| Acute gi blood loss imaging (78278) |
$804 |
$1,072 |
2.0× |
| Ankle 2 views (73600) |
$149.62 |
$199.50 |
1.7× |
| Clavicle complete (73000) |
$195.75 |
$261 |
2.2× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,233.75 |
$1,645 |
6.9× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,788.75 |
$2,385 |
10.0× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,380.38 |
$1,840.50 |
7.7× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,324.25 |
$3,099 |
13.0× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,288.88 |
$1,718.50 |
7.2× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,333.50 |
$1,778 |
7.4× |
| Computed tomography, bone mineral density study, 1 or more sites, axial skeleton (eg, hips, pelvis, spine) Age Under 21 (77078) |
$310.88 |
$414.50 |
3.5× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,723.12 |
$2,297.50 |
9.6× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$296.25 |
$395 |
2.8× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$413.25 |
$551 |
2.3× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$419.25 |
$559 |
2.3× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,281.38 |
$1,708.50 |
7.2× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,006.50 |
$1,342 |
9.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,600.12 |
$2,133.50 |
8.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,540.12 |
$2,053.50 |
14.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$2,271.38 |
$3,028.50 |
12.7× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,531.50 |
$2,042 |
8.5× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,458.75 |
$1,945 |
8.1× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,046.62 |
$1,395.50 |
5.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$733.50 |
$978 |
2.1× |
| CT abdomen and pelvis without contrast (74176) |
$419.25 |
$559 |
1.7× |
| CT abdomen w & w/o contrast (74170) |
$1,347.38 |
$1,796.50 |
7.5× |
| CT abdomen w/contrast (74160) |
$1,174.50 |
$1,566 |
6.6× |
| CT abdomen w/o contrast (74150) |
$945 |
$1,260 |
8.8× |
| CT cervical spine w/contrast (72126) |
$1,534.12 |
$2,045.50 |
4.3× |
| CT cervical spine w/o contrast (72125) |
$1,172.25 |
$1,563 |
11.0× |
| CT chest w/contrast (71260) |
$913.88 |
$1,218.50 |
5.1× |
| CT extremity upper w & w/o contrast (73202) |
$1,056 |
$1,408 |
5.9× |
| CT extremity upper w/o contrast (73200) |
$868.88 |
$1,158.50 |
8.1× |
| CT head/brain with contrast (70460) |
$881.62 |
$1,175.50 |
4.9× |
| CT head/brain without and with contrast (70470) |
$1,139.62 |
$1,519.50 |
6.4× |
| CT l-spine w/contrast (72132) |
$357 |
$476 |
1.0× |
| CT limited/localized follow up study (76380) |
$358.88 |
$478.50 |
4.0× |
| CT lower extremity w/dye (73701) |
$1,387.12 |
$1,849.50 |
7.7× |
| CT lumbar spine w/o contrast (72131) |
$311.25 |
$415 |
2.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,500.75 |
$2,001 |
8.4× |
| CT neck w/contrast (70491) |
$1,277.62 |
$1,703.50 |
7.1× |
| CT neck w/o contrast (70490) |
$1,281.75 |
$1,709 |
12.0× |
| CT pelvis w & w/o contrast (72194) |
$1,126.12 |
$1,501.50 |
6.3× |
| CT pelvis w/o contrast (72192) |
$924.38 |
$1,232.50 |
8.7× |
| CT thoracic spine w/contrast (72129) |
$359.25 |
$479 |
2.0× |
| CT thoracic spine w/o contrast (72128) |
$1,137.75 |
$1,517 |
10.7× |
| CT thorax lung cancer scr c- (71271) |
$331.88 |
$442.50 |
3.1× |
| CT thorax w/o contrast (71250) |
$765.38 |
$1,020.50 |
7.2× |
| CT upper extremity w/dye (73201) |
$1,002 |
$1,336 |
2.8× |
| CTA head w contrast (70496) |
$881.25 |
$1,175 |
4.9× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$246.38 |
$328.50 |
0.7× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$234.75 |
$313 |
2.2× |
| Fetal biophys profile w/o nst (76819) |
$347.25 |
$463 |
3.3× |
| Fetal biophysical profile non-stress testing (76818) |
$471 |
$628 |
4.4× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$304.12 |
$405.50 |
