| Abdomen 1 View (74018) |
— |
$125 |
— |
| Abdomen 2 views (74019) |
— |
$230 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$575 |
— |
| Adrenal Cortex & Medulla Img (78075) |
— |
$1,203 |
— |
Ankle 2 views (73600)
range across 5 matching MRF lines |
— |
$66–$95 |
— |
Arthrogram ankle (73615)
range across 3 matching MRF lines |
— |
$457–$1,000 |
— |
Arthrogram hip (73525)
range across 3 matching MRF lines |
— |
$900–$1,350 |
— |
Arthrogram Wrist (73115)
range across 3 matching MRF lines |
— |
$900–$1,350 |
— |
Bone age studies (77072)
range across 3 matching MRF lines |
— |
$63–$225 |
— |
Bone Imaging 3 Phase (78315)
range across 2 matching MRF lines |
— |
$694–$1,130 |
— |
| Bone Imaging Limited Area (78300) |
— |
$350 |
— |
| Bone Imaging Multiple Areas (78305) |
— |
$425 |
— |
| Bone Imaging Whole Body (78306) |
— |
$780 |
— |
| Bone survey infant (77076) |
— |
$140 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$499 |
— |
| Brain Imaging Minimum 4 Static Views (78605) |
— |
$454 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$403 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$420 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$594 |
— |
| Chest 1 view (71045) |
— |
$165 |
— |
| Chest 2 views (71046) |
— |
$125 |
— |
| Chest 3 views (71047) |
— |
$125 |
— |
| Chest 4 or more views (71048) |
— |
$230 |
— |
| Cholecystography Oral Contrast (74290) |
— |
$253 |
— |
| Cisternography Positive Contrast Rs&I (70015) |
— |
$682 |
— |
Clavicle complete (73000)
range across 4 matching MRF lines |
— |
$66–$140 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$235 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$253 |
— |
Contrast X-Ray Of Elbow (73085)
range across 3 matching MRF lines |
— |
$575–$850 |
— |
Contrast X-Ray Of Knee Joint (73580)
range across 3 matching MRF lines |
— |
$900–$1,350 |
— |
| Corpora cavernosography (74445) |
— |
$225 |
— |
CT abdomen and pelvis without and with contrast (74178)
range across 3 matching MRF lines |
— |
$1,529–$1,804 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$1,226 |
— |
| CT abdomen w contrast (74160) |
— |
$761 |
— |
| CT abdomen w wo contrast (74170) |
— |
$948 |
— |
| CT abdomen w/o contrast (74150) |
— |
$630 |
— |
CT Angio Abdomen and Pelvis (74174)
range across 2 matching MRF lines |
— |
$190–$530 |
— |
| CT Angio Chest (71275) |
— |
$1,361 |
— |
| CT Angio Head (70496) |
— |
$1,180 |
— |
CT angio hrt w/3d image (75574)
range across 2 matching MRF lines |
— |
$205–$852 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$1,361 |
— |
| CT Angio Neck (70498) |
— |
$1,180 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$1,361 |
— |
| CT bone density (77078) |
— |
$345 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$789 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$658 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$988 |
— |
| CT chest w contrast (71260) |
— |
$789 |
— |
| CT chest w/wo contrast (71270) |
— |
$988 |
— |
| CT head/brain with contrast (70460) |
— |
$630 |
— |
| CT head/brain without and with contrast (70470) |
— |
$789 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$145 |
— |
| CT iac w contrast (70481) |
— |
$630 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$988 |
— |
CT lower ext w/o (73700)
range across 3 matching MRF lines |
— |
$551–$1,101 |
— |
CT lower extremity w/contrast material (73701)
range across 3 matching MRF lines |
— |
$658–$1,316 |
— |
| CT lumbar spine w contrast (72132) |
— |
$789 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$658 |
— |
| CT maxillofacial w contrast (70487) |
— |
$630 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$529 |
— |
| CT neck tissue combo (70492) |
— |
$787 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$789 |
— |
| CT orbits w/o contrast (70480) |
— |
$529 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$948 |
— |
| CT pelvis w/o contrast (72192) |
— |
$658 |
— |
CT scan of leg combo (73702)
range across 3 matching MRF lines |
— |
$829–$1,651 |
— |
| CT scans face/jaw combo (70488) |
— |
$789 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$630 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$529 |
— |
| CT thoracic spine w contrast (72129) |
— |
$789 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$658 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$988 |
— |
| CT thorax w/o contrast (71250) |
— |
$658 |
— |
CT upper ext wo (73200)
range across 3 matching MRF lines |
— |
$557–$1,106 |
— |
CT upper extremity w/o & w/contrast material (73202)
range across 3 matching MRF lines |
— |
$829–$1,651 |
— |
CT upper extremity with contrast (73201)
range across 3 matching MRF lines |
— |
$658–$1,314 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$1,747 |
— |
Cta Abdomen (74175)
range across 2 matching MRF lines |
— |
$175–$1,328 |
— |
| CTA pelvis (72191) |
— |
$1,328 |
— |
| Dxa Bone Density Axial (77080) |
— |
$345 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$570 |
— |
| Esophagram (74220) |
— |
$253 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$210 |
— |
Fluoroscopy up to 1 hr (76000)
range across 3 matching MRF lines |
— |
$199–$495 |
— |
Foot 2 views (73620)
range across 3 matching MRF lines |
— |
$80–$120 |
— |
Forearm 2 views (73090)
range across 6 matching MRF lines |
— |
$80–$120 |
— |
Gastric emptying imaging study (78264)
range across 3 matching MRF lines |
— |
$482–$987 |
— |
| Gastroesophageal Reflux Exam (78262) |
— |
$681 |
— |
Gated Heart Planar Single (78472)
range across 2 matching MRF lines |
— |
$90–$812 |
— |
| Hand 2 views (73120) |
— |
$225 |
— |
| Heart first pass single,planar (78481) |
— |
$812 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$499 |
— |
Ht Muscle Image Spect Sing (78451)
range across 11 matching MRF lines |
— |
$125–$1,267 |
— |
Hysterosalpingogram (74740)
range across 3 matching MRF lines |
— |
$233–$450 |
— |
| Infusion Ivp (74410) |
— |
$450 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$844 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$844 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$712 |
