| Abdomen 1 View (74018) |
$192.75 |
$257 |
2.1× |
| Abdomen 2 views (74019) |
$243 |
$324 |
2.2× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$894.75 |
$1,193 |
2.1× |
| Ankle 2 views (73600) |
$176.25 |
$235 |
1.9× |
| Bone age studies (77072) |
$190.50 |
$254 |
1.7× |
| Bone Imaging 3 Phase (78315) |
$1,264.50 |
$1,686 |
3.0× |
| Bone Imaging Limited Area (78300) |
$816 |
$1,088 |
1.9× |
| Bone Imaging Multiple Areas (78305) |
$987 |
$1,316 |
2.3× |
| Bone Imaging Whole Body (78306) |
$1,234.50 |
$1,646 |
2.9× |
| Bone survey infant (77076) |
$333 |
$444 |
3.0× |
| Cat Scan Follow-Up Study (76380) |
$311.25 |
$415 |
3.3× |
| Chest 1 view (71045) |
$150.75 |
$201 |
1.6× |
| Chest 2 views (71046) |
$218.25 |
$291 |
2.3× |
| Chest 3 views (71047) |
$221.25 |
$295 |
2.4× |
| Chest 4 or more views (71048) |
$237.75 |
$317 |
2.1× |
| Clavicle complete (73000) |
$204.75 |
$273 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$497.25 |
$663 |
4.4× |
| Contrast X-Ray Bladder (74430) |
$364.50 |
$486 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,908.25 |
$5,211 |
10.5× |
| CT abdomen and pelvis without contrast (74176) |
$3,030.75 |
$4,041 |
11.9× |
| CT abdomen w contrast (74160) |
$1,704.75 |
$2,273 |
9.1× |
| CT abdomen w wo contrast (74170) |
$2,050.50 |
$2,734 |
10.9× |
| CT abdomen w/o contrast (74150) |
$1,561.50 |
$2,082 |
13.9× |
| CT Angio Abdomen and Pelvis (74174) |
$3,320.25 |
$4,427 |
8.9× |
| CT Angio Chest (71275) |
$2,639.25 |
$3,519 |
14.0× |
| CT Angio Head (70496) |
$2,043 |
$2,724 |
10.9× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,383.50 |
$3,178 |
12.7× |
| CT Angio Neck (70498) |
$2,383.50 |
$3,178 |
12.7× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,909.50 |
$2,546 |
10.2× |
| CT bone density (77078) |
$401.25 |
$535 |
4.3× |
| CT cervical spine w/ contrast (72126) |
$1,527 |
$2,036 |
4.1× |
| CT cervical spine w/o contrast (72125) |
$1,974.75 |
$2,633 |
17.6× |
| CT cervical spine w/wo cont (72127) |
$1,809.75 |
$2,413 |
9.6× |
| CT chest w contrast (71260) |
$1,736.25 |
$2,315 |
9.2× |
| CT chest w/wo contrast (71270) |
$2,110.50 |
$2,814 |
11.2× |
| CT head/brain with contrast (70460) |
$1,527 |
$2,036 |
8.1× |
| CT head/brain without and with contrast (70470) |
$2,022.75 |
$2,697 |
10.8× |
| CT iac w contrast (70481) |
$1,591.50 |
$2,122 |
8.5× |
| CT l-spine w&w/o contrast (72133) |
$1,809.75 |
$2,413 |
9.6× |
| CT lower ext w/o (73700) |
$1,454.25 |
$1,939 |
13.0× |
| CT lower extremity w/contrast material (73701) |
$1,527 |
$2,036 |
8.1× |
| CT lumbar spine w contrast (72132) |
$1,427.25 |
$1,903 |
3.8× |
| CT lumbar spine w/o contrast (72131) |
$1,974.75 |
$2,633 |
17.6× |
| CT maxillofacial w contrast (70487) |
$1,668.75 |
$2,225 |
8.9× |
| CT maxillofacial wo contrast (70486) |
$1,491 |
$1,988 |
13.3× |
| CT neck tissue combo (70492) |
$1,845.75 |
$2,461 |
9.8× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,845.75 |
$2,461 |
9.8× |
| CT orbits w/o contrast (70480) |
$1,275.75 |
$1,701 |
11.4× |
| CT pelvis w&w/o contrast (72194) |
$1,628.25 |
$2,171 |
8.7× |
| CT pelvis w/o contrast (72192) |
$1,640.25 |
$2,187 |
14.6× |
| CT scan of leg combo (73702) |
$1,809.75 |
$2,413 |
9.6× |
| CT scans face/jaw combo (70488) |
$1,784.25 |
$2,379 |
9.5× |
| CT soft tissue neck w contrast (70491) |
$1,420.50 |
