Imaging prices at Atrium Health Floyd Medical Center

Rome, GA · every code in this section with a posted price and a Medicare benchmark.

288 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
3-D radiotherapy plan dose-volume histograms (77295) $5,111.50 $10,223 3.6×
Abdomen 2 views (74019) $414.50 $829 3.9×
Acute gastrointestinal blood loss imaging (78278) $750.50 $1,501 1.8×
Angiography extremity unilateral rs&i (75710) $2,759 $5,518 0.9×
Angiography internal mammary rs&i (75756) $2,316 $4,632 0.7×
Ankle 2 views (73600) $151.50 $303 1.7×
Antegrade urography radiological supvj & interpj (74425) $395 $790 1.1×
Aortography abdominal serialography rs&i (75625) $3,518.50 $7,037 1.1×
Arthrogram elbow (73085) $361.50 $723 1.0×
Arthrogram hip (73525) $434 $868 1.2×
Arthrogram shoulder (73040) $567.50 $1,135 1.6×
Arthrogram wrist (73115) $288 $576 0.8×
Arthrography knee lt (73580) $281 $562 0.8×
Basic radiation dosimetry calculation (77300) $501 $1,002 3.7×
Bone &/Joint Imaging Limited Area (78300) $1,089.50 $2,179 2.7×
Bone &/joint imaging whole body (78306) $1,929.50 $3,859 4.8×
Bone age studies (77072) $277.50 $555 2.6×
Bone Imaging 3 Phase (78315) $938 $1,876 2.3×
Bone survey complete (77075) $533.50 $1,067 5.0×
Brachytx isodose complex (77318) $1,492.50 $2,985 3.9×
Brachytx isodose intermed (77317) $1,317 $2,634 3.5×
Brachytx isodose pln smpl w/dosimetry cal (77316) $1,078.50 $2,157 2.8×
Brain Imaging Vascular Flow Only (78610) $929 $1,858 1.7×
Cervical spine 2 or 3 views (72040) $232.50 $465 2.6×
Chest 1 view (71045) $390.50 $781 4.4×
Chest 3 views (71047) $648 $1,296 7.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $390 $780 2.2×
Clavicle complete (73000) $182.50 $365 2.1×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $246 $492 2.3×
Continuing medical physics consltj pr wk (77336) $616 $1,232 4.5×
CT abdomen and pelvis without and with contrast (74178) $4,355 $8,710 12.3×
CT abdomen and pelvis without contrast (74176) $3,786 $7,572 15.6×
CT abdomen w contrast (74160) $1,316 $2,632 7.4×
CT abdomen w wo contrast (74170) $1,826 $3,652 10.2×
CT abdomen w/o contrast (74150) $1,535 $3,070 14.5×
CT angio hrt w/3d image (75574) $1,624.50 $3,249 4.6×
CT angiography upper extremity lt (73206) $1,370 $2,740 7.7×
CT c-spine w/o contrast (72125) $1,475 $2,950 13.9×
CT cervical spine w&w/o contrast (72127) $1,545.50 $3,091 8.7×
CT cervical spine with contrast (72126) $1,615.50 $3,231 4.6×
CT chest w/wo contrast (71270) $1,694.50 $3,389 9.5×
CT chest with contrast (71260) $1,507.50 $3,015 8.5×
CT head/brain with contrast (70460) $1,615.50 $3,231 9.1×
CT head/brain without and with contrast (70470) $2,002 $4,004 11.2×
CT heart no contrast quant eval coronry calcium (75571) $360.50 $721 4.1×
CT iac w contrast (70481) $1,466.50 $2,933 8.2×
CT limited/localized follow up study (76380) $321 $642 3.6×
CT lower ext w/o (73700) $1,672 $3,344 15.7×
CT lower extremity w wo contrast (73702) $1,726 $3,452 9.7×
CT lower extremity with contrast (73701) $1,678.50 $3,357 9.4×
CT lumbar spine w & w/o contrast (72133) $1,812.50 $3,625 10.2×
CT lumbar spine w/o contrast (72131) $1,545.50 $3,091 14.6×
CT lumbar spine with contrast (72132) $1,615.50 $3,231 4.6×
CT maxillofacial w contrast (70487) $1,279 $2,558 7.2×
CT maxillofacial w/o contrast (70486) $1,096.50 $2,193 10.3×
CT maxillofacial w/wo contrast (70488) $1,512 $3,024 8.5×
CT neck soft tissue w contrast (70491) $1,306.50 $2,613 7.3×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $1,966.50 $3,933 11.0×
