICAL STRUCTURE PAR		$936.28
77301INTENSITY MODULATED RADIOTHERAPY PLAN, INCLUDING DOSE- VOLUME
HISTOGRAMS FOR TARGET AND CRITICAL STRUCTURE PAR		59$936.28
77305TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE		$116.84
77305TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE		26$37.81
77305TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); SIMPLE (ONE OR TWO PARALLEL OPPOSED UNMODIFIE		TC$63.46
77310TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D		$265.30
77310TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D		26$56.34
77310TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D		59$265.30
77310TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); INTERMEDIATE (THREE OR MORE TREATMENT PORTS D		TC$79.57
77315TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR		$265.30
77315TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR		26$84.54
77315TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR		59$265.30
77315TELETHERAPY, ISODOSE PLAN (WHETHER HAND OR COMPUTER
CALCULATED); COMPLEX (MANTLE OR INVERTED Y, TANGENTIAL POR		TC$90.77
77321SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY$265.30
77321SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODY26$51.28
77321SPECIAL TELETHERAPY PORT PLAN, PARTICLES, HEMI-BODY, TOTAL BODYTC$137.62
77326BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE
FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP		$116.84
77326BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE
FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP		26$50.15
77326BRACHYTHERAPY ISODOSE CALCULATION; SIMPLE (CALCULATION MADE
FROM SINGLE PLANE, ONE TO FOUR SOURCES/ RIBBON APP		TC$80.91
77327BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE
DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO		$265.30
77327BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE
DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO		26$75.50
77327BRACHYTHERAPY ISODOSE CALCULATION; INTERMEDIATE (MULTIPLANE
DOSAGE CALCULATIONS, APPLICATION INVOLVING FIVE TO		TC$118.50
77328BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE
PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU		$265.30
77328BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE
PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU		26$112.69
77328BRACHYTHERAPY ISODOSE CALCULATION; COMPLEX (MULTIPLANE ISODOSE
PLAN, VOLUME IMPLANT CALCULATIONS, OVER TEN SOU		TC$169.18
77331SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN
PRESCRIBED BY THE TREATING PHYSICIAN		$116.84
77331SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN
PRESCRIBED BY THE TREATING PHYSICIAN		26$47.28
77331SPECIAL DOSIMETRY (EG, TLD, MICRODOSIMETRY) (SPECIFY), ONLY WHEN
PRESCRIBED BY THE TREATING PHYSICIAN		TC$17.45
77332TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK,
SIMPLE BOLUS)		$190.47
77332TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK,
SIMPLE BOLUS)		26$29.78
77332TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK,
SIMPLE BOLUS)		59$190.47
77332TREATMENT DEVICES, DESIGN AND CONSTRUCTION; SIMPLE (SIMPLE BLOCK,
SIMPLE BOLUS)		TC$45.76
77333TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE
(MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS)		$190.47
77333TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE
(MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS)		26$45.15
77333TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE
(MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS)		59$190.47
77333TREATMENT DEVICES, DESIGN AND CONSTRUCTION; INTERMEDIATE
(MULTIPLE BLOCKS, STENTS, BITE BLOCKS, SPECIAL BOLUS)		TC$64.80
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		$190.47
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		26$66.94
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		59$190.47
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		LT$190.47
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		RT$190.47
77334TREATMENT DEVICES, DESIGN AND CONSTRUCTION; COMPLEX (IRREGULAR
BLOCKS, SPECIAL SHIELDS, COMPENSATORS, WEDGES,		TC$110.65
77336CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF
THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q		$116.84
77336CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF
THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q		59$116.84
77336CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF
THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q		LT$116.84
77336CONTINUING MEDICAL RADIATION PHYSICS CONSULTATION IN SUPPORT OF
THERAPEUTIC RADIOLOGIST INCLUDING CONTINUING Q		RT$116.84
77338MULTI-LEAF COLLIMATOR (MLC) DEVICE(S) FOR INTENSITY MODULATED
RADIATION THERAPY (IMRT), DESIGN AND		$286.03
77370SPECIAL MEDICAL RADIATION PHYSICS CONSULTATION$116.84
77371RADIATION TREATMENT DELIVERY, STEREOTACTIC RADIOSURGERY,
COMPLETE COURSE OF TREATMENT OF CEREBRAL LESION		$9,337.95
77385INTENSITY MODULATED RADIATION TREATMENT DELIVERY, INCLUDES
GUIDANCE AND TRACKING, WHEN PERFORMED; SIMPLE		$524.48
77386INTENSITY MODULATED RADIATION TREATMENT DELIVERY, INCLUDES
GUIDANCE AND TRACKING, WHEN PERFORMED; COMPLEX		$461.71
77399UNLISTED PROCEDURE, MEDICAL RADIATION PHYSICS, DOSIMETRY AND
TREATMENT DEVICES		$116.84
77401RADIATION TREATMENT DELIVERY, SUPERFICIAL AND/OR ORTHO VOLTAGE$98.88
77402RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT
OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N		$98.88
77403RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT
OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N		$98.88
77404RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT
OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N		$98.88
77406RADIATION TREATMENT DELIVERY, SINGLE TREATMENT AREA, SINGLE PORT
OR PARALLEL OPPOSED PORTS, SIMPLE BLOCKS OR N		$98.88
77407RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS,
THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US		$98.88
77408RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS,
THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US		$98.88
77409RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS,
THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US		$98.88
