| Abdomen 1 View (74018) |
— |
$199 |
— |
| Abdomen 2 views (74019) |
— |
$290 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,481 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$5,533 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$5,316 |
— |
Ankle 2 views (73600) range across 3 matching MRF lines |
— |
$302–$385 |
— |
| Arthrogram ankle (73615) |
— |
$1,309 |
— |
| Arthrogram hip (73525) |
— |
$524 |
— |
| Arthrogram Wrist (73115) |
— |
$1,309 |
— |
| Bone age studies (77072) |
— |
$241 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$1,664 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,523 |
— |
| Bone Imaging Whole Body (78306) |
— |
$1,583 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,133 |
— |
| Bone marrow imaging; whole body (78104) |
— |
$1,133 |
— |
| Bone survey infant (77076) |
— |
$469 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$6,533 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$561 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$1,205 |
— |
Chest 1 view (71045) range across 4 matching MRF lines |
— |
$146–$190 |
— |
Chest 2 views (71046) range across 8 matching MRF lines |
— |
$60–$345 |
— |
| Chest 3 views (71047) |
— |
$389 |
— |
| Chest 4 or more views (71048) |
— |
$423 |
— |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
— |
$384 |
— |
Clavicle complete (73000) range across 3 matching MRF lines |
— |
$225–$338 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$378 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$959 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$1,309 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$1,309 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$4,406 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$2,971 |
— |
| CT abdomen w contrast (74160) |
— |
$2,308 |
— |
| CT abdomen w wo contrast (74170) |
— |
$1,850 |
— |
| CT abdomen w/o contrast (74150) |
— |
$2,208 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$2,787 |
— |
| CT Angio Chest (71275) |
— |
$2,686 |
— |
| CT Angio Head (70496) |
— |
$2,497 |
— |
| CT angio hrt w/3d image (75574) |
— |
$1,916 |
— |
Ct Angio Lwr Extr W/O&W/Dye (73706) range across 3 matching MRF lines |
— |
$2,398–$2,732 |
— |
| CT Angio Neck (70498) |
— |
$2,132 |
— |
Ct Angio Upr Extrm W/O&W/Dye (73206) range across 3 matching MRF lines |
— |
$2,061–$2,271 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$3,156 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$1,797 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$1,762 |
— |
| CT chest w contrast (71260) |
— |
$2,065 |
— |
CT chest w/wo contrast (71270) range across 2 matching MRF lines |
— |
$1,850–$3,160 |
— |
| CT head/brain with contrast (70460) |
— |
$1,575 |
— |
| CT head/brain without and with contrast (70470) |
— |
$2,041 |
— |
| CT iac w contrast (70481) |
— |
$2,253 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$1,762 |
— |
CT lower ext w/o (73700) range across 15 matching MRF lines |
— |
$1,929–$2,894 |
— |
CT lower extremity w/contrast material (73701) range across 3 matching MRF lines |
— |
$2,043–$3,065 |
— |
| CT lumbar spine w contrast (72132) |
— |
$2,301 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$2,170 |
— |
| CT maxillofacial w contrast (70487) |
— |
$2,092 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$1,988 |
— |
| CT neck tissue combo (70492) |
— |
$2,519 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$2,681 |
— |
| CT orbits w/o contrast (70480) |
— |
$1,929 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$1,638 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,527 |
— |
CT scan of leg combo (73702) range across 3 matching MRF lines |
— |
$2,021–$2,762 |
— |
| CT scans face/jaw combo (70488) |
— |
$2,129 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$1,954 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$1,910 |
— |
| CT thoracic spine w contrast (72129) |
— |
$2,552 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$2,092 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$3,037 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,664 |
— |
CT upper ext wo (73200) range across 6 matching MRF lines |
— |
$1,929–$2,894 |
— |
CT upper extremity w/o & w/contrast material (73202) range across 3 matching MRF lines |
— |
$1,910–$2,243 |
— |
CT upper extremity with contrast (73201) range across 3 matching MRF lines |
— |
$1,970–$2,955 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$7,441 |
— |
| Cta Abdomen (74175) |
— |
$3,115 |
— |
| CTA head&neck c+ w/noncontrast img&post-pxessing (70471) |
— |
$4,600 |
— |
| Dxa Bone Density Axial (77080) |
— |
$426 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$287 |
— |
| Echo exam uterus (76831) |
— |
$491 |
— |
| Esophagram (74220) |
— |
$295 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$326 |
— |
Fetal Biophysical Profile W/O Non-Stress Testing (76819) range across 2 matching MRF lines |
— |
$379–$673 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$249 |
— |
Foot 2 views (73620) range across 3 matching MRF lines |
— |
$219–$329 |
— |
Forearm 2 views (73090) range across 3 matching MRF lines |
— |
$230–$345 |
— |
| Gastric emptying imaging study (78264) |
— |
$1,712 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,019 |
— |
Hand 2 views (73120) range across 3 matching MRF lines |