CT orbits w/o contrast (70480) $822 $1,644 7.7×
CT pelvis w & w/o contrast (72194) $1,693.50 $3,387 9.5×
CT pelvis w/o contrast (72192) $1,461.50 $2,923 13.8×
CT soft tissue neck w/o contrast (70490) $1,004.50 $2,009 9.5×
CT thoracic spine w/contrast (72129) $1,826 $3,652 10.2×
CT thoracic spine w/o contrast (72128) $1,781 $3,562 16.8×
CT thorax w/o contrast (71250) $1,359.50 $2,719 12.8×
CT upper extremity w/o contrast rt (73200) $1,520 $3,040 14.3×
CT upper extremity with contrast (73201) $1,683 $3,366 4.7×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,370 $2,740 7.7×
Cta Abdomen (74175) $1,791.50 $3,583 10.1×
CTA abdomen pelvis (74174) $1,124 $2,248 3.2×
CTA chest (71275) $1,507.50 $3,015 8.5×
Cta Head (70496) $1,686 $3,372 9.5×
CTA lwr ext w&w/o contrast (73706) $1,370 $2,740 7.7×
Cta Neck (70498) $1,686 $3,372 9.5×
Cta Pelvis (72191) $1,237.50 $2,475 6.9×
Cystography minimum 3 views rs&i (74430) $280.50 $561 0.8×
Doppler Echo Fetal Spectral Display Complete (76827) $895 $1,790 8.4×
Dxa bone density study 1/> sites axial skel (77080) $280 $560 2.6×
Echo exam of fetal heart (76825) $1,740.50 $3,481 3.1×
Echoencephalography real time imaging (76506) $767 $1,534 7.2×
Esophagus (74220) $309 $618 1.7×
Fetal biophysical profile non-stress testing (76818) $606.50 $1,213 5.7×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $606.50 $1,213 5.7×
Fluoroscopy up to 1 hr (76000) $538.50 $1,077 2.2×
Foot 2 views (73620) $167 $334 1.9×
Forearm 2 views (73090) $360.50 $721 4.1×
Gated Heart Planar Single (78472) $562.50 $1,125 1.4×
Hand 2 views (73120) $151.50 $303 1.4×
Hand 3 views (73130) $360.50 $721 4.1×
Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) $3,220 $6,440 4.6×
Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) $3,839.50 $7,679 5.4×
Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) $4,124.50 $8,249 5.8×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $1,529 $3,058 2.8×
Hepatobiliary syst imaging including gallbladder (78226) $1,015.50 $2,031 2.5×
Ht muscle image spect sing (78451) $1,688.50 $3,377 1.3×
Humerus Min 2 Views Left (73060) $349.50 $699 4.0×
Hysterosalpingogram (74740) $291 $582 1.2×
Image fusion (77399) $485 $970 3.6×
Interstitial radiation source applic complex (77778) $3,867 $7,734 5.5×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $801 $1,602 1.5×
Kidney img morphology vascular flow 1 w/rx (78708) $840.50 $1,681 1.5×
Kidney Img Morphology Vascular Flow Multiple (78709) $1,238 $2,476 2.2×
Knee 3 views (73562) $195.50 $391 2.2×
Liver & Spleen Imaging W/Vascular Flow (78216) $474 $948 1.2×
Lymphoscintigraphy (78195) $284.50 $569 0.5×
Meckels Diverticulum (78290) $489 $978 1.2×
Mlc imrt design & construction per imrt plan (77338) $2,028.50 $4,057 5.3×
Mr safety determination physician/other qhp (76016) $164 $328 1.9×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $110.50 $221 1.8×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $45.50 $91 1.5×
Mr safety implt electronics prepj supvj phys/qhp (76018) $171 $342 1.8×
Mr safety med physics xm customization plng&mntr (76017) $450.50 $901 1.9×
MRA head w & w/o contrast (70546) $2,599 $5,198 7.3×
MRA head w/o contrast (70544) $1,212 $2,424 5.0×
MRA head with contrast (70545) $1,264.50 $2,529 3.6×
Mra Neck W/O &W/Contrast Material (70549) $2,117.50 $4,235 6.0×
MRA neck w/o contrast (70547) $1,087.50 $2,175 4.5×
MRI abdomen w/o & w/contrast material (74183) $5,149 $10,298 14.5×