77411RADIATION TREATMENT DELIVERY, TWO SEPARATE TREATMENT AREAS,
THREE OR MORE PORTS ON A SINGLE TREATMENT AREA, US		$148.76
77412RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT
AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE		$148.76
77413RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT
AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE		$148.76
77413RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT
AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE		76$148.76
77414RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT
AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE		$148.76
77416RADIATION TREATMENT DELIVERY, THREE OR MORE SEPARATE TREATMENT
AREAS, CUSTOM BLOCKING, TANGENTIAL PORTS, WEDGE		$148.76
77417THERAPEUTIC RADIOLOGY PORT FILM(S)$49.20
77418INTENSITY MODULATED TREATMENT DELIVERY, SINGLE OR MULTIPLE
FIELDS/ARCS, VIA NARROW SPATIALLY AND TEPORALLY MOD		$361.34
77420WEEKLY RADIOLOGY THERAPY MANAGEMENT; SIMPLE$87.04
77421STEREOSCOPIC X-RAY GUIDANCE FOR LOCALIZATION OF TARGET VOLUME
FOR THE DELIVERY OF RADIATION THERAPY		$85.00
77422HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY; SINGLE
TREATMENT AREA USING A SINGLE PORT OR PARALLEL		$148.76
77423HIGH ENERGY NEUTRON RADIATION TREATMENT DELIVERY; 1 OR MORE
ISOCENTER(S) WITH COPLANAR OR NON-COPLANAR GEOMETR		$148.76
77425INTRAOPERATIVE RADIATION TREATMENT DELIVERY, ELECTRONS, SINGLE
TREATMENT SESSION		$131.95
77430WEEKLY RADIOLOGY THERAPY MANAGEMENT; COMPLEX$194.76
77431RADIATION THERAPY MANAGEMENT WITH COMPLETE COURSE OF THERAPY
CONSISTING OF ONE OR TWO FRACTIONS ONLY		$93.23
77470SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY
IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT		$389.02
77470SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY
IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT		26$107.53
77470SPECIAL TREATMENT PROCEDURE (EG, TOTAL BODY IRRADIATION, HEMIBODY
IRRADIATION, PER ORAL, VAGINAL CONE IRRADIAT		TC$380.46
77520PROTON BEAM DELIVERY TO A SINGLE TREATMENT AREA, SINGLEPORT,
CUSTOM BLOCK, W/ OR W/OUT COMPENSATIN, W/TREATMEN		$1,074.34
77522PROTON TREATMENT DELIVERY; SIMPLE, WITH COMPENSATION$1,074.34
77523PROTON BEAM DELIVERY TO ONE OR TWO TREATMENT AREAS, TWO OR
MORE PORTS, TWO OR MORE CUSTOM BLOCKS AND TWO OR MO		$1,285.31
77525PROTON TREATMENT DELIVERY; COMPLEX$1,285.31
77600HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A
DEPTH OF 4 CM OR LESS)		$376.63
77600HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A
DEPTH OF 4 CM OR LESS)		26$84.54
77600HYPERTHERMIA, EXTERNALLY GENERATED; SUPERFICIAL (IE, HEATING TO A
DEPTH OF 4 CM OR LESS)		TC$103.72
77605HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS
GREATER THAN 4 CM)		$376.63
77605HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS
GREATER THAN 4 CM)		26$112.69
77605HYPERTHERMIA, EXTERNALLY GENERATED; DEEP (IE, HEATING TO DEPTHS
GREATER THAN 4 CM)		TC$138.53
77610HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER
INTERSTITIAL APPLICATORS		$376.63
77610HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER
INTERSTITIAL APPLICATORS		26$84.54
77610HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); 5 OR FEWER
INTERSTITIAL APPLICATORS		TC$103.72
77615HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5
INTERSTITIAL APPLICATORS		$376.63
77615HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5
INTERSTITIAL APPLICATORS		26$112.69
77615HYPERTHERMIA GENERATED BY INTERSTITIAL PROBE(S); MORE THAN 5
INTERSTITIAL APPLICATORS		TC$138.53
77620HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S)$376.63
77620HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S)26$84.54
77620HYPERTHERMIA GENERATED BY INTRACAVITARY PROBE(S)TC$103.72
77750INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION$148.76
77750INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTION26$236.44
77750INFUSION OR INSTILLATION OF RADIOELEMENT SOLUTIONTC$45.43
77761INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE$375.50
77761INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLE26$183.52
77761INTRACAVITARY RADIOELEMENT APPLICATION; SIMPLETC$85.85
77762INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE$375.50
77762INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATE26$289.39
77762INTRACAVITARY RADIOELEMENT APPLICATION; INTERMEDIATETC$123.42
77763INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX$375.50
77763INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEX26$412.98
77763INTRACAVITARY RADIOELEMENT APPLICATION; COMPLEXTC$153.40
77767HIGH DOSE BRACHYTHERAPY THROUGH SKIN SURFACE, 1 CHANNEL OR UP
TO 2.0 CM		$177.80
77768HIGH DOSE BRACHYTHERAPY THROUGH SKIN SURFACE, 2 CHANNELS OR
MORE THAN 2.0 CM		$177.80
77770HIGH DOSE BRACHYTHERAPY, 1 CHANNEL$636.92
77771HIGH DOSE BRACHYTHERAPY, 2-12 CHANNELS$636.92
77772HIGH DOSE BRACHYTHERAPY, MORE THAN 12 CHANNELS$636.92
77776INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE$375.50
77776INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLE26$240.40
77776INTERSTITIAL RADIOELEMENT APPLICATION; SIMPLETC$74.32
77777INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE$375.50
77777INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATE26$360.30
77777INTERSTITIAL RADIOELEMENT APPLICATION; INTERMEDIATETC$144.46
77778INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX$755.05
77778INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEX26$539.78
77778INTERSTITIAL RADIOELEMENT APPLICATION; COMPLEXTC$174.78
77781REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE
POSITIONS OR CATHETERS		$878.17
77781REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE
POSITIONS OR CATHETERS		26$80.19
77781REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 1-4 SOURCE
POSITIONS OR CATHETERS		TC$693.44
77782REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE
POSITIONS OR CATHETERS		$878.17
77782REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE
POSITIONS OR CATHETERS		26$120.49
77782REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE
POSITIONS OR CATHETERS		76$878.17
77782REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 5-8 SOURCE
POSITIONS OR CATHETERS		TC$693.44
