| Abdomen 2 views (74019) |
$409.36 |
$731 |
4.1× |
| Ankle 2 views (73600) |
$379.12 |
$677 |
4.6× |
| Arthrogram elbow (73085) |
$478.24 |
$854 |
1.4× |
| Arthrogram hip (73525) |
$683.20 |
$1,220 |
2.0× |
| Arthrogram shoulder (73040) |
$478.24 |
$854 |
1.4× |
| Arthrogram wrist (73115) |
$265.44 |
$474 |
0.8× |
| Arthrography knee lt (73580) |
$478.24 |
$854 |
1.4× |
| Bone age studies (77072) |
$199.92 |
$357 |
2.0× |
| Bone survey complete (77075) |
$484.96 |
$866 |
4.9× |
| Cervical spine 2 or 3 views (72040) |
$436.80 |
$780 |
5.3× |
| Chest 1 view (71045) |
$229.60 |
$410 |
2.8× |
| Chest 3 views (71047) |
$362.32 |
$647 |
4.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$147.28 |
$263 |
0.9× |
| Clavicle complete (73000) |
$292.32 |
$522 |
3.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$80.64 |
$144 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$4,295.76 |
$7,671 |
12.9× |
| CT abdomen and pelvis without contrast (74176) |
$2,283.68 |
$4,078 |
10.0× |
| CT abdomen w contrast (74160) |
$3,646.72 |
$6,512 |
21.8× |
| CT abdomen w wo contrast (74170) |
$4,337.20 |
$7,745 |
25.9× |
| CT abdomen w/o contrast (74150) |
$3,226.16 |
$5,761 |
32.3× |
| CT angio hrt w/3d image (75574) |
$539.28 |
$963 |
1.6× |
| CT angiography upper extremity lt (73206) |
$396.48 |
$708 |
2.4× |
| CT c-spine w/o contrast (72125) |
$2,134.72 |
$3,812 |
21.4× |
| CT cere prfuj alys c+ w/o CT/CTA same anatomy (70473) |
$271.04 |
$484 |
1.6× |
| CT cervical spine w&w/o contrast (72127) |
$2,232.72 |
$3,987 |
13.3× |
| CT cervical spine with contrast (72126) |
$2,155.44 |
$3,849 |
6.5× |
| CT chest w/wo contrast (71270) |
$2,147.60 |
$3,835 |
12.8× |
| CT chest with contrast (71260) |
$2,062.48 |
$3,683 |
12.3× |
| CT colonography screening (74263) |
$1,910.16 |
$3,411 |
8.4× |
| CT head/brain with contrast (70460) |
$1,550.64 |
$2,769 |
9.2× |
| CT head/brain without and with contrast (70470) |
$1,620.64 |
$2,894 |
9.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$370.16 |
$661 |
4.5× |
| CT iac w contrast (70481) |
$1,316.56 |
$2,351 |
7.9× |
| CT limited/localized follow up study (76380) |
$370.72 |
$662 |
4.5× |
| CT lower ext w/o (73700) |
$829.92 |
$1,482 |
8.3× |
| CT lower extremity w wo contrast (73702) |
$1,191.68 |
$2,128 |
7.1× |
| CT lower extremity with contrast (73701) |
$971.04 |
$1,734 |
5.8× |
| CT lumbar spine w & w/o contrast (72133) |
$2,152.08 |
$3,843 |
12.8× |
| CT lumbar spine w/o contrast (72131) |
$1,929.76 |
$3,446 |
19.3× |
| CT lumbar spine with contrast (72132) |
$2,151.52 |
$3,842 |
6.5× |
| CT maxillofacial w contrast (70487) |
$1,942.64 |
$3,469 |
11.6× |
| CT maxillofacial w/o contrast (70486) |
$1,917.44 |
$3,424 |
19.2× |
| CT maxillofacial w/wo contrast (70488) |
$1,965.60 |
$3,510 |
11.7× |
| CT neck soft tissue w contrast (70491) |
$2,610.72 |
$4,662 |
15.6× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,663.20 |
$2,970 |
9.9× |
| CT orbits w/o contrast (70480) |
$1,012.48 |
$1,808 |
10.1× |
| CT pelvis w & w/o contrast (72194) |
$1,992.48 |
$3,558 |
11.9× |
| CT pelvis w/o contrast (72192) |
$1,942.64 |
$3,469 |
19.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$2,617.44 |
$4,674 |
15.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,537.76 |
$2,746 |
15.4× |
| CT thoracic spine w/contrast (72129) |
$975.52 |
$1,742 |
5.8× |
| CT thoracic spine w/o contrast (72128) |
$725.20 |
$1,295 |
7.3× |
| CT thoracic spine w/wo contrast (72130) |
$1,300.32 |
$2,322 |
7.8× |
| CT thorax w/o contrast (71250) |
$1,895.60 |
$3,385 |
19.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,020.88 |
$1,823 |
6.1× |
| CT upper extremity w/o contrast rt (73200) |
$832.16 |
$1,486 |
8.3× |
| CT upper extremity with contrast (73201) |
$998.48 |
$1,783 |
3.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$875.28 |
$1,563 |
5.2× |
| Cta Abdomen (74175) |
$1,512 |
$2,700 |
9.0× |
