| Ankle 2 views (73600) |
$148.05 |
$211.50 |
1.6× |
| Cholecystography, oral contrast Age Under 21 (74290) |
$121.80 |
$174 |
0.7× |
| Clavicle complete (73000) |
$148.40 |
$212 |
1.6× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$1,142.40 |
$1,632 |
3.1× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,259.30 |
$1,799 |
6.8× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,148.35 |
$1,640.50 |
6.2× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,259.65 |
$1,799.50 |
6.8× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,261.40 |
$1,802 |
6.8× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,257.55 |
$1,796.50 |
6.8× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$1,129.45 |
$1,613.50 |
6.1× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,258.60 |
$1,798 |
6.8× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$658 |
$940 |
6.0× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,110.90 |
$1,587 |
6.0× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$82.60 |
$118 |
0.4× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$870.45 |
$1,243.50 |
4.7× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$653.45 |
$933.50 |
5.9× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$614.60 |
$878 |
3.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$667.45 |
$953.50 |
6.1× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,226.05 |
$1,751.50 |
6.6× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,233.40 |
$1,762 |
6.7× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$288.40 |
$412 |
1.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,796.55 |
$2,566.50 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,139.25 |
$1,627.50 |
4.5× |
| CT abdomen w & w/o contrast (74170) |
$1,116.85 |
$1,595.50 |
6.0× |
| CT abdomen w/contrast (74160) |
$929.60 |
$1,328 |
5.0× |
| CT abdomen w/o contrast (74150) |
$664.30 |
$949 |
6.0× |
| CT cervical spine w/contrast (72126) |
$882.70 |
$1,261 |
2.4× |
| CT cervical spine w/o contrast (72125) |
$720.65 |
$1,029.50 |
6.5× |
| CT chest w/contrast (71260) |
$881.65 |
$1,259.50 |
4.8× |
| CT extremity upper w & w/o contrast (73202) |
$79.10 |
$113 |
0.4× |
| CT extremity upper w/o contrast (73200) |
$735 |
$1,050 |
6.7× |
| CT head/brain with contrast (70460) |
$795.90 |
$1,137 |
4.3× |
| CT head/brain without and with contrast (70470) |
$1,198.40 |
$1,712 |
6.5× |
| CT heart no contrast quant eval coronry calcium (75571) |
$392.35 |
$560.50 |
4.3× |
| CT l-spine w/contrast (72132) |
$883.05 |
$1,261.50 |
2.4× |
| CT limited/localized follow up study (76380) |
$775.60 |
$1,108 |
8.4× |
| CT lower extremity w/dye (73701) |
$881.30 |
$1,259 |
4.8× |
| CT lumbar spine w/o contrast (72131) |
$658 |
$940 |
6.0× |
| CT neck w/contrast (70491) |
$894.25 |
$1,277.50 |
4.8× |
| CT neck w/o contrast (70490) |
$735 |
$1,050 |
6.7× |
| CT pelvis w & w/o contrast (72194) |
$1,148 |
$1,640 |
6.2× |
| CT pelvis w/o contrast (72192) |
$660.80 |
$944 |
6.0× |
| CT thoracic spine w/contrast (72129) |
$249.20 |
$356 |
1.3× |
| CT thoracic spine w/o contrast (72128) |
$720.30 |
$1,029 |
6.5× |
| CT thorax lung cancer scr c- (71271) |
$265.30 |
$379 |
2.4× |
| CT thorax w/o contrast (71250) |
$722.75 |
$1,032.50 |
6.6× |
| CT upper extremity w/dye (73201) |
$796.95 |
$1,138.50 |
2.2× |
| CTA head w contrast (70496) |
$1,257.55 |
$1,796.50 |
6.8× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$21 |
$30 |
0.1× |
| Discography, cervical or thoracic, radiological supervision and interpretation Age Under 21 (72285) |
$77 |
$110 |
0.0× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$168.35 |
$240.50 |
1.5× |
| Dxa bone density/peripheral (77081) |
$110.95 |
$158.50 |
1.2× |
| Fetal biophys profile w/o nst (76819) |
$270.20 |
$386 |
2.5× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$308.70 |
$441 |
1.2× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,650.95 |
