| Abdomen 2 views (74019) |
$262.50 |
$525 |
2.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$1,133.50 |
$2,267 |
2.8× |
| Ankle 2 views (73600) |
$170.50 |
$341.01 |
2.0× |
| Arthrogram elbow (73085) |
$407.50 |
$815 |
1.2× |
| Arthrogram shoulder (73040) |
$371 |
$742 |
1.1× |
| Bone &/joint imaging whole body (78306) |
$1,053.50 |
$2,107 |
2.6× |
| Bone age studies (77072) |
$212.26 |
$424.52 |
2.0× |
| Bone Imaging 3 Phase (78315) |
$958 |
$1,916 |
2.4× |
| Bone survey complete (77075) |
$262.50 |
$525 |
2.5× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,861.50 |
$3,723 |
5.3× |
| Cervical spine 2 or 3 views (72040) |
$227.32 |
$454.63 |
2.6× |
| Chest 1 view (71045) |
$187 |
$374 |
2.1× |
| Chest 3 views (71047) |
$252.50 |
$505 |
2.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$469.50 |
$939 |
2.7× |
| Clavicle complete (73000) |
$178.14 |
$356.27 |
2.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$415 |
$830 |
4.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,125 |
$4,250 |
6.1× |
| CT abdomen and pelvis without contrast (74176) |
$1,366.75 |
$2,733.50 |
5.7× |
| CT abdomen w contrast (74160) |
$948 |
$1,896 |
5.4× |
| CT abdomen w wo contrast (74170) |
$1,043 |
$2,086 |
5.9× |
| CT abdomen w/o contrast (74150) |
$583.50 |
$1,167 |
5.6× |
| CT angiography upper extremity lt (73206) |
$1,440 |
$2,880 |
8.2× |
| CT c-spine w/o contrast (72125) |
$1,000 |
$2,000 |
9.6× |
| CT cervical spine w&w/o contrast (72127) |
$1,722 |
$3,444 |
9.8× |
| CT cervical spine with contrast (72126) |
$1,224 |
$2,448 |
3.5× |
| CT chest w/wo contrast (71270) |
$1,040.50 |
$2,081 |
5.9× |
| CT chest with contrast (71260) |
$1,250 |
$2,500 |
7.1× |
| CT head/brain with contrast (70460) |
$1,071.50 |
$2,143 |
6.1× |
| CT head/brain without and with contrast (70470) |
$948 |
$1,896 |
5.4× |
| CT heart no contrast quant eval coronry calcium (75571) |
$574 |
$1,148 |
6.6× |
| CT iac w contrast (70481) |
$1,066.50 |
$2,133 |
6.1× |
| CT limited/localized follow up study (76380) |
$353.50 |
$707 |
4.1× |
| CT lower ext w/o (73700) |
$583.50 |
$1,167 |
5.6× |
| CT lower extremity w wo contrast (73702) |
$1,389.50 |
$2,779 |
7.9× |
| CT lower extremity with contrast (73701) |
$1,503.50 |
$3,007 |
8.6× |
| CT lumbar spine w & w/o contrast (72133) |
$1,701 |
$3,402 |
9.7× |
| CT lumbar spine w/o contrast (72131) |
$1,000 |
$2,000 |
9.6× |
| CT lumbar spine with contrast (72132) |
$1,987 |
$3,974 |
5.7× |
| CT maxillofacial w contrast (70487) |
$948 |
$1,896 |
5.4× |
| CT maxillofacial w/o contrast (70486) |
$641.50 |
$1,283 |
6.1× |
| CT maxillofacial w/wo contrast (70488) |
$1,030.25 |
$2,060.50 |
5.9× |
| CT neck soft tissue w contrast (70491) |
$1,250 |
$2,500 |
7.1× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$994.25 |
$1,988.50 |
5.7× |
| CT orbits w/o contrast (70480) |
$583.50 |
$1,167 |
5.6× |
| CT pelvis w & w/o contrast (72194) |
$1,043 |
$2,086 |
5.9× |
| CT pelvis w/o contrast (72192) |
$583.50 |
$1,167 |
5.6× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,253 |
$2,506 |
7.1× |
| CT soft tissue neck w/o contrast (70490) |
$583.50 |
$1,167 |
5.6× |
| CT thoracic spine w/contrast (72129) |
$1,448 |
$2,896 |
8.2× |
| CT thoracic spine w/o contrast (72128) |
$641.50 |
$1,283 |
6.1× |
| CT thoracic spine w/wo contrast (72130) |
$1,721 |
$3,442 |
9.8× |
| CT thorax w/o contrast (71250) |
$831.25 |
$1,662.50 |
7.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,587.50 |
$3,175 |
9.0× |
| CT upper extremity w/o contrast rt (73200) |
$875 |
$1,750 |
8.4× |
| CT upper extremity with contrast (73201) |
$1,534 |
$3,068 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$2,085.50 |
$4,171 |
11.9× |
| Cta Abdomen (74175) |
$948 |
$1,896 |
5.4× |
| CTA abdomen pelvis (74174) |
$2,185 |
$4,370 |
6.3× |
| CTA chest (71275) |
$1,500 |
$3,000 |
8.5× |
| Cta Head (70496) |
$1,089.50 |
$2,179 |
6.2× |