$1,894 |
7.6× |
| CT soft tissue neck w/o contrast (70490) |
$1,340.25 |
$1,787 |
12.0× |
| CT thoracic spine w contrast (72129) |
$1,704 |
$2,272 |
9.1× |
| CT thoracic spine w/o contrast (72128) |
$1,934.25 |
$2,579 |
17.3× |
| CT thoracic spine w/wo cont (72130) |
$1,809.75 |
$2,413 |
9.6× |
CT thorax w/o contrast (71250)
range across 2 matching MRF lines |
$1,386–$1,482.75 |
$1,848–$1,977 |
varies |
| CT upper ext wo (73200) |
$1,454.25 |
$1,939 |
13.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,809.75 |
$2,413 |
9.6× |
| CT upper extremity with contrast (73201) |
$1,599 |
$2,132 |
4.3× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,320.25 |
$4,427 |
17.7× |
| Cta Abdomen (74175) |
$2,894.25 |
$3,859 |
15.4× |
| CTA pelvis (72191) |
$2,148 |
$2,864 |
11.4× |
| Discography Cerv/Thor Spine (72285) |
$4,035 |
$5,380 |
1.9× |
| Diskography lumbar (72295) |
$4,035 |
$5,380 |
1.9× |
| Dxa Bone Density Axial (77080) |
$504.75 |
$673 |
4.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$245.25 |
$327 |
2.6× |
| Esophagram (74220) |
$354.75 |
$473 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$618.75 |
$825 |
5.5× |
| Fluoroscopy up to 1 hr (76000) |
$528.75 |
$705 |
2.1× |
| Foot 2 views (73620) |
$176.25 |
$235 |
1.9× |
| Forearm 2 views (73090) |
$198 |
$264 |
2.1× |
| Gastric emptying imaging study (78264) |
$810 |
$1,080 |
1.9× |
| Gated Heart Planar Single (78472) |
$894.75 |
$1,193 |
2.1× |
| Hand 2 views (73120) |
$163.50 |
$218 |
1.5× |
| Hepatobil Syst Image W/Drug (78227) |
$1,415.25 |
$1,887 |
2.4× |
| Hepatobiliary System Imaging (78226) |
$1,168.50 |
$1,558 |
2.7× |
| Ht Muscle Image Spect Sing (78451) |
$1,475.25 |
$1,967 |
1.1× |
| K Flow/Funct Image Multiple (78709) |
$976.50 |
$1,302 |
1.7× |
| K Flow/Funct Image W/Drug (78708) |
$762.75 |
$1,017 |
1.3× |
| K Flow/Funct Image W/O Drug (78707) |
$879 |
$1,172 |
1.5× |
| Knee 3 Views (73562) |
$191.25 |
$255 |
2.1× |
| Liver & Spleen Imaging Static Only (78215) |
$1,061.25 |
$1,415 |
2.5× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$928.50 |
$1,238 |
2.2× |
| Lung Perf&Ventilat Diferentl (78598) |
$1,160.25 |
$1,547 |
2.0× |
| Lung Ventilat&Perfus Imaging (78582) |
$1,964.25 |
$2,619 |
3.4× |
| Magnetic Image Jaw Joint (70336) |
$2,316.75 |
$3,089 |
9.1× |
| Meckels Divert Exam (78290) |
$663.75 |
$885 |
1.5× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,412 |
$3,216 |
6.5× |
| MRA head w/o contrast (70544) |
$1,842.75 |
$2,457 |
7.2× |
| MRA head with contrast (70545) |
$1,977.75 |
$2,637 |
5.3× |
| MRA neck w contrast (70548) |
$1,818.75 |
$2,425 |
4.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,412 |
$3,216 |
6.5× |
| MRA neck w/o contrast (70547) |
$1,656.75 |
$2,209 |
6.5× |
| MRI abdomen w contrast (74182) |
$1,989.75 |
$2,653 |
5.3× |
| MRI abdomen w/o contrast (74181) |
$2,007.75 |
$2,677 |
7.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,082.75 |
$2,777 |
2.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$2,412 |
$3,216 |
6.5× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,082.75 |
$2,777 |
2.5× |
| MRI cervical spine w contrast (72142) |
$2,386.50 |
$3,182 |
6.4× |
| MRI cervical spine w/o cont (72141) |
$2,502.75 |
$3,337 |
9.8× |
| MRI chest w/o contrast (71550) |
$1,896 |
$2,528 |
7.4× |
| MRI chest with contrast (71551) |