77783REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE
POSITIONS OR CATHETERS		$878.17
77783REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE
POSITIONS OR CATHETERS		26$179.82
77783REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; 9-12 SOURCE
POSITIONS OR CATHETERS		TC$693.44
77784REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12
SOURCE POSITIONS OR CATHETERS		$878.17
77784REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12
SOURCE POSITIONS OR CATHETERS		26$270.35
77784REMOTE AFTERLOADING HIGH INTENSITY BRACHYTHERAPY; OVER 12
SOURCE POSITIONS OR CATHETERS		TC$693.44
77785REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY;
1 CHANNEL		$748.66
77786REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY;
2-12 CHANNELS		$748.66
77787REMOTE AFTERLOADING HIGH DOSE RATE RADIONUCLIDE BRACHYTHERAPY;
OVER 12 CHANNELS		$748.66
77789SURFACE APPLICATION OF RADIOELEMENT$98.88
77789SURFACE APPLICATION OF RADIOELEMENT26$53.93
77789SURFACE APPLICATION OF RADIOELEMENTTC$15.45
77790SUPERVISION, HANDLING, LOADING OF RADIOELEMENT$71.38
77790SUPERVISION, HANDLING, LOADING OF RADIOELEMENT26$53.93
77790SUPERVISION, HANDLING, LOADING OF RADIOELEMENTTC$17.45
77799UNLISTED PROCEDURE, CLINICAL BRACHYTHERAPY$878.17
78000THYROID UPTAKE; SINGLE DETERMINATION$96.29
78000THYROID UPTAKE; SINGLE DETERMINATION26$12.21
78000THYROID UPTAKE; SINGLE DETERMINATIONTC$32.90
78001THYROID UPTAKE; MULTIPLE DETERMINATIONS$96.29
78001THYROID UPTAKE; MULTIPLE DETERMINATIONS26$13.61
78001THYROID UPTAKE; MULTIPLE DETERMINATIONSTC$44.42
78003THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT
INCLUDING INITIAL UPTAKE STUDIES)		$237.62
78003THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT
INCLUDING INITIAL UPTAKE STUDIES)		26$16.66
78003THYROID UPTAKE; STIMULATION, SUPPRESSION OR DISCHARGE (NOT
INCLUDING INITIAL UPTAKE STUDIES)		TC$32.90
78006THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION$166.34
78006THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATION26$30.39
78006THYROID IMAGING, WITH UPTAKE; SINGLE DETERMINATIONTC$81.59
78007THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS$187.52
78007THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONS26$26.01
78007THYROID IMAGING, WITH UPTAKE; MULTIPLE DETERMINATIONSTC$87.85
78010THYROID IMAGING; ONLY$166.34
78010THYROID IMAGING; ONLY26$25.26
78010THYROID IMAGING; ONLYTC$61.88
78011THYROID IMAGING; WITH VASCULAR FLOW$166.34
78011THYROID IMAGING; WITH VASCULAR FLOW26$30.19
78011THYROID IMAGING; WITH VASCULAR FLOWTC$82.25
78012THYROID UPTAKE, SINGLE OR MULTIPLE, QUANTITATIVE MEASUREMENT(S)
(INCLUDING STIMULATION, SUPRESSION, OR		$130.29
78014THYROID IMAGING (INCLUDING VASCULAR FLOW, WHEN PERFORMED); WITH
SINGLE OR MULTIPLE UPTAKE(S)		$220.31
78015THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND
CHEST ONLY)		$279.21
78015THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND
CHEST ONLY)		26$34.92
78015THYROID CARCINOMA METASTASES IMAGING; LIMITED AREA (EG, NECK AND
CHEST ONLY)		TC$87.85
78016THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG,
URINARY RECOVERY)		$279.21
78016THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG,
URINARY RECOVERY)		26$42.57
78016THYROID CARCINOMA METASTASES IMAGING; WITH ADDITIONAL STUDIES (EG,
URINARY RECOVERY)		TC$118.83
78017THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS$194.04
78017THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREAS26$44.93
78017THYROID CARCINOMA METASTASES IMAGING; MULTIPLE AREASTC$127.10
78018THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY$279.21
78018THYROID CARCINOMA METASTASES IMAGING; WHOLE BODY26$49.40
78018THYROID CARCINOMA METASTASES IMAGING; WHOLE BODYTC$185.31
78070PARATHYROID IMAGING$187.52
78070PARATHYROID IMAGING26$26.59
78070PARATHYROID IMAGINGTC$61.88
78071PARATHYROID PLANAR IMAGING; WITH TOMOGRAPHIC (SPECT)$304.59
78072PARATHYROID PLANAR IMAGING; WITH TOMOGRAPHIC (SPECT), AND
CONCURRENTLY ACQUIRED COMPUTED TOMOGRAPHY		$304.59
78075ADRENAL IMAGING, CORTEX AND/OR MEDULLA$187.52
78075ADRENAL IMAGING, CORTEX AND/OR MEDULLA26$40.07
78075ADRENAL IMAGING, CORTEX AND/OR MEDULLATC$185.31
78099UNLISTED ENDOCRINE PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$166.34
78102BONE MARROW IMAGING; LIMITED AREA$264.12
78102BONE MARROW IMAGING; LIMITED AREA26$31.02
78102BONE MARROW IMAGING; LIMITED AREATC$69.72
78103BONE MARROW IMAGING; MULTIPLE AREAS$264.12
78103BONE MARROW IMAGING; MULTIPLE AREAS26$50.03
78103BONE MARROW IMAGING; MULTIPLE AREASTC$107.97
78104BONE MARROW IMAGING; WHOLE BODY$264.12
78104BONE MARROW IMAGING; WHOLE BODY26$51.26
78104BONE MARROW IMAGING; WHOLE BODYTC$138.87
78110PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); SINGLE SAMPLING		$232.47
78110PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); SINGLE SAMPLING		26$10.71
78110PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); SINGLE SAMPLING		TC$32.24
78111PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); MULTIPLE SAMPLINGS		$232.47
78111PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); MULTIPLE SAMPLINGS		26$14.48
78111PLASMA VOLUME, RADIONUCLIDE VOLUME-DILUTION TECHNIQUE (SEPARATE
PROCEDURE); MULTIPLE SAMPLINGS		TC$87.85
78120RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE
SAMPLING		$232.47
78120RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE
SAMPLING		26$17.42
78120RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); SINGLE
SAMPLING		TC$59.21
78121RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE
SAMPLINGS		$232.47
78121RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE
SAMPLINGS		26$19.53
78121RED CELL VOLUME DETERMINATION (SEPARATE PROCEDURE); MULTIPLE
SAMPLINGS		TC$99.13
78122WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE
MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU		$232.47
78122WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE
MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU		26$30.18
78122WHOLE BLOOD VOLUME DETERMINATION, INCLUDING SEPARATE
MEASUREMENT OF PLASMA VOLUME AND RED CELL VOLUME (RADIONU		TC$157.33
78130RED CELL SURVIVAL STUDY;$232.47
78130RED CELL SURVIVAL STUDY;26$33.20
78130RED CELL SURVIVAL STUDY;TC$97.46