$2,358.50 |
4.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$387.80 |
$554 |
1.1× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,151.85 |
$1,645.50 |
4.6× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,829.10 |
$2,613 |
5.0× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$395.50 |
$565 |
1.1× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$333.20 |
$476 |
1.3× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,365.70 |
$1,951 |
3.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,650.95 |
$2,358.50 |
4.5× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$96.60 |
$138 |
0.3× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,639.40 |
$2,342 |
4.5× |
| Mandible min 4v (70110) |
$178.15 |
$254.50 |
1.6× |
| MRA head w/o contrast (70544) |
$1,146.25 |
$1,637.50 |
4.6× |
| MRA neck w/ contrast (70548) |
$970.55 |
$1,386.50 |
2.6× |
| MRA neck w/o contrast (70547) |
$317.80 |
$454 |
1.3× |
| MRI abdomen w/contrast (74182) |
$112 |
$160 |
0.3× |
| MRI abdomen w/o contrast (74181) |
$1,131.20 |
$1,616 |
4.5× |
| MRI abdomen w/wo contrast (74183) |
$1,829.80 |
$2,614 |
5.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,179.85 |
$1,685.50 |
1.4× |
| MRI c-spine w&w/o cont (72156) |
$1,816.15 |
$2,594.50 |
4.9× |
| MRI cervical spine w/contrast (72142) |
$1,179.50 |
$1,685 |
3.2× |
| MRI chest w/contrast (71551) |
$112.70 |
$161 |
0.1× |
| MRI chest w/o contrast (71550) |
$1,207.15 |
$1,724.50 |
4.8× |
| MRI chest w/wo contrast (71552) |
$1,468.95 |
$2,098.50 |
4.0× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,866.55 |
$2,666.50 |
5.1× |
| MRI joint upr extrem w/dye (73222) |
$1,174.25 |
$1,677.50 |
1.4× |
| MRI joint upr extrem w/o dye (73221) |
$1,136.45 |
$1,623.50 |
4.5× |
| MRI lumbar spine w/contrast (72149) |
$1,320.20 |
$1,886 |
3.6× |
| MRI lumbar spine w/wo contrast (72158) |
$1,655.85 |
$2,365.50 |
4.5× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,830.15 |
$2,614.50 |
5.0× |
| MRI pelvis w & w/o contrast (72197) |
$1,652.35 |
$2,360.50 |
4.5× |
| MRI pelvis w/contrast (72196) |
$1,177.05 |
$1,681.50 |
3.2× |
| MRI pelvis w/o contrast (72195) |
$1,035.30 |
$1,479 |
4.1× |
| MRI spine cervical w/o contrast (72141) |
$1,035.65 |
$1,479.50 |
4.1× |
| MRI t-spine w&w/o cont (72157) |
$1,655.85 |
$2,365.50 |
4.5× |
| MRI thoracic spine w/contrast (72147) |
$116.20 |
$166 |
0.3× |
| MRI thoracic spine w/o contrst (72146) |
$1,127 |
$1,610 |
4.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,031.80 |
$1,474 |
4.1× |
| Ob us limited fetus(s) (76815) |
$302.75 |
$432.50 |
2.7× |
| Ob us nuchal meas 1 gest (76813) |
$77.70 |
$111 |
0.7× |
| Parathyroid planar imaging (78070) |
$387.80 |
$554 |
0.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$117.95 |
$168.50 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$17.50 |
$25 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$146.65 |
$209.50 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$215.25 |
$307.50 |
2.0× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$27.30 |
$39 |
0.2× |
| Radex hip unilateral with pelvis 1 view (73501) |
$136.85 |
$195.50 |
1.5× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$170.45 |
$243.50 |
1.9× |
| Radex hip unilateral with pelvis minimum 4 views (73503) |
$178.50 |
$255 |
1.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$158.90 |
$227 |
1.4× |
| Radex hips bilateral with pelvis minimum 5 views (73523) |
$88.90 |
$127 |
0.8× |
| Radex spine cervical 2 or 3 views (72040) |
$143.50 |
$205 |
1.6× |
| Radex spine cervical 4 or 5 views (72050) |
$196.70 |
$281 |
1.8× |
| Radex spine cervical 6 or more views (72052) |
$214.20 |
$306 |
1.9× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$149.80 |
$214 |
1.6× |
| Radiologic exam chest 3 views (71047) |
$170.10 |
$243 |
1.9× |
| Radiologic exam chest 4+ views (71048) |
$20.30 |
$29 |
0.2× |
| Radiologic exam colon double contrast study (74280) |