MRI abdomen w/o contrast (74181) $5,137.50 $10,275 21.2×
MRI any jnt lwr ext with con lt (73722) $3,126 $6,252 3.9×
MRI any jt upper extremity w/contrast matrl (73222) $2,861 $5,722 3.6×
MRI breast w/o contrast unilat (77046) $439 $878 1.8×
MRI cervical spine w/o contrast (72141) $1,229 $2,458 5.1×
MRI chest w/o & w/contrast material (71552) $4,357.50 $8,715 12.3×
MRI chest w/o contrast (71550) $1,857.50 $3,715 7.7×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $3,382 $6,764 14.0×
MRI orbit face &/neck w/o contrast (70540) $1,686 $3,372 7.0×
MRI orbit/face/neck w&w/o cont (70543) $2,368 $4,736 6.7×
MRI pelvis w/o & w/contrast material (72197) $4,395.50 $8,791 12.4×
MRI pelvis w/o contrast (72195) $2,229 $4,458 9.2×
MRI scan of arm joint before and after contrast (73223) $4,384 $8,768 12.4×
MRI scan of leg joint before and after contrast (73723) $4,384 $8,768 12.4×
MRI spectroscopy (76390) $2,327 $4,654 26.3×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,409.50 $4,819 6.8×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $4,455.50 $8,911 12.6×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $4,455.50 $8,911 12.6×
MRI thoracic spine w/o contrast (72146) $2,768 $5,536 11.4×
MRI tmj (70336) $1,880.50 $3,761 7.8×
MRI upper ext joint w/o contrast (73221) $3,433.50 $6,867 14.2×
MRI upper extrem other than jt w/o & w/contras (73220) $4,910 $9,820 13.9×
MRI upper extremity oth than jt w/o contr matrl (73218) $2,216.50 $4,433 9.1×
Myocardial Spect Multiple Studies (78452) $3,318 $6,636 2.5×
N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) $3,193.50 $6,387 3.7×
Neck soft tissue (70360) $151 $302 1.7×
Nm adrenal scan (78075) $1,005 $2,010 0.8×
Nm gastric emptying study (78264) $1,427 $2,854 3.5×
Ntsty modul radthx pln dose-vol histos (77301) $6,218.50 $12,437 4.4×
Nuclear Rx Oral Admin (79005) $1,246.50 $2,493 5.3×
Osseous survey infant (77076) $336 $672 3.2×
Parathyrd planar w/spect&CT (78072) $768 $1,536 1.4×
Parathyrd planar w/wo subtrj (78071) $1,597.50 $3,195 3.9×
Parathyroid imaging (78070) $768 $1,536 1.9×
Pelvis 1 or 2 views (72170) $392.50 $785 3.7×
PET image w/CT, skull-thigh (78815) $4,128.50 $8,257 2.8×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $4,526 $9,052 12.8×
Pulmonary Perfusion Imaging Particulate (78580) $724.50 $1,449 1.8×
Pulmonary Ventilation & Perfusion Imaging (78582) $1,165.50 $2,331 2.1×
Radex abscess/fistula/sinus tract rs&i (76080) $345.50 $691 0.6×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $312 $624 3.5×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $438.50 $877 4.1×
Radex hips bilateral with pelvis 2 views (73521) $332 $664 3.1×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $581.50 $1,163 5.5×
Radiation Delivery Stereotactic Cranial Linear (77372) $15,490 $30,980 2.1×
Radiation treatment delivery 1 mev >= complex (77412) $880 $1,760 1.6×
Radiation treatment delivery 1 mev >= simple (77402) $519.50 $1,039 5.0×
Radiation tx delivery 1 mev >= intermediate (77407) $645 $1,290 1.6×
Radiolog exam mandible compl minimum 4 views (70110) $261.50 $523 2.5×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $387.50 $775 4.4×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $513.50 $1,027 4.8×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $608.50 $1,217 6.9×
Radiologic exam colon single contrast study (74270) $720.50 $1,441 4.0×
Radiologic exam upr gi trc double contrast study (74246) $881.50 $1,763 4.9×