78135RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG,
SPLENIC AND/OR HEPATIC SEQUESTRATION)		$232.47
78135RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG,
SPLENIC AND/OR HEPATIC SEQUESTRATION)		26$33.79
78135RED CELL SURVIVAL STUDY; DIFFERENTIAL ORGAN/TISSUE KINETICS, (EG,
SPLENIC AND/OR HEPATIC SEQUESTRATION)		TC$166.18
78140LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG,
SPLENIC AND/OR HEPATIC)		$232.47
78140LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG,
SPLENIC AND/OR HEPATIC)		26$33.20
78140LABELED RED CELL SEQUESTRATION, DIFFERENTIAL ORGAN/TISSUE, (EG,
SPLENIC AND/OR HEPATIC)		TC$134.28
78160PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE$154.90
78160PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATE26$21.84
78160PLASMA RADIOIRON DISAPPEARANCE (TURNOVER) RATETC$125.09
78162RADIOIRON ORAL ABSORPTION$146.18
78162RADIOIRON ORAL ABSORPTION26$30.18
78162RADIOIRON ORAL ABSORPTIONTC$108.98
78170RADIOIRON RED CELL UTILIZATION$154.60
78170RADIOIRON RED CELL UTILIZATION26$23.58
78170RADIOIRON RED CELL UTILIZATIONTC$181.38
78172CHELATABLE IRON FOR ESTIMATION OF TOTAL BODY IRON26$36.81
78185SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW$264.12
78185SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOW26$27.88
78185SPLEEN IMAGING ONLY, WITH OR WITHOUT VASCULAR FLOWTC$80.58
78190KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL
ORGAN/TISSUE LOCALIZATION		$237.62
78190KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL
ORGAN/TISSUE LOCALIZATION		26$55.96
78190KINETICS, STUDY OF PLATELET SURVIVAL, WITH OR WITHOUT DIFFERENTIAL
ORGAN/TISSUE LOCALIZATION		TC$195.16
78191PLATELET SURVIVAL STUDY$237.62
78191PLATELET SURVIVAL STUDY26$41.88
78191PLATELET SURVIVAL STUDYTC$250.44
78192WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNING$177.50
78192WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNING26$53.93
78192WHITE BLOOD CELL LOCALIZATION; LIMITED AREA SCANNINGTC$115.92
78193WHITE BLOOD CELL LOCALIZATION; WHOLE BODY$413.40
78193WHITE BLOOD CELL LOCALIZATION; WHOLE BODY26$59.60
78193WHITE BLOOD CELL LOCALIZATION; WHOLE BODYTC$332.78
78195LYMPHATICS AND LYMPH GLANDS IMAGING$264.12
78195LYMPHATICS AND LYMPH GLANDS IMAGING26$63.16
78195LYMPHATICS AND LYMPH GLANDS IMAGINGLT$264.12
78195LYMPHATICS AND LYMPH GLANDS IMAGINGRT$264.12
78195LYMPHATICS AND LYMPH GLANDS IMAGINGTC$138.87
78199UNLISTED HEMATOPOIETIC, RETICULOENDOTHELIAL AND LYMPHATIC
PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE		$264.12
78201LIVER IMAGING; STATIC ONLY$290.75
78201LIVER IMAGING; STATIC ONLY26$28.78
78201LIVER IMAGING; STATIC ONLYTC$80.58
78202LIVER IMAGING; WITH VASCULAR FLOW$290.75
78202LIVER IMAGING; WITH VASCULAR FLOW26$53.30
78202LIVER IMAGING; WITH VASCULAR FLOWTC$98.46
78205LIVER IMAGING (SPECT)$290.75
78205LIVER IMAGING (SPECT)26$48.59
78205LIVER IMAGING (SPECT)TC$201.42
78206LIVER IMAGING (SPECT); WITH VASCULAR FLOW$295.24
78215LIVER AND SPLEEN IMAGING; STATIC ONLY$290.75
78215LIVER AND SPLEEN IMAGING; STATIC ONLY26$32.21
78215LIVER AND SPLEEN IMAGING; STATIC ONLYTC$100.12
78216LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW$290.75
78216LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOW26$33.80
78216LIVER AND SPLEEN IMAGING; WITH VASCULAR FLOWTC$118.83
78220LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES$290.75
78220LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGES26$36.56
78220LIVER FUNCTION STUDY WITH HEPATOBILIARY AGENTS, WITH SERIAL IMAGESTC$127.10
78223HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH
OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O		$290.75
78223HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH
OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O		26$39.33
78223HEPATOBILIARY DUCTAL SYSTEM IMAGING, INCLUDING GALLBLADDER, WITH
OR WITHOUT PHARMACOLOGIC INTERVENTION, WITH O		TC$125.09
78226HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN
PRESENT		$339.22
78227HEPATOBILIARY SYSTEM IMAGING, INCLUDING GALLBLADDER WHEN
PRESENT; WITH PHARMACOLOGIC INTERVENTION, INCLUDING		$297.35
78230SALIVARY GLAND IMAGING;$254.25
78230SALIVARY GLAND IMAGING;26$46.40
78230SALIVARY GLAND IMAGING;TC$74.32
78231SALIVARY GLAND IMAGING; WITH SERIAL IMAGES$254.25
78231SALIVARY GLAND IMAGING; WITH SERIAL IMAGES26$59.10
78231SALIVARY GLAND IMAGING; WITH SERIAL IMAGESTC$107.97
78232SALIVARY GLAND FUNCTION STUDY$254.25
78232SALIVARY GLAND FUNCTION STUDY26$32.88
78232SALIVARY GLAND FUNCTION STUDYTC$120.50
78258ESOPHAGEAL MOTILITY$254.25
78258ESOPHAGEAL MOTILITY26$50.30
78258ESOPHAGEAL MOTILITYTC$98.46
78261GASTRIC MUCOSA IMAGING$254.25
78261GASTRIC MUCOSA IMAGING26$46.94
78261GASTRIC MUCOSA IMAGINGTC$139.87
78262GASTROESOPHAGEAL REFLUX STUDY$254.25
78262GASTROESOPHAGEAL REFLUX STUDY26$46.30
78262GASTROESOPHAGEAL REFLUX STUDYTC$144.81
78264GASTRIC EMPTYING STUDY$254.25
78264GASTRIC EMPTYING STUDY26$40.65
78264GASTRIC EMPTYING STUDYTC$140.54
78265STOMACH EMPTYING AND SMALL BOWEL TRANSIT STUDY$304.32
78266STOMACH EMPTYING AND SMALL BOWEL WITH COLON TRANSIT STUDY$403.78
78267UREA BREATH TEST, C-14; ACQUISITION FOR ANALYSIS$11.77
78268UREA BREATH TEST, C-14; ANALYSIS$100.89
78270VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC
FACTOR		$237.62
78270VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC
FACTOR		26$14.86
78270VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITHOUT INTRINSIC
FACTOR		TC$52.95
78271VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC
FACTOR		$237.62
78271VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC
FACTOR		26$14.86
78271VITAMIN B-12 ABSORPTION STUDY (EG, SCHILLING TEST); WITH INTRINSIC
FACTOR		TC$56.28
78272VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT
INTRINSIC FACTOR		$237.62
78272VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT
INTRINSIC FACTOR		26$16.49
78272VITAMIN B-12 ABSORPTION STUDIES COMBINED, WITH AND WITHOUT
INTRINSIC FACTOR		TC$79.24
78276GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATION$111.98
78276GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATION26$33.67
78276GASTROINTESTINAL ASPIRATE BLOOD LOSS LOCALIZATIONTC$108.98
78278ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING$254.25