$2,082.75 |
$2,777 |
2.5× |
| MRI chest wo w contrast (71552) |
$2,412 |
$3,216 |
6.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,228.25 |
$2,971 |
6.0× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,412 |
$3,216 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,860 |
$2,480 |
7.3× |
| MRI lumbar spine w contrast (72149) |
$2,530.50 |
$3,374 |
6.8× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,610 |
$3,480 |
7.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,802.25 |
$2,403 |
7.0× |
| MRI orbit face neck w contrast (70542) |
$2,287.50 |
$3,050 |
6.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,412 |
$3,216 |
6.5× |
| MRI pelvis w contrast (72196) |
$2,287.50 |
$3,050 |
6.1× |
| MRI pelvis w/o & w contrast (72197) |
$2,412 |
$3,216 |
6.5× |
| MRI pelvis w/o contrast (72195) |
$1,772.25 |
$2,363 |
6.9× |
| MRI thoracic spine w/o contrast (72146) |
$2,568.75 |
$3,425 |
10.0× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,082.75 |
$2,777 |
5.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,772.25 |
$2,363 |
6.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,639.25 |
$3,519 |
7.1× |
| MRI, abdomen, combo (74183) |
$2,658.75 |
$3,545 |
7.1× |
| MRI, dorsal spine combo (72157) |
$2,639.25 |
$3,519 |
7.1× |
| MRI, dorsal spine contrast (72147) |
$2,287.50 |
$3,050 |
6.1× |
| MRI, joint upper extrem (73221) |
$1,952.25 |
$2,603 |
7.6× |
| MRI, joint upper extrem combo (73223) |
$2,412 |
$3,216 |
6.5× |
| MRI, lumbar spine combo (72158) |
$2,767.50 |
$3,690 |
7.4× |
| Myocardial Spect Multiple Studies (78452) |
$2,892.75 |
$3,857 |
2.1× |
| Neck soft tissue (70360) |
$155.25 |
$207 |
1.7× |
| Parathyroid Planar Imaging (78070) |
$976.50 |
$1,302 |
2.3× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$1,031.25 |
$1,375 |
2.4× |
| Pelvis 1 or 2 views (72170) |
$185.25 |
$247 |
1.7× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$937.50 |
$1,250 |
2.2× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$359.25 |
$479 |
3.2× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$213.75 |
$285 |
2.3× |
| Radex Calcaneus Minimum 2 Views (73650) |
$216 |
$288 |
2.3× |
| Radex elbow complete minimum 3 views (73080) |
$225.75 |
$301 |
2.4× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$299.25 |
$399 |
2.7× |
| Radex fingr minimum 2 views (73140) |
$132.75 |
$177 |
1.4× |
| Radex foot complete minimum 3 views (73630) |
$213.75 |
$285 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$204.75 |
$273 |
2.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$106.50 |
$142 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$315 |
$420 |
2.8× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$230.25 |
$307 |
2.5× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$295.50 |
$394 |
3.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$249 |
$332 |
2.7× |
| Radex shoulder complete minimum 2 views (73030) |
$234.75 |
$313 |
2.5× |
| Radex Sinuses Paransl < 3 Views (70210) |
$142.50 |
$190 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$145.50 |
$194 |
1.6× |
| Radex Sternum Minimum 2 Views (71120) |
$204.75 |
$273 |
2.2× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$299.25 |
$399 |
3.2× |
| Radex Toe Minimum 2 Views (73660) |
$171 |
$228 |
1.8× |
Radex upper extremity infant minimum 2 views (73092)
