| Abdomen 2 views (74019) |
$60 |
$200 |
0.6× |
| Acute venous thrombus image (78456) |
$756.30 |
$2,521 |
0.6× |
| Angiography extremity bilateral rs&i (75716) |
$2,017.95 |
$6,726.50 |
0.7× |
| Angiography extremity unilateral rs&i (75710) |
$3,690.04 |
$12,300.16 |
1.2× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,000 |
$10,000 |
0.6× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$19,117.95 |
$63,726.50 |
6.4× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,017.95 |
$6,726.50 |
0.7× |
| Ankle 2 views (73600) |
$69.60 |
$232 |
0.9× |
| Aortogram thoracic (75605) |
$3,000 |
$10,000 |
0.6× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$2,017.95 |
$6,726.50 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,017.95 |
$6,726.50 |
0.7× |
| Arthrogram elbow (73085) |
$303.90 |
$1,013 |
0.9× |
| Arthrogram hip (73525) |
$180 |
$600 |
0.5× |
| Arthrogram shoulder (73040) |
$309 |
$1,030 |
0.9× |
| Arthrogram wrist (73115) |
$303.90 |
$1,013 |
0.9× |
| Arthrography knee lt (73580) |
$303.90 |
$1,013 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$221.55 |
$738.50 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$710.85 |
$2,369.50 |
1.9× |
| Bone age studies (77072) |
$79.80 |
$266 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$710.85 |
$2,369.50 |
1.9× |
| Bone survey complete (77075) |
$248.10 |
$827 |
2.5× |
| Brain image w/flow 4 + views (78606) |
$287.55 |
$958.50 |
0.6× |
| Brain imaging < 4 static views w vascular flow (78601) |
$221.55 |
$738.50 |
0.6× |
| Brain Imaging Minimum 4 Static Views (78605) |
$287.55 |
$958.50 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$287.55 |
$958.50 |
0.6× |
| Cervical spine 2 or 3 views (72040) |
$152.40 |
$508 |
1.9× |
| Chest 1 view (71045) |
$30.90 |
$103 |
0.4× |
| Chest 3 views (71047) |
$130.20 |
$434 |
1.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$245.55 |
$818.50 |
1.5× |
| Clavicle complete (73000) |
$113.40 |
$378 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$115.50 |
$385 |
1.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,633.50 |
$5,445 |
5.0× |
| CT abdomen and pelvis without contrast (74176) |
$1,534.05 |
$5,113.50 |
6.8× |
| CT abdomen w contrast (74160) |
$883.35 |
$2,944.50 |
5.4× |
| CT abdomen w wo contrast (74170) |
$1,339.50 |
$4,465 |
8.1× |
| CT abdomen w/o contrast (74150) |
$905.10 |
$3,017 |
9.2× |
| CT angiography upper extremity lt (73206) |
$571.50 |
$1,905 |
3.5× |
| CT c-spine w/o contrast (72125) |
$799.65 |
$2,665.50 |
8.1× |
| CT cervical spine w&w/o contrast (72127) |
$777.30 |
$2,591 |
4.7× |
| CT cervical spine with contrast (72126) |
$825 |
$2,750 |
2.5× |
| CT chest w/wo contrast (71270) |
$1,313.25 |
$4,377.50 |
8.0× |
| CT chest with contrast (71260) |
$966.45 |
$3,221.50 |
5.9× |
| CT head/brain with contrast (70460) |
$789.15 |
$2,630.50 |
4.8× |
| CT head/brain without and with contrast (70470) |
$1,224.90 |
$4,083 |
7.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$19.50 |
$65 |
0.2× |
| CT iac w contrast (70481) |
$825 |
$2,750 |
5.0× |
| CT lower ext w/o (73700) |
$727.35 |
$2,424.50 |
7.4× |
| CT lower extremity w wo contrast (73702) |
$878.40 |
$2,928 |
5.3× |
| CT lower extremity with contrast (73701) |
$825 |
$2,750 |
5.0× |
| CT lumbar spine w & w/o contrast (72133) |
$891 |
$2,970 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$946.80 |
$3,156 |
9.6× |
| CT lumbar spine with contrast (72132) |
$825 |
$2,750 |
2.5× |
| CT maxillofacial w contrast (70487) |
$884.70 |
$2,949 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$737.40 |
$2,458 |
7.5× |
| CT maxillofacial w/wo contrast (70488) |
$958.65 |
$3,195.50 |
5.8× |
| CT neck soft tissue w contrast (70491) |
$701.25 |
$2,337.50 |
4.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$899.25 |
$2,997.50 |
5.5× |
| CT orbits w/o contrast (70480) |
$827.25 |
$2,757.50 |
8.4× |
| CT pelvis w & w/o contrast (72194) |
$1,343.55 |
$4,478.50 |
8.1× |
| CT pelvis w/o contrast (72192) |
$983.85 |
$3,279.50 |