$724.85 |
$1,035.50 |
3.9× |
| Radiologic exam colon single contrast study (74270) |
$474.60 |
$678 |
2.6× |
| Radiologic exam esophagus single contrast study (74220) |
$314.30 |
$449 |
1.7× |
| Radiologic exam small int single contrast study (74250) |
$438.20 |
$626 |
2.4× |
| Radiologic exam swallow function contrast study (74230) |
$360.50 |
$515 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$322.35 |
$460.50 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$343.70 |
$491 |
1.9× |
| Radiologic examination femur 1 view (73551) |
$42 |
$60 |
0.5× |
| Radiologic examination femur minimum 2 views (73552) |
$183.75 |
$262.50 |
2.0× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$119.35 |
$170.50 |
1.3× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$162.40 |
$232 |
1.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$171.85 |
$245.50 |
1.6× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$130.55 |
$186.50 |
1.4× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$142.10 |
$203 |
1.5× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$13.30 |
$19 |
0.1× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$160.65 |
$229.50 |
1.8× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$162.75 |
$232.50 |
1.8× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$142.10 |
$203 |
1.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$180.95 |
$258.50 |
1.6× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$142.10 |
$203 |
1.5× |
| Radiologic examination, mastoids; less than 3 views per side Age Under 21 (70120) |
$54.60 |
$78 |
0.5× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$163.10 |
$233 |
1.8× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$253.05 |
$361.50 |
2.3× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$196.35 |
$280.50 |
1.8× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$148.75 |
$212.50 |
1.3× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$430.15 |
$614.50 |
1.2× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$161.35 |
$230.50 |
1.8× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$154.35 |
$220.50 |
1.7× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$142.10 |
$203 |
1.3× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$154.35 |
$220.50 |
1.4× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$132.30 |
$189 |
1.2× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$224.70 |
$321 |
2.0× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$178.85 |
$255.50 |
1.6× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$165.90 |
$237 |
1.8× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$145.60 |
$208 |
1.6× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$147.70 |
$211 |
1.6× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$181.30 |
$259 |
1.6× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$59.50 |
$85 |
0.6× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$140.70 |
$201 |
1.5× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$10.50 |
$15 |
0.1× |
| Review by radiologist of urinary bladder and urethra images with contrast and after passing urine (74455) |
$149.80 |
$214 |
0.6× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$166.60 |
$238 |
0.7× |
| Scapula complete (73010) |
$130.90 |
$187 |
1.2× |
| Screening digital breast tomosynthesis bi (77063) |
$133.70 |
$191 |
— |
| Ultrasound breast limited (76642) |
$301 |
$430 |
3.3× |
| Ultrasound, abdomen limited (76705) |
$263.90 |
$377 |
2.4× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$267.40 |
$382 |
2.4× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$389.55 |
$556.50 |
3.5× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$1,099 |
$1,570 |
4.4× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$333.20 |
$476 |
3.0× |
| Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning (separate procedure) Age Under 21 (76873) |
$250.60 |
$358 |