78278ACUTE GASTROINTESTINAL BLOOD LOSS IMAGING26$42.68
78278ACUTE GASTROINTESTINAL BLOOD LOSS IMAGINGTC$166.18
78280GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING)$101.57
78280GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING)26$19.61
78280GASTROINTESTINAL BLOOD LOSS STUDY (EG, STOOL COUNTING)TC$110.65
78282GASTROINTESTINAL PROTEIN LOSS$254.25
78282GASTROINTESTINAL PROTEIN LOSS26$25.47
78290BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION,
VOLVULUS)		$254.25
78290BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION,
VOLVULUS)		26$52.28
78290BOWEL IMAGING (EG, ECTOPIC GASTRIC MUCOSA, MECKEL’S LOCALIZATION,
VOLVULUS)		TC$103.72
78291PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER
SHUNT)		$254.25
78291PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER
SHUNT)		26$59.60
78291PERITONEAL-VENOUS SHUNT PATENCY TEST (EG, FOR LEVEEN, DENVER
SHUNT)		TC$104.39
78299UNLISTED GASTROINTESTINAL PROCEDURE, DIAGNOSTIC NUCLEAR
MEDICINE		$254.25
78300BONE AND/OR JOINT IMAGING; LIMITED AREA$269.25
78300BONE AND/OR JOINT IMAGING; LIMITED AREA26$36.41
78300BONE AND/OR JOINT IMAGING; LIMITED AREATC$85.17
78305BONE AND/OR JOINT IMAGING; MULTIPLE AREAS$269.25
78305BONE AND/OR JOINT IMAGING; MULTIPLE AREAS26$55.87
78305BONE AND/OR JOINT IMAGING; MULTIPLE AREASTC$125.09
78306BONE AND/OR JOINT IMAGING; WHOLE BODY$269.25
78306BONE AND/OR JOINT IMAGING; WHOLE BODY26$56.14
78306BONE AND/OR JOINT IMAGING; WHOLE BODYTC$145.80
78310BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLY$118.50
78310BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLY26$48.41
78310BONE AND/OR JOINT IMAGING; VASCULAR FLOW ONLYTC$40.17
78315BONE AND/OR JOINT IMAGING; THREE PHASE STUDY$269.25
78315BONE AND/OR JOINT IMAGING; THREE PHASE STUDY26$61.56
78315BONE AND/OR JOINT IMAGING; THREE PHASE STUDY59$269.25
78315BONE AND/OR JOINT IMAGING; THREE PHASE STUDYTC$162.92
78320BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)$269.25
78320BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)26$70.41
78320BONE AND/OR JOINT IMAGING; TOMOGRAPHIC (SPECT)TC$201.42
78350BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES;
SINGLE PHOTON ABSORPTIOMETRY		$49.20
78350BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES;
SINGLE PHOTON ABSORPTIOMETRY		26$15.00
78350BONE DENSITY (BONE MINERAL CONTENT) STUDY, ONE OR MORE SITES;
SINGLE PHOTON ABSORPTIOMETRY		TC$25.96
78399UNLISTED MUSCULOSKELETAL PROCEDURE, DIAGNOSTIC NUCLEAR
MEDICINE		$269.25
78414DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG,
EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR W		$283.53
78414DETERMINATION OF CENTRAL C-V HEMODYNAMICS (NON-IMAGING) (EG,
EJECTION FRACTION WITH PROBE TECHNIQUE) WITH OR W		26$42.64
78428CARDIAC SHUNT DETECTION$283.53
78428CARDIAC SHUNT DETECTION26$30.71
78428CARDIAC SHUNT DETECTIONTC$76.99
78445NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)$140.49
78445NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)26$41.75
78445NON-CARDIAC VASCULAR FLOW IMAGING (IE, ANGIOGRAPHY, VENOGRAPHY)TC$64.47
78451MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); SINGLE STUDY,
AT REST OR STRESS		$744.13
78452MYOCARDIAL PERFUSION IMAGING, TOMOGRAPHIC (SPECT); MULTIPLE
STUDIES, AT REST OR STRESS AND/OR REDISTRUBUTION		$744.13
78454MYOCARDIAL PERFUSION IMAGING, PLANAR; MULITPLE STUDIES, AT REST
AND/OR STRESS AND/OR REDISTRIBUTION AND/OR		$775.57
78455VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN)$194.13
78455VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN)26$43.69
78455VENOUS THROMBOSIS STUDY (EG, RADIOACTIVE FIBRINOGEN)TC$135.95
78456ACUTE VENOUS THROMBOSIS IMAGING, PEPTIDE$140.49
78457VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL$140.49
78457VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERAL26$44.60
78457VENOUS THROMBOSIS IMAGING, VENOGRAM; UNILATERALTC$90.77
78458VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL$140.49
78458VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERAL26$47.76
78458VENOUS THROMBOSIS IMAGING (EG, VENOGRAM); BILATERALTC$136.96
78459MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), METABOLIC
EVALUATION		$907.31
78460MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR
STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH		$283.53
78460MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR
STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH		26$58.64
78460MYOCARDIAL PERFUSION IMAGING; (PLANAR) SINGLE STUDY, AT REST OR
STRESS (EXERCISE AND/OR PHARMACOLOGIC), WITH		TC$80.58
78461MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST
AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)		$450.07
78461MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST
AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)		26$69.45
78461MYOCARDIAL PERFUSION IMAGING; MULTIPLE STUDIES,(PLANAR)AT REST
AND/OR STRESS (EXERCISE AND/OR PHARMACOLOGIC)		TC$161.25
78464MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY
AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG		$283.53
78464MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY
AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG		26$73.69
78464MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), SINGLE STUDY
AT REST OR STRESS (EXERCISE AND/OR PHARMACOLOG		TC$241.83
78465MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE
STUDIES, AT REST AND/OR STRESS (EXERCISE AND		$450.07
78465MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE
STUDIES, AT REST AND/OR STRESS (EXERCISE AND		26$98.96
78465MYOCARDIAL PERFUSION IMAGING; TOMOGRAPHIC (SPECT), MULTIPLE
STUDIES, AT REST AND/OR STRESS (EXERCISE AND		TC$402.50
78466MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR
QUANTITATIVE		$283.53
78466MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR
QUANTITATIVE		26$47.26
78466MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; QUALITATIVE OR
QUANTITATIVE		TC$89.77
78468MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY
FIRST PASS TECHNIQUE		$283.53
78468MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY
FIRST PASS TECHNIQUE		26$53.93
78468MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; WITH EJECTION FRACTION BY