10.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,070.10 |
$3,567 |
6.5× |
| CT soft tissue neck w/o contrast (70490) |
$693 |
$2,310 |
7.0× |
| CT thoracic spine w/contrast (72129) |
$825 |
$2,750 |
5.0× |
| CT thoracic spine w/o contrast (72128) |
$854.25 |
$2,847.50 |
8.7× |
| CT thoracic spine w/wo contrast (72130) |
$891 |
$2,970 |
5.4× |
| CT thorax w/o contrast (71250) |
$920.10 |
$3,067 |
9.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,125.90 |
$3,753 |
6.8× |
| CT upper extremity w/o contrast rt (73200) |
$800.40 |
$2,668 |
8.1× |
| CT upper extremity with contrast (73201) |
$825 |
$2,750 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$812.25 |
$2,707.50 |
4.9× |
| Cta Abdomen (74175) |
$622.35 |
$2,074.50 |
3.8× |
| CTA abdomen pelvis (74174) |
$1,244.10 |
$4,147 |
3.8× |
| CTA chest (71275) |
$1,313.70 |
$4,379 |
8.0× |
| Cta Head (70496) |
$571.50 |
$1,905 |
3.5× |
| CTA lwr ext w&w/o contrast (73706) |
$571.50 |
$1,905 |
3.5× |
| Cta Neck (70498) |
$571.50 |
$1,905 |
3.5× |
| Cta Pelvis (72191) |
$622.35 |
$2,074.50 |
3.8× |
| Cystography minimum 3 views rs&i (74430) |
$150 |
$500 |
0.5× |
| Dxa bone density study 1/> sites axial skel (77080) |
$190.35 |
$634.50 |
1.9× |
| Esophagus (74220) |
$185.70 |
$619 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$120 |
$400 |
0.5× |
| Foot 2 views (73620) |
$76.35 |
$254.50 |
0.9× |
| Forearm 2 views (73090) |
$105.75 |
$352.50 |
1.3× |
| Hand 2 views (73120) |
$84.15 |
$280.50 |
0.9× |
| Hand 3 views (73130) |
$105.90 |
$353 |
1.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$287.55 |
$958.50 |
0.6× |
| Ht muscle image spect sing (78451) |
$646.50 |
$2,155 |
0.5× |
| Humerus Min 2 Views Left (73060) |
$107.55 |
$358.50 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$287.55 |
$958.50 |
0.6× |
| Knee 3 views (73562) |
$74.25 |
$247.50 |
0.9× |
| Liver & spleen imaging static only (78215) |
$221.55 |
$738.50 |
0.6× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$221.55 |
$738.50 |
0.6× |
| MRA head w & w/o contrast (70546) |
$956.25 |
$3,187.50 |
2.9× |
| MRA head w/o contrast (70544) |
$688.24 |
$2,294.16 |
3.1× |
| MRA head with contrast (70545) |
$956.25 |
$3,187.50 |
2.9× |
| MRA neck w contrast (70548) |
$956.25 |
$3,187.50 |
2.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$956.25 |
$3,187.50 |
2.9× |
| MRA neck w/o contrast (70547) |
$717.30 |
$2,391 |
3.2× |
| MRI abdomen w contrast (74182) |
$693 |
$2,310 |
2.1× |
| MRI abdomen w/o & w/contrast material (74183) |
$998.25 |
$3,327.50 |
3.0× |
| MRI abdomen w/o contrast (74181) |
$777.30 |
$2,591 |
3.5× |
| MRI any jnt lwr ext with con lt (73722) |
$693 |
$2,310 |
0.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$693 |
$2,310 |
0.9× |
| MRI c-spine with contrast (72142) |
$693 |
$2,310 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$777.30 |
$2,591 |
3.5× |
| MRI chest w/o & w/contrast material (71552) |
$998.25 |
$3,327.50 |
3.0× |
| MRI chest w/o contrast (71550) |
$777.30 |
$2,591 |
3.5× |
| MRI chest with contrast (71551) |
$693 |
$2,310 |
0.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$693 |
$2,310 |
2.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$693 |
$2,310 |
2.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$729.60 |
$2,432 |
3.3× |
| MRI orbit face &/neck w/o contrast (70540) |
$777.30 |
$2,591 |
3.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$998.25 |
$3,327.50 |
3.0× |
| MRI orbit/face/neck w/contrast (70542) |
$693 |
$2,310 |
2.1× |
| MRI pelvis w contrast (72196) |
$693 |
$2,310 |
2.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$998.25 |
$3,327.50 |
3.0× |
| MRI pelvis w/o contrast (72195) |
$777.15 |
$2,590.50 |
3.5× |
| MRI scan of arm joint before and after contrast (73223) |
$772.20 |
$2,574 |
2.4× |
| MRI scan of leg joint before and after contrast (73723) |
$772.20 |
$2,574 |
2.4× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$998.25 |
$3,327.50 |
3.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$693 |
$2,310 |