— |
| Kidney Imaging Morphol (78700) |
— |
$550 |
— |
Knee 3 Views (73562)
range across 3 matching MRF lines |
— |
$130–$195 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$362 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$974 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$952 |
— |
| Lymph System Imaging (78195) |
— |
$512 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$2,042 |
— |
| Meckels Divert Exam (78290) |
— |
$375 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$50 |
— |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
— |
$185 |
— |
| MRA head w/o contrast (70544) |
— |
$1,282 |
— |
| MRA neck w contrast (70548) |
— |
$1,328 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$2,155 |
— |
| MRA neck w/o contrast (70547) |
— |
$1,282 |
— |
| MRI abdomen w contrast (74182) |
— |
$1,447 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$1,134 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$1,361 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$2,042 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$1,305 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$2,541 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$2,071 |
— |
| MRI cardiac w/o contrast (75557) |
— |
$1,248 |
— |
| MRI cervical spine w contrast (72142) |
— |
$1,384 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$1,134 |
— |
| MRI chest w/o contrast (71550) |
— |
$1,293 |
— |
| MRI chest with contrast (71551) |
— |
$1,475 |
— |
| MRI chest wo w contrast (71552) |
— |
$2,212 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$1,361 |
— |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720)
range across 3 matching MRF lines |
— |
$2,071–$3,108 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$1,248 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$1,384 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$2,076 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$1,248 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$1,361 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$2,064 |
— |
| MRI pelvis w contrast (72196) |
— |
$1,361 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$2,082 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$1,248 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$1,192 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$1,361 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$1,248 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$2,076 |
— |
| MRI, abdomen, combo (74183) |
— |
$2,082 |
— |
| MRI, dorsal spine combo (72157) |
— |
$2,042 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$1,293 |
— |
| MRI, joint upper extrem (73221) |
— |
$1,248 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$2,042 |
— |
| MRI, lumbar spine combo (72158) |
— |
$2,099 |
— |
| Myelogram cervical (72240) |
— |
$900 |
— |
| Myelogram Lumbar (72265) |
— |
$900 |
— |
| Myelography thoracic (72255) |
— |
$900 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$145 |
— |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
— |
$150 |
— |
| Neck soft tissue (70360) |
— |
$120 |
— |
| Nm csf leak detection (78650) |
— |
$1,203 |
— |
| Nm whole blood volume (78122) |
— |
$831 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$457 |
— |
| Panoramic X-ray of jaws (70355) |
— |
$180 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$663 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$225 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$780 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$140 |
— |
Radex abscess/fistula/sinus tract rs&i (76080)
range across 2 matching MRF lines |
— |
$188–$900 |
— |
Radex Ankle Complete Minimum 3 Views (73610)
range across 6 matching MRF lines |
— |
$74–$103 |
— |
Radex Calcaneus Minimum 2 Views (73650)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
Radex elbow complete minimum 3 views (73080)
range across 4 matching MRF lines |
— |
$103–$180 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$115 |
— |
Radex fingr minimum 2 views (73140)
range across 5 matching MRF lines |
— |
$56–$140 |
— |
Radex foot complete minimum 3 views (73630)
range across 7 matching MRF lines |
— |
$120–$180 |
— |
Radex Hand Minimum 3 Views (73130)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$80 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$225 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$120 |
— |
Radex Ribs Unilateral 2 Views (71100)
range across 4 matching MRF lines |
— |
$103–$180 |
— |
Radex shoulder complete minimum 2 views (73030)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$120 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$120 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$120 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$120 |
— |
Radex Toe Minimum 2 Views (73660)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$225 |
— |
Radex Wrist Complete Minimum 3 Views (73110)
range across 3 matching MRF lines |
— |
$120–$180 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$450 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$225 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$230 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$337 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$254 |
— |
Radiologic exam knee complete 4/more views (73564)
range across 3 matching MRF lines |
— |
$130–$195 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$245 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$225 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$253 |
— |
Radiologic exam upr gi trc double contrast study (74246)
range across 2 matching MRF lines |
— |
$253–$365 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$120 |
— |
Radiologic examination femur minimum 2 views (73552)
range across 5 matching MRF lines |
— |
$120–$180 |
— |
Radiologic examination knee 1/2 views (73560)
range across 4 matching MRF lines |
— |