2.3× |
| Umbilical-artery Doppler (OB) (76820) |
$63.70 |
$91 |
0.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$193.90 |
$277 |
1.0× |
| Urography antegrade rs&i (74425) |
$195.30 |
$279 |
0.5× |
| Urography, infusion, drip technique and/or bolus technique; Age Under 21 (74410) |
$31.50 |
$45 |
0.2× |
| Us abdominal aorta real time screen study aaa (76706) |
$351.05 |
$501.50 |
3.2× |
| Us breast uni real time with image complete (76641) |
$374.50 |
$535 |
3.4× |
| Us chest (76604) |
$319.55 |
$456.50 |
2.9× |
| Us compl joint r-t w/image documentation (76881) |
$389.20 |
$556 |
3.5× |
| Us encephalogram (76506) |
$161.70 |
$231 |
1.5× |
| Us exam, pelvic, limited (76857) |
$236.95 |
$338.50 |
2.1× |
| Us inft hips r-t img dynamic req phys/qhp manj (76885) |
$402.85 |
$575.50 |
4.4× |
| Us inft hips r-t img lmtd static phys/qhp manj (76886) |
$40.60 |
$58 |
0.4× |
| US OB Follow-Up/Repeat (76816) |
$141.40 |
$202 |
1.3× |
| Us ob transvaginal (76817) |
$311.15 |
$444.50 |
2.8× |
| Us retroperitoneal complete (76770) |
$291.20 |
$416 |
2.6× |
| Us retroperitoneal ltd (76775) |
$287.35 |
$410.50 |
2.6× |
| Us scrotum (76870) |
$322 |
$460 |
2.9× |
| Us soft tissue head/neck (76536) |
$380.10 |
$543 |
3.4× |
| Us spinal canal (76800) |
$84.70 |
$121 |
0.8× |
| Us transrectal (76872) |
$198.80 |
$284 |
1.8× |
| X-ray exam hips bi 3-4 views (73522) |
$208.25 |
$297.50 |
1.9× |
| X-ray exam of finger(s) (73140) |
$163.80 |
$234 |
1.8× |
| X-ray exam of knee 1 or 2 (73560) |
$149.45 |
$213.50 |
1.6× |
| X-ray exam ribs bil 3 views (71110) |
$167.65 |
$239.50 |
1.5× |
| X-ray exam ribs uni 2 views (71100) |
$151.20 |
$216 |
1.6× |
| X-ray heel (73650) |
$130.20 |
$186 |
1.4× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$143.50 |
$205 |
1.3× |
| Xr abdomen 1 view (74018) |
$119.35 |
$170.50 |
1.3× |
| Xr abdomen 2 views (74019) |
$143.50 |
$205 |
1.3× |
| Xr arthrogram ankle (73615) |
$184.10 |
$263 |
0.5× |
| Xr arthrogram elbow (73085) |
$35 |
$50 |
0.1× |
| Xr arthrogram hip (73525) |
$611.45 |
$873.50 |
1.7× |
| Xr arthrogram knee (73580) |
$158.20 |
$226 |
0.4× |
| Xr arthrogram wrist (73115) |
$193.90 |
$277 |
0.5× |
| Xr bone age studies (77072) |
$203 |
$290 |
1.8× |
| Xr bone length study (77073) |
$321.65 |
$459.50 |
2.9× |
| Xr bone survey infant (77076) |
$153.30 |
$219 |
1.4× |
| Xr bone survey ltd (77074) |
$93.10 |
$133 |
0.8× |
| Xr chest 1 view (71045) |
$119.35 |
$170.50 |
1.3× |
| Xr chest 2 views (71046) |
$143.50 |
$205 |
1.6× |
| Xr eye foreign body (70030) |
$119.35 |
$170.50 |
1.3× |
| Xr facial bones 3+ views (70150) |
$180.95 |
$258.50 |
1.6× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$130.20 |
$186 |
1.4× |
| Xr forearm 2 views (73090) |
$130.20 |
$186 |
1.4× |
| Xr hand 2v (73120) |
$130.55 |
$186.50 |
1.2× |
| Xr hysterosalpingogram (74740) |
$470.40 |
$672 |
1.9× |
| Xr neck soft tissue (70360) |
$135.80 |
$194 |
1.5× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$165.55 |
$236.50 |
1.8× |
| Xr osseous survey complete (77075) |
$446.95 |
$638.50 |
4.1× |
| Xr pelvis 1-2 views (72170) |
$130.90 |
$187 |
1.2× |
| Xr pelvis min 3 view (72190) |
$166.60 |
$238 |
1.5× |
| Xr sacrum/coccyx 2+ views (72220) |
$148.40 |
$212 |
1.6× |
| Xr shoulder 1 view (73020) |
$128.80 |
$184 |
1.4× |
| Xr sinuses 3+ views (70220) |
$173.95 |
$248.50 |
1.9× |
| Xr skull min 4 view (70260) |
$156.45 |
$223.50 |
1.4× |
| Xr spine 1 view (72020) |
$76.30 |
$109 |
0.8× |
| Xr spine thoracic 3v (72072) |
$143.50 |
$205 |
1.3× |
| Xr sternum 2+ views (71120) |
$149.10 |
$213 |
1.6× |
| Xr stress view joint (77071) |
$78.40 |
$112 |
0.9× |
| Xr surgical specimen (76098) |
$51.80 |
$74 |
0.1× |
| Xr t-spine 2 views (72070) |
$131.60 |
$188 |
1.2× |
| Xr tibia/fibula 2 views (73590) |
$141.40 |
$202 |
1.5× |
| Xr tmj bilateral (70330) |
$174.30 |
$249 |
1.9× |
| Xr wrist 2 views (73100) |
$149.45 |
$213.50 |
1.6× |