| CTA abdomen pelvis (74174) |
$3,780 |
$6,750 |
11.3× |
| CTA chest (71275) |
$2,925.44 |
$5,224 |
17.4× |
| Cta Head (70496) |
$1,907.92 |
$3,407 |
11.4× |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
$621.04 |
$1,109 |
1.9× |
| CTA lwr ext w&w/o contrast (73706) |
$396.48 |
$708 |
2.4× |
| Cta Neck (70498) |
$2,563.68 |
$4,578 |
15.3× |
| Cta Pelvis (72191) |
$1,285.20 |
$2,295 |
7.7× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$200.48 |
$358 |
2.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$545.44 |
$974 |
5.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$188.16 |
$336 |
2.3× |
| Dxa bone density study axial skeleton (77085) |
$261.52 |
$467 |
2.6× |
| Fetal biophysical profile non-stress testing (76818) |
$263.20 |
$470 |
2.6× |
| Fluoroscopy up to 1 hr (76000) |
$379.12 |
$677 |
1.7× |
| Foot 2 views (73620) |
$359.24 |
$641.50 |
4.3× |
| Forearm 2 views (73090) |
$291.20 |
$520 |
3.5× |
| Hand 2 views (73120) |
$118.16 |
$211 |
1.2× |
| Hand 3 views (73130) |
$314.72 |
$562 |
3.8× |
| Humerus Min 2 Views Left (73060) |
$208.32 |
$372 |
2.5× |
| Knee 3 views (73562) |
$476.56 |
$851 |
5.7× |
| Mammary ductogram or galactogram multiple (77054) |
$287.84 |
$514 |
1.3× |
| Mammary ductogram or galactogram single (77053) |
$255.92 |
$457 |
1.1× |
| Mr safety determination physician/other qhp (76016) |
$133.28 |
$238 |
1.6× |
| Mr safety implant pos&/immoblj supvj phys/qhp (76019) |
$90.16 |
$161 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$37.52 |
$67 |
1.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$138.88 |
$248 |
1.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$365.68 |
$653 |
1.6× |
| MRA head w & w/o contrast (70546) |
$609.84 |
$1,089 |
1.8× |
| MRA head w/o contrast (70544) |
$542.08 |
$968 |
2.4× |
| MRA head with contrast (70545) |
$549.36 |
$981 |
1.6× |
| MRA neck w contrast (70548) |
$912.80 |
$1,630 |
2.7× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,463.28 |
$2,613 |
4.4× |
| MRA neck w/o contrast (70547) |
$883.12 |
$1,577 |
3.9× |
| MRI abdomen w contrast (74182) |
$939.68 |
$1,678 |
2.8× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,252.16 |
$2,236 |
3.8× |
| MRI abdomen w/o contrast (74181) |
$600.32 |
$1,072 |
2.6× |
| MRI any jnt lwr ext with con lt (73722) |
$1,373.12 |
$2,452 |
1.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,835.28 |
$5,063 |
3.8× |
| MRI bone marrow blood supply (77084) |
$856.80 |
$1,530 |
3.8× |
| MRI breast w/o contrast bilateral (77047) |
$2,845.92 |
$5,082 |
12.5× |
| MRI breast w/o contrast unilat (77046) |
$1,719.76 |
$3,071 |
7.5× |
| MRI c-spine with contrast (72142) |
$693.84 |
$1,239 |
2.1× |
| MRI cervical spine w/o contrast (72141) |
$443.52 |
$792 |
1.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,098.16 |
$1,961 |
3.3× |
| MRI chest w/o contrast (71550) |
$943.60 |
$1,685 |
4.1× |
| MRI chest with contrast (71551) |
$995.12 |
$1,777 |
1.3× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,070.72 |
$1,912 |
3.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,029.84 |
$1,839 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$615.44 |
$1,099 |
2.7× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,075.76 |
$1,921 |
4.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,159.20 |
$2,070 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$1,132.88 |
$2,023 |
3.4× |
| MRI pelvis w contrast (72196) |
$1,029.84 |
$1,839 |
3.1× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,303.68 |
$2,328 |
3.9× |
| MRI pelvis w/o contrast (72195) |
$893.76 |
$1,596 |
3.9× |
| MRI scan of arm joint before and after contrast (73223) |
$3,780 |
$6,750 |
11.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,388.24 |
$2,479 |
4.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$708.40 |
$1,265 |
2.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$2,354.24 |
$4,204 |
7.1× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$2,403.52 |