1.2× |
| Gated heart planar single (78472) |
$1,000.12 |
$1,333.50 |
2.4× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,093.12 |
$1,457.50 |
2.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$856.12 |
$1,141.50 |
2.1× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$819.38 |
$1,092.50 |
2.0× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,060.88 |
$1,414.50 |
1.9× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$605.62 |
$807.50 |
1.1× |
| Lung perfusion imaging (78580) |
$605.62 |
$807.50 |
1.5× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,594.12 |
$2,125.50 |
4.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,248 |
$1,664 |
3.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,028.62 |
$1,371.50 |
4.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,476.38 |
$1,968.50 |
4.1× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,039.12 |
$1,385.50 |
2.9× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,530.38 |
$2,040.50 |
6.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$985.50 |
$1,314 |
2.8× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$2,711.25 |
$3,615 |
7.6× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,874.25 |
$2,499 |
5.3× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,653.38 |
$2,204.50 |
4.6× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,715.62 |
$2,287.50 |
4.8× |
| Mandible min 4v (70110) |
$269.62 |
$359.50 |
2.5× |
| MRA head w/o contrast (70544) |
$1,554 |
$2,072 |
6.4× |
| MRA neck w/ contrast (70548) |
$940.88 |
$1,254.50 |
2.6× |
| MRA neck w/o contrast (70547) |
$1,518 |
$2,024 |
6.2× |
| MRI abdomen w/contrast (74182) |
$1,173.38 |
$1,564.50 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$1,114.50 |
$1,486 |
4.6× |
| MRI abdomen w/wo contrast (74183) |
$1,588.50 |
$2,118 |
4.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,379.62 |
$1,839.50 |
1.7× |
| MRI c-spine w&w/o cont (72156) |
$1,629.38 |
$2,172.50 |
4.6× |
| MRI cervical spine w/contrast (72142) |
$1,126.50 |
$1,502 |
3.2× |
| MRI chest w/contrast (71551) |
$1,152 |
$1,536 |
1.4× |
| MRI chest w/o contrast (71550) |
$1,764 |
$2,352 |
7.2× |
| MRI chest w/wo contrast (71552) |
$2,391.38 |
$3,188.50 |
6.7× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,734 |
$2,312 |
4.9× |
| MRI joint upr extrem w/dye (73222) |
$1,394.25 |
$1,859 |
1.7× |
| MRI joint upr extrem w/o dye (73221) |
$1,128.38 |
$1,504.50 |
4.6× |
| MRI lumbar spine w/contrast (72149) |
$1,458 |
$1,944 |
4.1× |
| MRI lumbar spine w/wo contrast (72158) |
$1,616.62 |
$2,155.50 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,801.12 |
$2,401.50 |
5.1× |
| MRI pelvis w & w/o contrast (72197) |
$2,103 |
$2,804 |
5.9× |
| MRI pelvis w/contrast (72196) |
$1,035.75 |
$1,381 |
2.9× |
| MRI pelvis w/o contrast (72195) |
$1,514.62 |
$2,019.50 |
6.2× |
| MRI spine cervical w/o contrast (72141) |
$1,341.75 |
$1,789 |
5.5× |
| MRI t-spine w&w/o cont (72157) |
$1,599.38 |
$2,132.50 |
4.5× |
| MRI thoracic spine w/contrast (72147) |
$1,117.50 |
$1,490 |
3.1× |
| MRI thoracic spine w/o contrst (72146) |
$1,310.25 |
$1,747 |
5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,296.75 |
$1,729 |
5.3× |
| Myocardial spect multiple studies (78452) |
$1,376.25 |
$1,835 |
1.0× |
| Nm bone 3 phase (78315) |
$1,054.50 |
$1,406 |
2.6× |
| Nm bone imaging whole body (78306) |
$942 |
$1,256 |
2.3× |
| Nm gastric emptying (78264) |
$796.12 |
$1,061.50 |
1.9× |
| Nm lung ventilation imaging (78579) |
$502.88 |
$670.50 |
1.2× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$688.12 |
$917.50 |
1.7× |
| Ob us limited fetus(s) (76815) |
$288.38 |
$384.50 |
2.7× |
| Parathyroid planar imaging (78070) |
$696.38 |
$928.50 |
1.7× |
| Pulmonary ventilation & perfusion imaging (78582) |
$874.12 |
$1,165.50 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$272.25 |
$363 |
2.5× |
| Radex hip unilateral with pelvis 1 view (73501) |