2.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$998.25 |
$3,327.50 |
3.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$693 |
$2,310 |
2.1× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$998.25 |
$3,327.50 |
3.0× |
| MRI thoracic spine w/o contrast (72146) |
$777.30 |
$2,591 |
3.5× |
| MRI tmj (70336) |
$777.30 |
$2,591 |
3.5× |
| MRI upper ext joint w/o contrast (73221) |
$536.25 |
$1,787.50 |
2.4× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$772.20 |
$2,574 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$536.25 |
$1,787.50 |
2.4× |
| Myocardial Spect Multiple Studies (78452) |
$646.50 |
$2,155 |
0.5× |
| Neck soft tissue (70360) |
$120.60 |
$402 |
1.5× |
| Nm gastric emptying study (78264) |
$221.55 |
$738.50 |
0.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$723.29 |
$2,410.98 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$221.55 |
$738.50 |
0.6× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$287.55 |
$958.50 |
0.6× |
| Osseous survey infant (77076) |
$189 |
$630 |
1.9× |
| Parathyroid imaging (78070) |
$646.50 |
$2,155 |
1.7× |
| Pelvis 1 or 2 views (72170) |
$111.90 |
$373 |
1.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$772.20 |
$2,574 |
2.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$221.55 |
$738.50 |
0.6× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$287.55 |
$958.50 |
0.6× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$182.10 |
$607 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$118.95 |
$396.50 |
1.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$152.25 |
$507.50 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$37.80 |
$126 |
0.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$119.85 |
$399.50 |
1.2× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$83.70 |
$279 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$243.60 |
$812 |
1.5× |
| Radiologic exam upr gi trc double contrast study (74246) |
$236.25 |
$787.50 |
1.4× |
| Radiologic exam upr gi trc single contrast study (74240) |
$296.10 |
$987 |
1.8× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$120.75 |
$402.50 |
1.5× |
| Radiological examination surgical specimen (76098) |
$240 |
$800 |
0.5× |
| Ribs bilateral 3 views (71110) |
$151.20 |
$504 |
1.5× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$756.30 |
$2,521 |
1.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$756.30 |
$2,521 |
1.5× |
| Sacroiliac Joints < 3 Views (72200) |
$107.70 |
$359 |
1.1× |
| Scanogram (77073) |
$424.50 |
$1,415 |
4.3× |
| Scapula complete (73010) |
$102.45 |
$341.50 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$123.75 |
$412.50 |
5.3× |
| Sella turcica (70240) |
$124.65 |
$415.50 |
1.5× |
| Small bowel series (74250) |
$217.50 |
$725 |
1.3× |
| Spine thoracic 3 views (72072) |
$182.25 |
$607.50 |
1.9× |
| Splenoportograpy rs&i (75810) |
$2,222.55 |
$7,408.50 |
0.7× |
| Testicular Imaging With Vascular Flow (78761) |
$221.55 |
$738.50 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$221.55 |
$738.50 |
0.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$756.30 |
$2,521 |
1.5× |
| Ultrasound, abdomen limited (76705) |
$197.55 |
$658.50 |
2.0× |
| Upper Extremity Infant (73092) |
$107.85 |
$359.50 |
1.1× |
| Ureteral Reflux Study Rp Voiding Cystogram (78740) |
$221.55 |
$738.50 |
0.6× |
| Urethrocystography voiding (74455) |
$257.85 |
$859.50 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$300.60 |
$1,002 |
1.8× |
| Us breast unilateral complete (76641) |
$128.10 |
$427 |
1.3× |
| Us breast unilateral limited (76642) |
$95.10 |
$317 |
1.2× |
| Us ob transvaginal (76817) |
$287.70 |
$959 |
2.9× |
| Us pelvic non ob complete (76856) |
$256.05 |
$853.50 |
2.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$178.05 |
$593.50 |
1.8× |
| Us pregnancy ltd (76815) |
$287.70 |
$959 |
2.9× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$287.70 |
$959 |
2.9× |
| Us retroperitoneal complete (76770) |
$197.55 |
$658.50 |
2.0× |
| Us retroperitoneal limited (76775) |
$232.80 |
$776 |
2.4× |