| CTA lwr ext w&w/o contrast (73706) |
$948 |
$1,896 |
5.4× |
| Cta Neck (70498) |
$1,250 |
$2,500 |
7.1× |
| Cta Pelvis (72191) |
$1,022 |
$2,044 |
5.8× |
| Cystography minimum 3 views rs&i (74430) |
$440 |
$880 |
1.3× |
| Dxa bone density study 1/> sites axial skel (77080) |
$262.50 |
$525 |
2.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$135.50 |
$271 |
1.6× |
| Esophagus (74220) |
$427 |
$854 |
2.4× |
| Fluoroscopy up to 1 hr (76000) |
$496.25 |
$992.50 |
2.1× |
| Foot 2 views (73620) |
$170.50 |
$341.01 |
2.0× |
| Forearm 2 views (73090) |
$170.50 |
$341.01 |
2.0× |
| Gated Heart Planar Single (78472) |
$1,118 |
$2,236 |
2.8× |
| Hand 2 views (73120) |
$170.50 |
$341.01 |
1.6× |
| Hand 3 views (73130) |
$197.30 |
$394.60 |
2.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,191.75 |
$2,383.50 |
2.2× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$720 |
$1,440 |
1.8× |
| Ht muscle image spect sing (78451) |
$2,238 |
$4,476 |
1.7× |
| Humerus Min 2 Views Left (73060) |
$178.40 |
$356.80 |
2.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$752 |
$1,504 |
1.4× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$854 |
$1,708 |
1.6× |
| Knee 3 views (73562) |
$187.20 |
$374.40 |
2.1× |
| Lymphoscintigraphy (78195) |
$733.50 |
$1,467 |
1.3× |
| Meckels Diverticulum (78290) |
$633.50 |
$1,267 |
1.6× |
| MRA head w & w/o contrast (70546) |
$1,675.50 |
$3,351 |
4.8× |
| MRA head w/o contrast (70544) |
$1,212.50 |
$2,425 |
5.1× |
| MRA head with contrast (70545) |
$1,319.50 |
$2,639 |
3.8× |
| MRA neck w contrast (70548) |
$1,569 |
$3,138 |
4.5× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,987 |
$3,974 |
5.7× |
| MRA neck w/o contrast (70547) |
$1,212.50 |
$2,425 |
5.1× |
| MRI abdomen w contrast (74182) |
$2,033.50 |
$4,067 |
5.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$2,200 |
$4,400 |
6.3× |
| MRI abdomen w/o contrast (74181) |
$1,212.50 |
$2,425 |
5.1× |
| MRI any jnt lwr ext with con lt (73722) |
$2,047.25 |
$4,094.50 |
2.6× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$450 |
$900 |
0.6× |
| MRI breast w/o contrast bilateral (77047) |
$1,297.50 |
$2,595 |
5.4× |
| MRI breast w/o contrast unilat (77046) |
$1,307 |
$2,614 |
5.5× |
| MRI c-spine with contrast (72142) |
$1,927 |
$3,854 |
5.5× |
| MRI cervical spine w/o contrast (72141) |
$1,500 |
$3,000 |
6.3× |
| MRI chest w/o & w/contrast material (71552) |
$2,144.50 |
$4,289 |
6.1× |
| MRI chest w/o contrast (71550) |
$1,333.50 |
$2,667 |
5.6× |
| MRI chest with contrast (71551) |
$1,931 |
$3,862 |
2.5× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,751.50 |
$3,503 |
5.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,751.50 |
$3,503 |
5.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,212.50 |
$2,425 |
5.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,492.50 |
$2,985 |
6.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$2,142 |
$4,284 |
6.1× |
| MRI orbit/face/neck w/contrast (70542) |
$1,492.50 |
$2,985 |
4.3× |
| MRI pelvis w contrast (72196) |
$1,932.50 |
$3,865 |
5.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,126.50 |
$4,253 |
6.1× |
| MRI pelvis w/o contrast (72195) |
$1,671.50 |
$3,343 |
7.0× |
| MRI scan of arm joint before and after contrast (73223) |
$2,163.50 |
$4,327 |
6.2× |
| MRI scan of leg joint before and after contrast (73723) |
$2,142 |
$4,284 |
6.1× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$2,185 |
$4,370 |
6.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,987 |
$3,974 |
5.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,200 |
$4,400 |
6.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,927 |
$3,854 |
5.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,987 |
$3,974 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,212.50 |
$2,425 |
5.1× |
| MRI tmj (70336) |
$400 |
$800 |
1.7× |
| MRI upper ext joint w/o contrast (73221) |
$1,333.50 |
$2,667 |
