EXAM NAME

COST

CPT/HCPCS CODE

Acute gastrointestinal blood loss imaging $971.00 78278
Bone scan, 3 phase $972.00 78315
Bone scan, whole body $972.00 78306
Cardiac blood pool imaging, gated equilibrium, planar $1,149.00 78472
Cisternogram for CSF leak, lumbar injection $2,662.00 78650, 62270
Cisternogram, lumbar injection $2,662.00 78630, 62270
Gastric emptying scan $972.00 78264
Hepatobiliary (liver and gallbladder) scan $1,118.00 78226
Hepatobiliary (liver and gallbladder) scan with drug intervention $1,118.00 78227
Inflammatory process localization, limited area (white blood cell scan) $1,971.00 78805
Inflammatory process localization, whole body (white blood cell scan) $1,971.00 78806
Kidney scan with vascular flow, with and without drug intervention $1,251.00 78709
Kidney scan with vascular flow, without drug intervention $1,251.00 78707
Liver and spleen with vascular flow $1,118.00 78216
Lung scan, differential, perfusion $918.00 78597
Lung scan, differential, ventilation and perfusion $1,293.00 78598
Lung scan, perfusion $918.00 78580
Lung scan, ventilation $918.00 78579
Lung scan, ventilation and perfusion $1,293.00 78582
Lymphoscintigraphy $1,039.00 78195
Myocardial perfusion imaging, SPECT $3,461.00 78452
Parathyroid imaging, planar only $861.00 78070
Parathyroid imaging, SPECT and planar $2,216.00 78231
Salivary gland imaging with serial images $971.00 78071
Thyroid scan, imaging only $550.00 78013
Thyroid scan, uptake and imaging $861.00 78014
Thyroid scan, uptake only $421.00 78012

 

Additional charges for radiopharmaceuticals may apply