$128.62 |
$171.50 |
1.4× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$151.50 |
$202 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$216 |
$288 |
2.0× |
| Radex spine cervical 2 or 3 views (72040) |
$199.12 |
$265.50 |
2.2× |
| Radex spine cervical 4 or 5 views (72050) |
$334.50 |
$446 |
3.1× |
| Radex spine cervical 6 or more views (72052) |
$437.25 |
$583 |
4.1× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$246.38 |
$328.50 |
2.8× |
| Radiologic exam colon double contrast study (74280) |
$603.38 |
$804.50 |
3.4× |
| Radiologic exam colon single contrast study (74270) |
$441.75 |
$589 |
2.5× |
| Radiologic exam esophagus single contrast study (74220) |
$333.38 |
$444.50 |
1.9× |
| Radiologic exam small int single contrast study (74250) |
$399.75 |
$533 |
2.2× |
| Radiologic exam swallow function contrast study (74230) |
$312.38 |
$416.50 |
1.7× |
| Radiologic exam upr gi trc double contrast study (74246) |
$570 |
$760 |
3.2× |
| Radiologic exam upr gi trc single contrast study (74240) |
$536.25 |
$715 |
3.0× |
| Radiologic examination femur minimum 2 views (73552) |
$167.25 |
$223 |
1.9× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$118.50 |
$158 |
1.3× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$170.25 |
$227 |
1.9× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$237.75 |
$317 |
2.2× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$133.12 |
$177.50 |
1.5× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$178.50 |
$238 |
2.0× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$229.50 |
$306 |
2.6× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$157.50 |
$210 |
1.8× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$168.38 |
$224.50 |
1.9× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$194.25 |
$259 |
2.2× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$189.75 |
$253 |
1.8× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$221.62 |
$295.50 |
2.5× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$192.38 |
$256.50 |
2.2× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$255 |
$340 |
2.4× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$201.75 |
$269 |
1.9× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$169.12 |
$225.50 |
1.6× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$413.62 |
$551.50 |
1.2× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$162 |
$216 |
1.8× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$203.62 |
$271.50 |
2.3× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$205.50 |
$274 |
1.9× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$199.88 |
$266.50 |
1.9× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$203.25 |
$271 |
1.9× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$301.12 |
$401.50 |
2.8× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$159.75 |
$213 |
1.8× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$183.75 |
$245 |
2.1× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$149.25 |
$199 |
1.7× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$154.88 |
$206.50 |
1.7× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$208.50 |
$278 |
2.0× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$264.75 |
$353 |
3.0× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$183 |
$244 |
2.1× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$144.75 |
$193 |
1.4× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$437.62 |
$583.50 |
1.8× |
| Scapula complete (73010) |
$180.75 |
$241 |
1.7× |
| Screening digital breast tomosynthesis bi (77063) |
$20.25 |
$27 |
— |
| Thyroid imaging with vascular flow (78013) |
$541.88 |
$722.50 |
1.3× |
| Thyroid uptake single/multiple quant measurement (78012) |
$601.12 |
$801.50 |
1.5× |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$654.38 |
$872.50 |
1.6× |
| Ultrasound breast limited (76642) |
$262.50 |
$350 |
3.0× |
| Ultrasound, abdomen limited (76705) |