range across 2 matching MRF lines |
$113.25–$120.75 |
$151–$161 |
varies |
| Radex Wrist Complete Minimum 3 Views (73110) |
$204.75 |
$273 |
2.2× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$282.75 |
$377 |
2.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$252.75 |
$337 |
2.3× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$338.25 |
$451 |
3.0× |
| Radiologic exam knee complete 4/more views (73564) |
$213.75 |
$285 |
1.9× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$204.75 |
$273 |
1.8× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$466.50 |
$622 |
2.5× |
| Radiologic exam swallow function contrast study (74230) |
$379.50 |
$506 |
2.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$356.25 |
$475 |
1.9× |
| Radiologic examination femur 1 view (73551) |
$162.75 |
$217 |
1.7× |
| Radiologic examination femur minimum 2 views (73552) |
$191.25 |
$255 |
2.1× |
| Radiologic examination knee 1/2 views (73560) |
$176.25 |
$235 |
1.9× |
| Radiologic Examination Osseous Survey Limited (77074) |
$265.50 |
$354 |
2.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$198 |
$264 |
2.1× |
| Ribs bilateral 3 views (71110) |
$312 |
$416 |
2.8× |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
$780.75 |
$1,041 |
1.8× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$928.50 |
$1,238 |
2.2× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,374 |
$1,832 |
2.4× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$3,225 |
$4,300 |
2.3× |
| Scapula (73010) |
$204.75 |
$273 |
1.8× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$66.75 |
$89 |
2.9× |
| Sella turcica (70240) |
$160.50 |
$214 |
1.7× |
| Shoulder 1 view (73020) |
$119.25 |
$159 |
1.3× |
| Skull less than 4 views (70250) |
$219.75 |
$293 |
2.0× |
| Spleen Imaging (78185) |
$928.50 |
$1,238 |
2.2× |
| Sternoclavicular joints (71130) |
$165 |
$220 |
1.8× |
| Superior sagittal sinus venogram (75870) |
$4,413.75 |
$5,885 |
1.3× |
| Testicular Imaging W/Flow (78761) |
$795.75 |
$1,061 |
1.9× |
| Thoracic spine 2 views (72070) |
$213.75 |
$285 |
1.9× |
| Thoracic spine 3 views (72072) |
$222.75 |
$297 |
2.0× |
| Thoracolumbar 2 views (72080) |
$141 |
$188 |
1.5× |
| Thyroid Imaging With Vascular Flow (78013) |
$769.50 |
$1,026 |
1.8× |
| Thyroid Uptake Measurement (78012) |
$417 |
$556 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$851.25 |
$1,135 |
2.0× |
Ultrasound Breast Limited (76642)
range across 2 matching MRF lines |
$390–$420 |
$520–$560 |
varies |
| Ultrasound elastography first target lesion (76982) |
$255 |
$340 |
2.3× |
| Ultrasound Elastography Parenchyma (76981) |
$255 |
$340 |
2.3× |
| Ultrasound Exam Aaa Screen (76706) |
$361.50 |
$482 |
3.2× |
| Ultrasound, abdomen limited (76705) |
$361.50 |
$482 |
3.2× |
| Urethrocystogram voiding (74455) |
$398.25 |
$531 |
1.6× |
| Urethrocystography retrograde (74450) |
$371.25 |
$495 |
1.5× |
Us breast unilateral complete (76641)
range across 2 matching MRF lines |
$390–$460.50 |
$520–$614 |
varies |
| Us chest (76604) |
$259.50 |
$346 |
2.3× |
| Us complete joint (76881) |
$383.25 |
$511 |
3.4× |
| Us exam, pelvic, limited (76857) |
$348 |
$464 |
3.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$308.25 |
$411 |
2.8× |
| Us ob detailed single fetus (76811) |
$559.50 |
$746 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$298.50 |