| Us scrotum and contents (76870) |
$234.90 |
$783 |
2.4× |
| Us soft tissue head/neck (76536) |
$276.60 |
$922 |
2.8× |
| Us transrectal (76872) |
$277.50 |
$925 |
2.8× |
| Us xtr non-vasc lmtd (76882) |
$219 |
$730 |
2.2× |
| Vascular flow imaging (78445) |
$221.55 |
$738.50 |
0.6× |
| Venogram extremity bilateral (75822) |
$840 |
$2,800 |
0.6× |
| Venography caval inferior serialography rs&i (75825) |
$2,134.95 |
$7,116.50 |
0.7× |
| Venography caval superior serialography rs&i (75827) |
$540 |
$1,800 |
0.4× |
| Venography extremity unilateral rs&i (75820) |
$480 |
$1,600 |
0.3× |
| Wrist 2 views (73100) |
$84.15 |
$280.50 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$83.55 |
$278.50 |
0.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$165.45 |
$551.50 |
2.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$113.25 |
$377.50 |
1.4× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$481.95 |
$1,606.50 |
2.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$100.20 |
$334 |
1.2× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$129 |
$430 |
1.6× |
| X-ray exam hip uni 1 view (73501) |
$57.75 |
$192.50 |
0.7× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$66 |
$220 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$196.05 |
$653.50 |
2.0× |
| X-ray exam of femur 1 (73551) |
$241.50 |
$805 |
3.0× |
| X-ray eye for foreign body (70030) |
$49.50 |
$165 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$162.75 |
$542.50 |
1.7× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$129 |
$430 |
1.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$111.90 |
$373 |
1.4× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$100.50 |
$335 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$82.50 |
$275 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$82.50 |
$275 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$107.85 |
$359.50 |
1.3× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$129 |
$430 |
1.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$214.95 |
$716.50 |
2.2× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$92.55 |
$308.50 |
0.9× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$116.10 |
$387 |
1.4× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$37.80 |
$126 |
0.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$144 |
$480 |
1.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$129 |
$430 |
1.3× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$316.95 |
$1,056.50 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$136.20 |
$454 |
1.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$153.90 |
$513 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$131.10 |
$437 |
1.6× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$141.75 |
$472.50 |
1.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$167.55 |
$558.50 |
2.0× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$93.45 |
$311.50 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$186.15 |
$620.50 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$92.55 |
$308.50 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$98.85 |
$329.50 |
1.2× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$131.40 |
$438 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$168.45 |
$561.50 |
1.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$89.70 |
$299 |
1.1× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$93.45 |
$311.50 |
1.1× |
| Xr arthrogram ankle (73615) |
$303.90 |
$1,013 |
0.9× |
| Xr c-spine 6 or more views (72052) |
$258 |
$860 |
2.6× |
| Xr finger(s) 2+ views (73140) |
$92.55 |
$308.50 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$128.40 |
$428 |
1.3× |
| Xr optic foramina (70190) |
$55.20 |
$184 |
0.7× |
| Xr shoulder 1 view (73020) |
$92.55 |
$308.50 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$201.60 |
$672 |
2.1× |
| Xr tibia/fibula 2 views (73590) |
$107.85 |
$359.50 |
1.3× |
| Xr tmj bilateral (70330) |
$192.45 |
$641.50 |
2.4× |
| Xray knee 1 or 2 views rt (73560) |
$86.32 |
$287.75 |
1.1× |