FIRST PASS TECHNIQUE		TC$125.09
78469MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH
OR WITHOUT QUANTIFICATION		$283.53
78469MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH
OR WITHOUT QUANTIFICATION		26$79.38
78469MYOCARDIAL IMAGING, INFARCT AVID, PLANAR; TOMOGRAPHIC SPECT WITH
OR WITHOUT QUANTIFICATION		TC$178.70
78472CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT
REST, WALL MOTION STUDY PLUS EJECTION FRACTION,		$283.53
78472CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT
REST, WALL MOTION STUDY PLUS EJECTION FRACTION,		26$74.49
78472CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; SINGLE STUDY AT
REST, WALL MOTION STUDY PLUS EJECTION FRACTION,		TC$188.22
78473CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES,
WALL MOTION STUDY PLUS EJECTION FRACTION, RES		$339.36
78473CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES,
WALL MOTION STUDY PLUS EJECTION FRACTION, RES		26$75.90
78473CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM; MULTIPLE STUDIES,
WALL MOTION STUDY PLUS EJECTION FRACTION, RES		TC$282.00
78478MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR
QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO		$101.43
78478MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR
QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO		26$31.98
78478MYOCARDIAL PERFUSION STUDY WITH WALL MOTION, QUALITATIVE OR
QUANTITATIVE STUDY (LIST SEPARATELY IN ADDITION TO		TC$53.28
78480MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST
SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)		$101.43
78480MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST
SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)		26$31.98
78480MYOCARDIAL PERFUSION STUDY WITH EJECTION FRACTION (LIST
SEPARATELY IN ADDITION TO CODE FOR PRIMARY PROCEDURE)		TC$53.28
78481CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE;
SINGLE STUDY, AT REST OR WITH STRESS		$283.53
78481CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE;
SINGLE STUDY, AT REST OR WITH STRESS		26$66.62
78481CARDIAC BLOOD POOL IMAGING,(PLANAR), FIRST PASS TECHNIQUE;
SINGLE STUDY, AT REST OR WITH STRESS		TC$178.70
78483CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE;
MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE		$339.36
78483CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE;
MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE		26$75.90
78483CARDIAC BLOOD POOL IMAGING, (PLANAR) FIRST PASS TECHNIQUE;
MULTIPLE STUDIES, AT REST AND WITH STRESS (EXERCISE		TC$268.80
78491MYOCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET),
PERFUSION; SINGLE STUDY AT REST OR STRESS		$907.31
78492MYCARDIAL IMAGING, POSITRON EMISSION TOMOGRAPHY (PET), PERFUSION;
MULTIPLE STUDIES AT REST AND/OR STRESS		$2,816.24
78494CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SPECT, AT REST, WALL
MOTION STUDY PLUS EJECTION FRACTION, WITH		$278.32
78496CARDIAC BLOOD POOL IMAGING, GATED EQUILIBRIUM, SINGLE STUDY, AT
REST, WITH RIGHT VENTRICULAR EJECTION FRACTION		$101.43
78499UNLISTED CARDIOVASCULAR PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$283.53
78580PULMONARY PERFUSION IMAGING; PARTICULATE$223.69
78580PULMONARY PERFUSION IMAGING; PARTICULATE26$48.34
78580PULMONARY PERFUSION IMAGING; PARTICULATETC$117.16
78581PULMONARY PERFUSION IMAGING; GASEOUS$95.78
78581PULMONARY PERFUSION IMAGING; GASEOUS26$33.22
78581PULMONARY PERFUSION IMAGING; GASEOUSTC$81.59
78582PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGING$175.64
78582PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGING26$49.76
78582PULMONARY VENTILATION ( EG, AEROSOL OR GAS) AND PERFUSION IMAGINGTC$128.68
78584PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE
BREATH		$364.64
78584PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE
BREATH		26$51.24
78584PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION; SINGLE
BREATH		TC$108.98
78585PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION;
REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR		$364.64
78585PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION;
REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR		26$55.96
78585PULMONARY PERFUSION IMAGING, PARTICULATE, WITH VENTILATION;
REBREATHING AND WASHOUT, WITH OR WITHOUT SINGLE BR		TC$192.23
78586PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION$223.69
78586PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTION26$31.00
78586PULMONARY VENTILATION IMAGING, AEROSOL; SINGLE PROJECTIONTC$88.52
78587PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG,
ANTERIOR, POSTERIOR, LATERAL VIEWS)		$223.69
78587PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG,
ANTERIOR, POSTERIOR, LATERAL VIEWS)		26$33.44
78587PULMONARY VENTILATION IMAGING, AEROSOL; MULTIPLE PROJECTIONS (EG,
ANTERIOR, POSTERIOR, LATERAL VIEWS)		TC$95.78
78588PULMONY PERFUSION IMAGING PARTICULATE WITH VENTILATION IMAGING$364.64
78591PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE
PROJECTION		$223.69
78591PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE
PROJECTION		26$31.00
78591PULMONARY VENTILATION IMAGING, GASEOUS, SINGLE BREATH, SINGLE
PROJECTION		TC$97.46
78593PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO		$223.69
78593PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO		26$33.34
78593PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; SINGLE PRO		TC$117.83
78594PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P		$223.69
78594PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P		26$57.21
78594PULMONARY VENTILATION IMAGING, GASEOUS, WITH REBREATHING AND
WASHOUT WITH OR WITHOUT SINGLE BREATH; MULTIPLE P		TC$169.86
78596PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION
(VENTILATION/PERFUSION) STUDY		$364.64
78596PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION
(VENTILATION/PERFUSION) STUDY		26$65.54
78596PULMONARY QUANTITATIVE DIFFERENTIAL FUNCTION
(VENTILATION/PERFUSION) STUDY		TC$241.83
78597QUANTITATIVE DIFFERENTIAL PULMONARY PERFUSION, INCLUDING IMAGING
WHEN PERFORMED		$287.24
78599UNLISTED RESPIRATORY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$223.69