$4,292 |
7.2× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,155.84 |
$2,064 |
3.5× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,180.48 |
$2,108 |
3.5× |
| MRI thoracic spine w/o contrast (72146) |
$1,107.68 |
$1,978 |
4.9× |
| MRI tmj (70336) |
$952 |
$1,700 |
4.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,765.68 |
$3,153 |
7.7× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,098.16 |
$1,961 |
3.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,015.84 |
$1,814 |
4.5× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$5,103.84 |
$9,114 |
2.4× |
| Neck soft tissue (70360) |
$267.68 |
$478 |
3.2× |
| Osseous survey infant (77076) |
$141.68 |
$253 |
1.4× |
| Osseous survey limited (77074) |
$397.60 |
$710 |
4.0× |
| Pelvis 1 or 2 views (72170) |
$214.48 |
$383 |
2.1× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,098.16 |
$1,961 |
3.3× |
| Pr sono bone density measure,peripheral (76977) |
$67.20 |
$120 |
0.7× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$147.84 |
$264 |
1.8× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$208.88 |
$373 |
2.1× |
| Radex hips bilateral with pelvis 2 views (73521) |
$395.36 |
$706 |
4.0× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$247.52 |
$442 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$329.28 |
$588 |
3.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$154.56 |
$276 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$204.96 |
$366 |
2.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$491.68 |
$878 |
4.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$329.28 |
$588 |
4.0× |
| Radiologic exam colon single contrast study (74270) |
$425.04 |
$759 |
2.5× |
| Radiologic exam upr gi trc single contrast study (74240) |
$406 |
$725 |
2.4× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$154.56 |
$276 |
1.9× |
| Radiological examination surgical specimen (76098) |
$711.20 |
$1,270 |
1.4× |
| Ribs bilateral 3 views (71110) |
$276.08 |
$493 |
2.8× |
| Sacroiliac Joints < 3 Views (72200) |
$86.24 |
$154 |
0.9× |
| Scapula complete (73010) |
$233.52 |
$417 |
2.3× |
| Screening digital breast tomosynthesis (77063) |
$29.68 |
$53 |
1.3× |
| Small bowel series (74250) |
$486.64 |
$869 |
2.9× |
| Spine thoracic 3 views (72072) |
$462.56 |
$826 |
4.6× |
| Temporomandble Jt Arthrography Rs&I (70332) |
$243.60 |
$435 |
1.1× |
| Thoracolumbar 2 views (72080) |
$166.32 |
$297 |
2.0× |
| Tmj unilateral (70328) |
$113.68 |
$203 |
1.4× |
| Ultrasound, abdomen limited (76705) |
$248.08 |
$443 |
2.5× |
| Unlisted Ultrasound Procedure (76999) |
$322 |
$575 |
3.9× |
| Upper Extremity Infant (73092) |
$148.40 |
$265 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$366.80 |
$655 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$778.96 |
$1,391 |
4.6× |
| Us abdl aorta screen aaa (76706) |
$245.84 |
$439 |
2.5× |
| Us breast unilateral complete (76641) |
$1,030.96 |
$1,841 |
10.3× |
| Us breast unilateral limited (76642) |
$962.64 |
$1,719 |
11.6× |
| Us chest (76604) |
$111.44 |
$199 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$119.28 |
$213 |
1.2× |
| Us ob transvaginal (76817) |
$786.80 |
$1,405 |
7.9× |
| Us pelvic non ob complete (76856) |
$2,294.88 |
$4,098 |
23.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$1,036.56 |
$1,851 |
10.4× |
| Us pregnancy ltd (76815) |
$329.28 |
$588 |
3.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$757.68 |
$1,353 |
7.6× |
| Us retroperitoneal complete (76770) |
$283.92 |
$507 |
2.8× |
| Us retroperitoneal limited (76775) |
$331.52 |
$592 |
3.3× |
| Us scrotum and contents (76870) |
$1,126.16 |
$2,011 |
11.3× |
| Us soft tissue head/neck (76536) |
$1,197.84 |
$2,139 |
12.0× |
| Us transrectal (76872) |
$551.04 |
$984 |
5.5× |
| Us xtr non-vasc lmtd (76882) |
$64.40 |
$115 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$58.80 |
$105 |
0.7× |