$398 |
2.7× |
Us ob transvaginal (76817)
range across 2 matching MRF lines |
$333–$345.75 |
$444–$461 |
varies |
| Us pelvic non ob complete (76856) |
$644.25 |
$859 |
5.8× |
Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801)
range across 2 matching MRF lines |
$191.25–$487.50 |
$255–$650 |
varies |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$344.25 |
$459 |
3.1× |
| Us retroperitoneal complete (76770) |
$522.75 |
$697 |
4.7× |
| Us retroperitoneal limited (76775) |
$394.50 |
$526 |
3.5× |
| Us scrotum and contents (76870) |
$488.25 |
$651 |
4.4× |
| Us thyroid (76536) |
$468 |
$624 |
4.2× |
| Wrist 2 views (73100) |
$191.25 |
$255 |
2.1× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$211.50 |
$282 |
2.3× |
| X-Ray Bend Only L-S Spine (72120) |
$298.50 |
$398 |
2.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$198 |
$264 |
2.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$255 |
$340 |
2.7× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$273.75 |
$365 |
2.4× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$279 |
$372 |
2.5× |
| X-Ray Exam Hip Uni 1 View (73501) |
$195 |
$260 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$232.50 |
$310 |
2.5× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$250.50 |
$334 |
2.2× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$333 |
$444 |
3.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$351 |
$468 |
3.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$369.75 |
$493 |
3.3× |
| X-Ray Exam L-S Spine Bending (72114) |
$383.25 |
$511 |
3.4× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$242.25 |
$323 |
2.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$339.75 |
$453 |
3.0× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$276 |
$368 |
2.5× |
| X-ray eye for foreign body (70030) |
$116.25 |
$155 |
1.2× |
| X-ray humerus (73060) |
$204.75 |
$273 |
2.2× |
| X-ray IV pyelogram+tomography (74415) |
$696.75 |
$929 |
3.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$224.25 |
$299 |
2.4× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$185.25 |
$247 |
2.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$249 |
$332 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$128.25 |
$171 |
1.4× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$367.50 |
$490 |
3.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$198 |
$264 |
1.8× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$171 |
$228 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$216 |
$288 |
2.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$264 |
$352 |
2.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$336.75 |
$449 |
3.0× |
| X-ray thoracic spine 4 vw (72074) |
$279.75 |
$373 |
2.5× |
| X-Ray Tmj Unilat (70328) |
$158.25 |
$211 |
1.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$462.75 |
$617 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$227.25 |
$303 |
2.0× |
| X-Rays Bone Survey Complete (77075) |
$673.50 |
$898 |
6.0× |
| Xr c-spine 4 or 5 views (72050) |
$283.50 |
$378 |
2.5× |
| Xr facial bones less than 3 views (70140) |
$185.25 |
$247 |
2.0× |
| XR Mastoids < 3 Views Bilateral (70120) |
$309.75 |
$413 |
2.8× |
| Xr orbits complete 4 views (70200) |
$237 |
$316 |
2.1× |
| Xr Tomogram Single Plane (76100) |
$52.50 |
$70 |
0.5× |