78600BRAIN IMAGING, LIMITED PROCEDURE; STATIC$348.76
78600BRAIN IMAGING, LIMITED PROCEDURE; STATIC26$41.08
78600BRAIN IMAGING, LIMITED PROCEDURE; STATICTC$98.46
78601BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW$348.76
78601BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOW26$43.09
78601BRAIN IMAGING, LIMITED PROCEDURE; WITH VASCULAR FLOWTC$115.92
78605BRAIN IMAGING, COMPLETE STUDY; STATIC$348.76
78605BRAIN IMAGING, COMPLETE STUDY; STATIC26$43.57
78605BRAIN IMAGING, COMPLETE STUDY; STATICTC$115.92
78606BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW$348.76
78606BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOW26$45.95
78606BRAIN IMAGING, COMPLETE STUDY; WITH VASCULAR FLOWTC$132.03
78607BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT)$348.76
78607BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT)26$83.65
78607BRAIN IMAGING, COMPLETE STUDY; TOMOGRAPHIC (SPECT)TC$223.80
78608BRAIN IMAGING POSITRON EMISSION TOMOGRAPHY (PET); METABOLIC
EVALUATION		$1,303.36
78610BRAIN IMAGING, VASCULAR FLOW ONLY$348.76
78610BRAIN IMAGING, VASCULAR FLOW ONLY26$45.47
78610BRAIN IMAGING, VASCULAR FLOW ONLYTC$53.94
78615CEREBRAL BLOOD FLOW$348.76
78615CEREBRAL BLOOD FLOW26$37.41
78615CEREBRAL BLOOD FLOW52$66.98
78615CEREBRAL BLOOD FLOWTC$131.36
78630CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); CISTERNOGRAPHY		$236.16
78630CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); CISTERNOGRAPHY		26$70.82
78630CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); CISTERNOGRAPHY		TC$171.78
78635CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); VENTRICULOGRAPHY		$236.16
78635CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); VENTRICULOGRAPHY		26$41.88
78635CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); VENTRICULOGRAPHY		TC$86.84
78645CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); SHUNT EVALUATION		$236.16
78645CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); SHUNT EVALUATION		26$39.43
78645CEREBROSPINAL FLUID FLOW, IMAGING (NOT INCLUDING INTRODUCTION OF
MATERIAL); SHUNT EVALUATION		TC$117.16
78647CEREBROSPINAL FLUID FLOW, IMAGING; TOMOGRAPHIC (SPECT)$236.16
78650CSF LEAKAGE DETECTION AND LOCALIZATION$236.16
78650CSF LEAKAGE DETECTION AND LOCALIZATION26$43.15
78650CSF LEAKAGE DETECTION AND LOCALIZATIONTC$158.33
78652CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT)$275.28
78652CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT)26$61.31
78652CSF LEAKAGE DETECTION AND LOCALIZATION TOMOGRAPHIC (ECT)TC$201.42
78655RADIONUCLIDE IDENTIFICATION OF EYE TUMOR$219.19
78655RADIONUCLIDE IDENTIFICATION OF EYE TUMOR26$28.43
78655RADIONUCLIDE IDENTIFICATION OF EYE TUMORTC$169.86
78660RADIONUCLIDE DACRYOCYSTOGRAPHY$236.16
78660RADIONUCLIDE DACRYOCYSTOGRAPHY26$42.77
78660RADIONUCLIDE DACRYOCYSTOGRAPHYTC$72.40
78699UNLISTED NERVOUS SYSTEM PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$348.76
78700KIDNEY IMAGING; STATIC ONLY$246.57
78700KIDNEY IMAGING; STATIC ONLY26$37.92
78700KIDNEY IMAGING; STATIC ONLYTC$103.72
78701KIDNEY IMAGING; WITH VASCULAR FLOW$246.57
78701KIDNEY IMAGING; WITH VASCULAR FLOW26$39.61
78701KIDNEY IMAGING; WITH VASCULAR FLOWTC$121.51
78704KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM)$246.57
78704KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM)26$39.15
78704KIDNEY IMAGING; WITH FUNCTION STUDY (IE, IMAGING RENOGRAM)TC$134.94
78707KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY
WITHOUT PHARMACOLOGICAL INTERVENTION		$246.57
78707KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY
WITHOUT PHARMACOLOGICAL INTERVENTION		26$48.30
78707KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY
WITHOUT PHARMACOLOGICAL INTERVENTION		TC$152.74
78708KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; SINGLE STUDY,
WITH PHARMACOLOGICAL INTERVENTION (EG, ANGIOTEN		$279.86
78709KIDNEY IMAGING WITH VASCULAR FLOW AND FUNCTION; MULTIPLE
STUDIES, WITH AND WITHOUT PHARMACOLOGICAL		$279.86
78710KIDNEY IMAGING, TOMOGRAPHIC (SPECT)$246.57
78710KIDNEY IMAGING, TOMOGRAPHIC (SPECT)26$45.17
78710KIDNEY IMAGING, TOMOGRAPHIC (SPECT)TC$201.42
78715KIDNEY VASCULAR FLOW ONLY$246.57
78715KIDNEY VASCULAR FLOW ONLY26$17.11
78715KIDNEY VASCULAR FLOW ONLYTC$53.94
78725KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION$96.29
78725KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTION26$26.81
78725KIDNEY FUNCTION STUDY WITHOUT PHARMACOLOGIC INTERVENTIONTC$60.88
78726KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTION$166.72
78726KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTION26$59.23
78726KIDNEY FUNCTION STUDY INCLUDING PHARMACOLOGIC INTERVENTIONTC$101.05
78727KIDNEY TRANSPLANT EVALUATION$211.58
78727KIDNEY TRANSPLANT EVALUATION26$67.08
78727KIDNEY TRANSPLANT EVALUATIONTC$135.95
78730URINARY BLADDER RESIDUAL STUDY$41.39
78730URINARY BLADDER RESIDUAL STUDY26$23.55
78730URINARY BLADDER RESIDUAL STUDYTC$50.02
78740URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM)$246.57
78740URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM)26$39.37
78740URETERAL REFLUX STUDY (RADIONUCLIDE VOIDING CYSTOGRAM)TC$72.40
78760TESTICULAR IMAGING;$246.57
78760TESTICULAR IMAGING;26$33.99
78760TESTICULAR IMAGING;TC$91.44
78761TESTICULAR IMAGING; WITH VASCULAR FLOW$246.57
78761TESTICULAR IMAGING; WITH VASCULAR FLOW26$36.27
78761TESTICULAR IMAGING; WITH VASCULAR FLOWTC$108.98
78799UNLISTED GENITOURINARY PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$246.57
78800RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA$279.21
78800RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREA26$35.30
78800RADIONUCLIDE LOCALIZATION OF TUMOR; LIMITED AREATC$115.92
78801RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS$279.21
78801RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREAS26$58.88
78801RADIONUCLIDE LOCALIZATION OF TUMOR; MULTIPLE AREASTC$144.13
78802RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY$279.21
78802RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODY26$60.75
78802RADIONUCLIDE LOCALIZATION OF TUMOR; WHOLE BODYTC$188.90
78803TUMOR LOCALIZATION (SPECT)$279.21
78803TUMOR LOCALIZATION (SPECT)26$73.69
78803TUMOR LOCALIZATION (SPECT)TC$223.80