| Wrist 2 views (73100) |
$298.48 |
$533 |
3.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$576.80 |
$1,030 |
5.8× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$204.40 |
$365 |
2.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$496.72 |
$887 |
6.0× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$585.76 |
$1,046 |
3.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$401.52 |
$717 |
4.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$459.76 |
$821 |
5.5× |
| X-ray exam entire spi 4/5 vw (72083) |
$269.36 |
$481 |
2.7× |
| X-ray exam hip uni 1 view (73501) |
$73.92 |
$132 |
0.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$305.20 |
$545 |
3.7× |
| X-ray exam hip uni 4/> views (73503) |
$360.64 |
$644 |
3.6× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$793.52 |
$1,417 |
7.9× |
| X-ray exam of femur 1 (73551) |
$115.36 |
$206 |
1.4× |
| X-ray eye for foreign body (70030) |
$128.24 |
$229 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$80.08 |
$143 |
0.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$61.60 |
$110 |
0.7× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$458.08 |
$818 |
5.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$142.24 |
$254 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$121.52 |
$217 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$526.96 |
$941 |
5.3× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$66.64 |
$119 |
0.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$145.60 |
$260 |
1.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$381.36 |
$681 |
3.8× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$841.68 |
$1,503 |
8.4× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$477.68 |
$853 |
4.8× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$411.04 |
$734 |
4.9× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$165.20 |
$295 |
1.7× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$259.28 |
$463 |
2.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$825.44 |
$1,474 |
2.5× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$194.32 |
$347 |
2.3× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$276.08 |
$493 |
2.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$329.28 |
$588 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$96.32 |
$172 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$286.72 |
$512 |
3.4× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$399.84 |
$714 |
4.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$151.76 |
$271 |
1.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$94.64 |
$169 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$82.32 |
$147 |
0.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$80.64 |
$144 |
0.8× |
| X-Ray Spine One View - Xr Spine (72020) |
$238 |
$425 |
2.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$162.40 |
$290 |
2.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$134.40 |
$240 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$432.88 |
$773 |
4.3× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$486.64 |
$869 |
4.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$232.40 |
$415 |
2.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$460.88 |
$823 |
5.5× |
| Xr arthrogram ankle (73615) |
$478.24 |
$854 |
1.4× |
| Xr c-spine 6 or more views (72052) |
$748.16 |
$1,336 |
7.5× |
| Xr chest 4+ views (71048) |
$394.24 |
$704 |
3.9× |
| Xr Cholecystography Oral Contrast (74290) |
$219.52 |
$392 |
1.3× |
| Xr finger(s) 2+ views (73140) |
$240.52 |
$429.50 |
2.9× |
| XR Mastoids < 3 Views Bilateral (70120) |
$101.36 |
$181 |
1.0× |
| Xr shoulder 1 view (73020) |
$64.40 |
$115 |
0.8× |
| Xr spine cervical 4 or 5 views (72050) |
$675.36 |
$1,206 |
6.8× |
| Xr tibia/fibula 2 views (73590) |
$356.16 |
$636 |
4.3× |
| Xr tmj bilateral (70330) |
$227.92 |
$407 |
2.7× |
| Xray knee 1 or 2 views rt (73560) |
$224 |
$400 |
2.7× |