Radiologic exam upr gi trc single contrast study (74240) $786.50 $1,573 4.4×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $240 $480 2.7×
Radiological examination surgical specimen (76098) $111 $222 0.2×
Review by radiologist of liver vein image with assessment of blood flow (75889) $3,585 $7,170 1.1×
Ribs bilateral 3 views (71110) $327 $654 3.1×
Rp loclzj tum plnr whole body single day imaging (78802) $1,016.50 $2,033 1.8×
Rp loclzj tum spect 1 area single day imaging (78803) $1,081.50 $2,163 2.0×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $1,038.50 $2,077 0.8×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $3,441 $6,882 2.4×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $1,961.50 $3,923 1.5×
Rp Therapy Intravenous Administration (79101) $885 $1,770 3.7×
Sacroiliac Joints < 3 Views (72200) $185.50 $371 1.7×
Scanogram (77073) $288.50 $577 2.7×
Scapula complete (73010) $176 $352 1.7×
Screening digital breast tomosynthesis (77063) $66.50 $133 2.8×
Small bowel series (74250) $408.50 $817 2.3×
Spec medical radj physics consltj (77370) $859 $1,718 6.3×
Spec telethx port pln parts hemibdy tot bdy (77321) $1,207.50 $2,415 3.2×
Special dosimetry (77331) $464.50 $929 3.4×
Special treatment procedure (77470) $2,111 $4,222 3.8×
Spine thoracic 3 views (72072) $365 $730 3.4×
Stereotactic body radiation delivery (77373) $7,025.50 $14,051 3.9×
Telethx isodose pln cplx w/basic dosimetry (77307) $1,686.50 $3,373 4.4×
Telethx isodose pln smpl w/dosimetry calculation (77306) $921 $1,842 2.4×
Ther rad simulaj-aided field setting complex (77290) $1,839.50 $3,679 4.8×
Ther rad simulaj-aided field setting simple (77280) $881.50 $1,763 6.5×
Thoracolumbar 2 views (72080) $350.50 $701 4.0×
Thyroid carcinoma metastases img whole body (78018) $1,040 $2,080 1.9×
Thyroid Imaging With Vascular Flow (78013) $355 $710 0.9×
Thyroid uptake measurement (78012) $265 $530 0.7×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $252.50 $505 0.6×
Tmj unilateral (70328) $179.50 $359 2.0×
Treatment device intermediate (77333) $852 $1,704 6.2×
Treatment devices simple (77332) $560.50 $1,121 4.1×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $1,389 $2,778 2.5×
Tx devices design & construction complex (77334) $1,144.50 $2,289 3.0×
Ultrasound, abdomen limited (76705) $1,178.50 $2,357 11.1×
Unlisted Ultrasound Procedure (76999) $441.50 $883 5.0×
Upper Extremity Infant (73092) $76.50 $153 0.7×
Urethrocystography retrograde rs&i (74450) $798.50 $1,597 3.3×
Urethrocystography voiding (74455) $255 $510 1.1×
Us abdl aorta screen aaa (76706) $271 $542 2.6×
Us breast unilateral complete (76641) $744 $1,488 7.0×
Us breast unilateral limited (76642) $744 $1,488 8.4×
Us chest (76604) $558 $1,116 5.3×
Us compl joint r-t w/image documentation (76881) $618 $1,236 5.8×
Us guided compression repair (76936) $1,475.50 $2,951 6.7×
Us infant hips dynamic (76885) $281 $562 3.2×
Us kidney transplant (76776) $438.50 $877 4.1×
Us ob transvaginal (76817) $471.50 $943 4.4×
Us pelvic non ob complete (76856) $841 $1,682 7.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $521 $1,042 4.9×
Us pregnancy ltd (76815) $618 $1,236 5.8×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $841 $1,682 7.9×
Us retroperitoneal complete (76770) $1,089.50 $2,179 10.3×
Us retroperitoneal limited (76775) $1,035.50 $2,071 9.8×
Us scrotum and contents (76870) $1,327 $2,654 12.5×
Us soft tissue head/neck (76536) $789.50 $1,579 7.4×
Us spinal canal and contents (76800) $491 $982 4.6×
Us transrectal prostate volume (76873) $449.50 $899 4.2×