5.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,872 |
$3,744 |
5.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,333.50 |
$2,667 |
5.6× |
| Myocardial infarct spect (78469) |
$580 |
$1,160 |
1.1× |
| Myocardial Spect Multiple Studies (78452) |
$3,149.50 |
$6,299 |
2.4× |
| Neck soft tissue (70360) |
$205.50 |
$411 |
2.4× |
| Nm bone marrow wb (78104) |
$903 |
$1,806 |
2.3× |
| Nm gastric emptying study (78264) |
$1,053.50 |
$2,107 |
2.6× |
| Osseous survey infant (77076) |
$656 |
$1,312 |
6.3× |
| Osseous survey limited (77074) |
$439 |
$878 |
4.2× |
| Parathyrd planar w/wo subtrj (78071) |
$1,175 |
$2,350 |
2.9× |
| Parathyroid imaging (78070) |
$1,053.50 |
$2,107 |
2.6× |
| Pelvis 1 or 2 views (72170) |
$164.90 |
$329.80 |
1.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$2,057 |
$4,114 |
5.9× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$620 |
$1,240 |
1.5× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$1,228 |
$2,456 |
2.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$230 |
$460 |
0.4× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$203.12 |
$406.25 |
2.3× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$251.62 |
$503.25 |
2.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$241.09 |
$482.18 |
2.3× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$257 |
$514 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$289 |
$578 |
2.8× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$205.50 |
$411 |
2.4× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$205.50 |
$411 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$469.50 |
$939 |
2.7× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$510 |
$1,020 |
2.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$469.50 |
$939 |
2.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$181.33 |
$362.66 |
2.1× |
| Radiological examination surgical specimen (76098) |
$112 |
$224 |
0.2× |
| Ribs bilateral 3 views (71110) |
$322.78 |
$645.56 |
3.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,874 |
$3,748 |
4.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$270 |
$540 |
0.5× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$580 |
$1,160 |
1.1× |
| Sacroiliac Joints < 3 Views (72200) |
$108.87 |
$217.74 |
1.0× |
| Scanogram (77073) |
$319 |
$638 |
3.0× |
| Scapula complete (73010) |
$215.18 |
$430.36 |
2.1× |
| Screening digital breast tomosynthesis (77063) |
$34.25 |
$68.50 |
1.5× |
| Sella turcica (70240) |
$139.50 |
$279 |
1.6× |
| Small bowel series (74250) |
$469.50 |
$939 |
2.7× |
| Spine thoracic 3 views (72072) |
$267.06 |
$534.12 |
2.6× |
| Thoracolumbar 2 views (72080) |
$168.03 |
$336.06 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$820.50 |
$1,641 |
2.0× |
| Tmj unilateral (70328) |
$135.50 |
$271 |
1.6× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$1,558.50 |
$3,117 |
2.9× |
| Ultrasound, abdomen limited (76705) |
$481.50 |
$963 |
4.6× |
| Unlisted musculoskeletal procedure, diagnostic nuclear medicine UNSCHEDULED (78399) |
$853.50 |
$1,707 |
2.1× |
| Unlisted Ultrasound Procedure (76999) |
$472 |
$944 |
5.4× |
| Upper Extremity Infant (73092) |
$149 |
$298 |
1.4× |
| Urethrocystography voiding (74455) |
$463 |
$926 |
1.9× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$467.50 |
$935 |
2.7× |
| Us abdl aorta screen aaa (76706) |
$437.50 |
$875 |
4.2× |
| Us breast unilateral complete (76641) |
$482.50 |
$965 |
4.6× |
| Us breast unilateral limited (76642) |
$342.50 |
$685 |
3.9× |
| Us chest (76604) |
$437.50 |
$875 |
4.2× |
| Us kidney transplant (76776) |
$367 |
$734 |
3.5× |
| Us ob transvaginal (76817) |
$481.50 |
$963 |
4.6× |
| Us pelvic non ob complete (76856) |
$481.50 |
$963 |
4.6× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$437.50 |
$875 |
4.2× |
| Us pregnancy ltd (76815) |
$365.50 |
$731 |
3.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$531.25 |
$1,062.50 |
5.1× |
| Us retroperitoneal complete (76770) |