78804RADIOPHARMACEUTICAL LOCALIZATION OF TUMOR OR DISTRUBUTION OF
RADIOPHARMACEUTICAL AGENT, WHOLE BODY		$736.68
78805RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREA$279.21
78805RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREA26$38.23
78805RADIONUCLIDE LOCALIZATION OF ABSCESS; LIMITED AREATC$115.92
78806RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODY$279.21
78806RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODY26$43.92
78806RADIONUCLIDE LOCALIZATION OF ABSCESS; WHOLE BODYTC$188.90
78807RADIONUCLIDE LOCALIZATION OF ABSCESS, SPECT$279.21
78811TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); LIMITED AREA, (
EG, CHEST, HEAD/NECK )		$1,303.36
78812TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET); SKULL BASE TO
MID THIGH		$1,303.36
78813TUMOR IMAGING, POSITRON EMISSION TOMOGRAPHY (PET) ; WHOLE BODY$1,303.36
78814TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI		$1,416.69
78814TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI		PI$1,416.69
78814TUMOR IMAGING, (PET); WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; LI		PS$1,416.69
78815TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION
CORRECTION AND ANATOMICAL LOCALIZATION; SKULL		$1,416.69
78815TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION
CORRECTION AND ANATOMICAL LOCALIZATION; SKULL		PI$1,416.69
78815TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION
CORRECTION AND ANATOMICAL LOCALIZATION; SKULL		PS$1,416.69
78815TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION
CORRECTION AND ANATOMICAL LOCALIZATION; SKULL		QR$1,416.69
78815TUMOR IMAGING, (PET) WITHCONCURENTLY ACQUIRED CT FOR ATTENUATION
CORRECTION AND ANATOMICAL LOCALIZATION; SKULL		TC$1,416.69
78816TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO		$1,416.69
78816TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO		PI$1,416.69
78816TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO		PS$1,416.69
78816TUMOR IMAGING, (PET) WITH CONCURRENTLY ACQUIRED CT FOR
ATTENUATION CORRECTION AND ANATOMICAL LOCALIZATION; WHO		QR$1,416.69
78890GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		$50.81
78890GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		26$3.36
78890GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		TC$44.42
78891GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		$101.90
78891GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		26$6.72
78891GENERATION OF AUTOMATED DATA: INTERACTIVE PROCESS INVOLVING
NUCLEAR PHYSICIAN AND/OR ALLIED HEALTH PROFESSIONA		TC$89.77
78999UNLISTED MISCELLANEOUS PROCEDURE, DIAGNOSTIC NUCLEAR MEDICINE$96.29
79000RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING
EVALUATION OF PATIENT		$210.04
79000RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING
EVALUATION OF PATIENT		26$95.70
79000RADIONUCLIDE THERAPY, HYPERTHYROIDISM; INITIAL, INCLUDING
EVALUATION OF PATIENT		TC$89.77
79001RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY$173.65
79001RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPY26$76.64
79001RADIONUCLIDE THERAPY, HYPERTHYROIDISM; SUBSEQUENT, EACH THERAPYTC$44.42
79005RADIOPHARMACEUTICAL THERAPY, BY ORAL ADMINISTRATION$261.41
79020RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC
DISEASE), INCLUDING EVALUATION OF PATIENT		$217.53
79020RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC
DISEASE), INCLUDING EVALUATION OF PATIENT		26$93.23
79020RADIONUCLIDE THERAPY, THYROID SUPPRESSION (EUTHYROID CARDIAC
DISEASE), INCLUDING EVALUATION OF PATIENT		TC$89.77
79030RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMA$292.87
79030RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMA26$133.23
79030RADIONUCLIDE ABLATION OF GLAND FOR THYROID CARCINOMATC$89.77
79035RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMA$323.10
79035RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMA26$106.45
79035RADIONUCLIDE THERAPY FOR METASTASES OF THYROID CARCINOMATC$89.77
79100RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH
TREATMENT		$184.60
79100RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH
TREATMENT		26$78.03
79100RADIONUCLIDE THERAPY, POLYCYTHEMIA VERA, CHRONIC LEUKEMIA, EACH
TREATMENT		TC$89.77
79101RADIOPHARMACEUTICAL THERAPY, BY INTRAVENOUS ADMINISTRATION$261.41
79200INTRACAVITARY RADIOACTIVE COLLOID THERAPY$261.41
79200INTRACAVITARY RADIOACTIVE COLLOID THERAPY26$135.01
79200INTRACAVITARY RADIOACTIVE COLLOID THERAPYTC$89.77
79300INTERSTITIAL RADIOACTIVE COLLOID THERAPY$261.41
79300INTERSTITIAL RADIOACTIVE COLLOID THERAPY26$108.57
79400RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGIC$193.13
79400RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGIC26$96.35
79400RADIONUCLIDE THERAPY, NONTHYROID, NONHEMATOLOGICTC$89.77
79403RADIOPHARMACEUTICAL THERAPY, RADIOLABELED MONOCLONAL ANTIBODY
BY INTRAVENOUS INFUSION		$623.35
79420INTRAVASCULAR RADIONUCLIDE THERAPY, PARTICULATE26$102.20
79440INTRA-ARTICULAR RADIONUCLIDE THERAPY$261.41
79440INTRA-ARTICULAR RADIONUCLIDE THERAPY26$130.76
79440INTRA-ARTICULAR RADIONUCLIDE THERAPYTC$89.77
79445RADIOPHARMACEUTICAL THERAPY, BY INTRA-ARTERIAL PARTICULATE
ADMINISTRATION		$261.41
79999UNLISTED RADIONUCLIDE THERAPEUTIC PROCEDURE$261.41
chest x-ray cpt codes list
Chest X-Ray CPT Codes

Radiology CPT Codes 2023 Pdf :

Please find the 2023 Radiology CPT codes Pdf from attachment.

Radiology CPT Codes 2023 Pdf Download

The list of Radiology CPT codes 2023 along with the CPT code for chest X-ray is updated as per the latest info available on authorized resources like CMS, and other government portals. if any discrepancy is found please let us know via the contact us page.

Note- CPT is registered trademark of American Medical Association. The content shared in this website is for education and training purpose only.

MRI Scan in radiology codes

List of CPT Codes in Medical Billing | CPT Code Lookup

Workers Compensation Insurance List and Phone Number

List of Modifiers in Medical Billing

Insurance Payer Id List

Timely Filing Limit of Insurance Companies in Medical Billing 

An Overview of American Healthcare System

CPT Code 93306 description

ICD 10 Code For Low Back Pain

ICD 10 Code for Chest Pain