$74–$180 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$215 |
— |
Radiologic examination tibia & fibula 2 views (73590)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
| Ribs bilateral 3 views (71110) |
— |
$225 |
— |
Rp loclzj tum plnr 1 area single day imaging (78800)
range across 3 matching MRF lines |
— |
$438–$550 |
— |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
— |
$532 |
— |
Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804)
range across 4 matching MRF lines |
— |
$1,685–$2,280 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$1,203 |
— |
Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803)
range across 10 matching MRF lines |
— |
$710–$1,318 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$125 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$350 |
— |
| Salivary Gland Imaging Serial Images (78231) |
— |
$575 |
— |
Scapula (73010)
range across 3 matching MRF lines |
— |
$120–$180 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$60 |
— |
| Sella turcica (70240) |
— |
$120 |
— |
Shoulder 1 view (73020)
range across 3 matching MRF lines |
— |
$120–$180 |
— |
Shoulder Arthrography (73040)
range across 3 matching MRF lines |
— |
$457–$675 |
— |
| Sialogram (70390) |
— |
$450 |
— |
| Skull less than 4 views (70250) |
— |
$225 |
— |
| Sternoclavicular joints (71130) |
— |
$120 |
— |
Temporomandble Jt Arthrography Rs&I (70332)
range across 3 matching MRF lines |
— |
$450–$675 |
— |
| Testicular Imaging W/Flow (78761) |
— |
$395 |
— |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
— |
$253 |
— |
| Thoracic spine 2 views (72070) |
— |
$225 |
— |
| Thoracic spine 3 views (72072) |
— |
$230 |
— |
| Thoracolumbar 2 views (72080) |
— |
$120 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$350 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$619 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$350 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$350 |
— |
Ultrasound Breast Limited (76642)
range across 3 matching MRF lines |
— |
$120–$330 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$210 |
— |
Ultrasound, abdomen limited (76705)
range across 2 matching MRF lines |
— |
$101–$234 |
— |
| Ureteral Reflux Study (78740) |
— |
$403 |
— |
Urethrocystogram voiding (74455)
range across 3 matching MRF lines |
— |
$194–$450 |
— |
| Urethrocystography retrograde (74450) |
— |
$450 |
— |
Us breast unilateral complete (76641)
range across 3 matching MRF lines |
— |
$225–$450 |
— |
| Us chest (76604) |
— |
$225 |
— |
| Us exam, pelvic, limited (76857) |
— |
$225 |
— |
Us kidney transplant (76776)
range across 3 matching MRF lines |
— |
$225–$338 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$199 |
— |
| Us ob detailed single fetus (76811) |
— |
$409 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$225 |
— |
| Us ob transvaginal (76817) |
— |
$225 |
— |
| Us pelvic non ob complete (76856) |
— |
$225 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$314 |
— |
Us retroperitoneal complete (76770)
range across 2 matching MRF lines |
— |
$117–$295 |
— |
Us retroperitoneal limited (76775)
range across 2 matching MRF lines |
— |
$125–$225 |
— |
| Us scrotum and contents (76870) |
— |
$225 |
— |
Us thyroid (76536)
range across 2 matching MRF lines |
— |
$135–$225 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,370 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,370 |
— |
Wrist 2 views (73100)
range across 3 matching MRF lines |
— |
$120–$180 |
— |
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050)
range across 2 matching MRF lines |
— |
$91–$165 |
— |
X-ray antegrade pyelogram tube (74425)
range across 10 matching MRF lines |
— |
$159–$900 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070)
range across 6 matching MRF lines |
— |
$66–$140 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$900 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$120 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$225 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$450 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$120 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$120 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$225 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$225 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$100 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$450 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$225 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$205 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$241 |
— |
X-Ray Exam Unilat Ribs/Chest (71101)
range across 3 matching MRF lines |
— |
$225–$335 |
— |
X-ray humerus (73060)
range across 6 matching MRF lines |
— |
$120–$180 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$450 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$180 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$120 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$225 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$74 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$350 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$225 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$215 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$120 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$120 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$225 |
— |
X-Ray Stress View (77071)
range across 3 matching MRF lines |
— |
$120–$180 |
— |
X-ray thoracic spine 4 vw (72074)
range across 3 matching MRF lines |
— |
$230–$240 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$80 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$900 |
— |
X-Rays Bone Length Studies (77073)
range across 2 matching MRF lines |
— |
$120–$225 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$175 |
— |
Xr c-spine 4 or 5 views (72050)
range across 3 matching MRF lines |
— |
$205–$225 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$85 |
— |
| Xr orbits complete 4 views (70200) |
— |
$225 |
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