$481.50 |
$963 |
4.6× |
| Us retroperitoneal limited (76775) |
$656 |
$1,312 |
6.3× |
| Us scrotum and contents (76870) |
$2,085.50 |
$4,171 |
19.9× |
| Us soft tissue head/neck (76536) |
$481.50 |
$963 |
4.6× |
| Us xtr non-vasc lmtd (76882) |
$481.50 |
$963 |
4.6× |
| Venogram extremity bilateral (75822) |
$833.50 |
$1,667 |
0.5× |
| Wrist 2 views (73100) |
$170.50 |
$341.01 |
2.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$289 |
$578 |
2.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$196.23 |
$392.46 |
2.3× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$187.05 |
$374.10 |
2.1× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$418 |
$836 |
2.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$161.26 |
$322.51 |
1.9× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$181.05 |
$362.10 |
2.1× |
| X-ray exam hip uni 1 view (73501) |
$183.05 |
$366.10 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$194.58 |
$389.16 |
2.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$364 |
$728 |
3.5× |
| X-ray exam of femur 1 (73551) |
$162.33 |
$324.66 |
1.9× |
| X-ray eye for foreign body (70030) |
$205.50 |
$411 |
2.4× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$289 |
$578 |
2.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$192 |
$384 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$187.05 |
$374.10 |
2.1× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$161.26 |
$322.51 |
1.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$167.50 |
$335 |
1.9× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$257.43 |
$514.86 |
2.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$289.06 |
$578.13 |
3.3× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$152 |
$304 |
1.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$243.76 |
$487.52 |
2.3× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$275.90 |
$551.80 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$289 |
$578 |
2.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$205.50 |
$411 |
2.4× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$262.50 |
$525 |
2.5× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$255.52 |
$511.04 |
2.4× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$458.50 |
$917 |
1.3× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$201.66 |
$403.32 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$262.50 |
$525 |
2.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$390 |
$780 |
3.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$232.90 |
$465.80 |
2.2× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$181.33 |
$362.66 |
2.1× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$190.58 |
$381.16 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$201.50 |
$403 |
2.3× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$187 |
$374 |
2.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$289 |
$578 |
2.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$262.50 |
$525 |
2.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$163.78 |
$327.55 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$161.35 |
$322.70 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$193.28 |
$386.56 |
2.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$138.50 |
$277.01 |
1.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$183.05 |
$366.10 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$289 |
$578 |
2.8× |
| Xr chest 4+ views (71048) |
$278.50 |
$557 |
2.7× |
| Xr finger(s) 2+ views (73140) |
$167.92 |
$335.83 |
1.9× |
| Xr optic foramina (70190) |
$162.50 |
$325 |
1.9× |
| Xr shoulder 1 view (73020) |
$133.22 |
$266.42 |
1.5× |
| Xr spine cervical 4 or 5 views (72050) |
$269.52 |
$539.04 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$170.54 |
$341.08 |
2.0× |
| Xr tmj bilateral (70330) |
$366 |
$732 |
4.2× |
| Xray knee 1 or 2 views rt (73560) |
$168.08 |
$336.16 |
1.9× |