Us xtr non-vasc lmtd (76882) $594.50 $1,189 5.6×
Us, eye b-scan (76512) $318.50 $637 3.0×
Venography extremity unilateral rs&i (75820) $495 $990 0.3×
Wrist 2 views (73100) $151.50 $303 1.7×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $549.50 $1,099 5.2×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $291 $582 3.3×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $371.50 $743 4.2×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $825.50 $1,651 4.6×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $166.50 $333 1.9×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $362.50 $725 4.1×
X-ray exam hip uni 1 view (73501) $232.50 $465 2.6×
X-Ray Exam Hip Uni 2-3 Views (73502) $282 $564 3.2×
X-ray exam hip uni 4/> views (73503) $332 $664 3.1×
X-Ray Exam Hips Bi 3-4 Views (73522) $396 $792 3.7×
X-Ray Exam Hips Bi 5/> Views (73523) $556 $1,112 5.2×
X-ray exam of femur 1 (73551) $140 $280 1.6×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $247 $494 2.3×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $202 $404 2.3×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $412 $824 4.7×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $218.50 $437 2.5×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $199 $398 2.3×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $427 $854 4.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $213.50 $427 2.4×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $76.50 $153 0.9×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $412 $824 3.9×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $730 $1,460 6.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $399 $798 3.8×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $235.50 $471 2.7×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $273.50 $547 3.1×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $339 $678 3.2×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $412 $824 3.9×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $252.50 $505 2.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $365 $730 3.4×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $432 $864 4.1×
X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) $185.50 $371 1.7×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $371.50 $743 4.2×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $391 $782 4.4×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $354.50 $709 4.0×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $144 $288 1.6×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $436.50 $873 4.1×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $284 $568 2.7×
X-Ray Spine One View - Xr Spine (72020) $144 $288 1.6×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $194.50 $389 2.2×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $185.50 $371 2.1×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $192 $384 1.8×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $449.50 $899 4.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $162 $324 1.8×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $376 $752 4.3×
Xr c-spine 6 or more views (72052) $453.50 $907 4.3×
Xr chest 4+ views (71048) $308.50 $617 2.9×
Xr finger(s) 2+ views (73140) $254.50 $509 2.9×
Xr shoulder 1 view (73020) $121 $242 1.4×
Xr spine cervical 4 or 5 views (72050) $583.50 $1,167 5.5×
Xr tibia/fibula 2 views (73590) $360.50 $721 4.1×
Xr tmj bilateral (70330) $212 $424 2.4×
Xray knee 1 or 2 views rt (73560) $192 $384 2.2×