$357.38 |
$476.50 |
3.3× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$281.06 |
$374.75 |
2.6× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$466.88 |
$622.50 |
4.4× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$451.50 |
$602 |
1.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$174.75 |
$233 |
1.6× |
| Urea breath test, C-14 (isotopic); analysis Other Outpatient (78268) |
$2,049 |
$2,732 |
21.7× |
| Urethrocystography retrograde rs&i (74450) |
$392.25 |
$523 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$537.75 |
$717 |
3.0× |
| Urography antegrade rs&i (74425) |
$514.50 |
$686 |
1.4× |
| Us abdominal aorta real time screen study aaa (76706) |
$424.12 |
$565.50 |
4.0× |
| Us breast uni real time with image complete (76641) |
$246 |
$328 |
2.3× |
| Us chest (76604) |
$267.38 |
$356.50 |
2.5× |
| Us encephalogram (76506) |
$214.12 |
$285.50 |
2.0× |
| Us exam, pelvic, limited (76857) |
$295.88 |
$394.50 |
2.8× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$407.25 |
$543 |
4.6× |
| US OB Follow-Up/Repeat (76816) |
$323.25 |
$431 |
3.0× |
| Us ob transvaginal (76817) |
$398.25 |
$531 |
3.7× |
| Us retroperitoneal complete (76770) |
$451.12 |
$601.50 |
4.2× |
| Us retroperitoneal ltd (76775) |
$302.62 |
$403.50 |
2.8× |
| Us scrotum (76870) |
$369.75 |
$493 |
3.5× |
| Us soft tissue head/neck (76536) |
$411 |
$548 |
3.8× |
| Us spinal canal (76800) |
$407.25 |
$543 |
3.8× |
| X-ray exam of finger(s) (73140) |
$184.50 |
$246 |
2.1× |
| X-ray exam of knee 1 or 2 (73560) |
$155.25 |
$207 |
1.7× |
| X-ray exam ribs bil 3 views (71110) |
$256.88 |
$342.50 |
2.4× |
| X-ray exam ribs uni 2 views (71100) |
$164.25 |
$219 |
1.8× |
| X-ray heel (73650) |
$144.38 |
$192.50 |
1.6× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$193.50 |
$258 |
1.8× |
| X-ray retrograde pyelogram (74420) |
$441.38 |
$588.50 |
1.2× |
| Xr abdomen 1 view (74018) |
$150.38 |
$200.50 |
1.7× |
| Xr abdomen 2 views (74019) |
$185.62 |
$247.50 |
1.7× |
| Xr arthrogram ankle (73615) |
$503.25 |
$671 |
1.4× |
| Xr arthrogram elbow (73085) |
$337.50 |
$450 |
0.9× |
| Xr arthrogram hip (73525) |
$570 |
$760 |
1.6× |
| Xr arthrogram knee (73580) |
$637.50 |
$850 |
1.8× |
| Xr arthrogram wrist (73115) |
$696.75 |
$929 |
2.0× |
| Xr bone age studies (77072) |
$148.50 |
$198 |
1.4× |
| Xr bone length study (77073) |
$189.38 |
$252.50 |
1.8× |
| Xr bone survey infant (77076) |
$240.38 |
$320.50 |
2.3× |
| Xr bone survey ltd (77074) |
$212.62 |
$283.50 |
2.0× |
| Xr chest 1 view (71045) |
$127.50 |
$170 |
1.4× |
| Xr chest 2 views (71046) |
$158.62 |
$211.50 |
1.8× |
| Xr eye foreign body (70030) |
$156.75 |
$209 |
1.8× |
| Xr facial bones 3+ views (70150) |
$228.38 |
$304.50 |
2.1× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$168.75 |
$225 |
1.9× |
| Xr forearm 2 views (73090) |
$152.25 |
$203 |
1.7× |
| Xr hand 2v (73120) |
$149.62 |
$199.50 |
1.4× |
| Xr hysterosalpingogram (74740) |
$471 |
$628 |
1.9× |
| Xr neck soft tissue (70360) |
$143.62 |
$191.50 |
1.6× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$174 |
$232 |
2.0× |
| Xr osseous survey complete (77075) |
$372 |
$496 |
3.5× |
| Xr pelvis 1-2 views (72170) |
$183.75 |
$245 |
1.7× |
| Xr pelvis min 3 view (72190) |
$238.88 |
$318.50 |
2.2× |
| Xr sacrum/coccyx 2+ views (72220) |
$159.38 |
$212.50 |
1.8× |
| Xr shoulder 1 view (73020) |
$135.75 |
$181 |
1.5× |
| Xr sinuses 3+ views (70220) |
$225 |
$300 |
2.5× |
| Xr skull min 4 view (70260) |
$329.62 |
$439.50 |
3.1× |
| Xr spine 1 view (72020) |
$133.12 |
$177.50 |
1.5× |
| Xr spine thoracic 3v (72072) |
$281.62 |
$375.50 |
2.6× |
| Xr sternum 2+ views (71120) |
$255.75 |
$341 |
2.9× |
| Xr surgical specimen (76098) |
$250.12 |
$333.50 |
0.4× |
| Xr t-spine 2 views (72070) |
$211.50 |
$282 |
2.0× |
| Xr tibia/fibula 2 views (73590) |
$154.12 |
$205.50 |
1.7× |
| Xr wrist 2 views (73100) |
$136.12 |
$181.50 |
1.5× |