— |
$279–$476 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$1,131 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$1,965 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$2,481 |
— |
| Hysterosalpingogram (74740) |
— |
$1,292 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$311 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$1,869 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$738 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,133 |
— |
Knee 3 Views (73562) range across 3 matching MRF lines |
— |
$257–$386 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$2,481 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$2,481 |
— |
| Lymph System Imaging (78195) |
— |
$2,481 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$2,414 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$713 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$475 |
— |
| Meckels Divert Exam (78290) |
— |
$1,492 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$54 |
— |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
— |
$202 |
— |
| Mr safety implt pos&/immoblj (76019) |
— |
$131 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$4,749 |
— |
| MRA head w/o contrast (70544) |
— |
$2,058 |
— |
| MRA head with contrast (70545) |
— |
$2,948 |
— |
| MRA neck w contrast (70548) |
— |
$3,083 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$4,049 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,777 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,948 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,387 |
— |
MRI any jt lower extrem w/contrast material (73722) range across 12 matching MRF lines |
— |
$2,371–$3,821 |
— |
MRI any jt lower extrem w/o & w/contrast matrl (73723) range across 12 matching MRF lines |
— |
$4,260–$6,390 |
— |
MRI any jt upper extremity w/contrast matrl (73222) range across 9 matching MRF lines |
— |
$2,371–$3,557 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$4,344 |
— |
| MRI Breast Without Contrast Material Unilateral (77046) |
— |
$3,441 |
— |
| MRI cervical spine w contrast (72142) |
— |
$3,623 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$2,599 |
— |
| MRI chest w/o contrast (71550) |
— |
$3,446 |
— |
| MRI chest with contrast (71551) |
— |
$2,777 |
— |
| MRI chest wo w contrast (71552) |
— |
$4,749 |
— |
MRI lower extrem oth/thn jt w/contrast matrl (73719) range across 18 matching MRF lines |
— |
$2,948–$4,982 |
— |
MRI lower extrem oth/thn jt w/o & w/contr matr (73720) range across 18 matching MRF lines |
— |
$3,895–$5,843 |
— |
MRI lower extrem oth/thn jt w/o contr matrl (73718) range across 18 matching MRF lines |
— |
$2,777–$3,564 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$3,623 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$4,204 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$2,777 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$2,948 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$5,937 |
— |
| MRI pelvis w contrast (72196) |
— |
$2,948 |
— |
MRI pelvis w/o & w contrast (72197) range across 3 matching MRF lines |
— |
$2,777–$4,296 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$2,383 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$2,712 |
— |
MRI upper extremity oth than jt w/contr matrl (73219) range across 3 matching MRF lines |
— |
$2,948–$3,126 |
— |
MRI upper extremity oth than jt w/o contr matrl (73218) range across 21 matching MRF lines |
— |
$1,980–$2,983 |
— |
Mri Uppr Extremity W/O&W/Dye (73220) range across 21 matching MRF lines |
— |
$2,066–$3,099 |
— |
| MRI, abdomen, combo (74183) |
— |
$4,296 |
— |
| MRI, dorsal spine combo (72157) |
— |
$3,426 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$3,623 |
— |
MRI, joint upper extrem (73221) range across 9 matching MRF lines |
— |
$2,401–$2,811 |
— |
MRI, joint upper extrem combo (73223) range across 9 matching MRF lines |
— |
$4,749–$4,911 |
— |
| MRI, lumbar spine combo (72158) |
— |
$3,972 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$2,586 |
— |
| Neck soft tissue (70360) |
— |
$200 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$1,451 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$1,572 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$1,190 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$230 |
— |
| Peritoneogram Rs&I (74190) |
— |
$1,103 |
— |
| Pet Image W/Ct Lmtd (78814) |
— |
$6,533 |
— |
| PET image w/CT, full body (78816) |
— |
$6,533 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$4,913 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$2,481 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$374 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$640 |
— |
Radex Ankle Complete Minimum 3 Views (73610) range across 3 matching MRF lines |
— |
$243–$365 |
— |
Radex Calcaneus Minimum 2 Views (73650) range across 3 matching MRF lines |
— |
$201–$302 |
— |
Radex elbow complete minimum 3 views (73080) range across 3 matching MRF lines |
— |
$271–$406 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$276 |
— |
Radex fingr minimum 2 views (73140) range across 3 matching MRF lines |
— |
$172–$258 |
— |
Radex foot complete minimum 3 views (73630) range across 3 matching MRF lines |
— |
$236–$354 |
— |
Radex Hand Minimum 3 Views (73130) range across 3 matching MRF lines |
— |
$239–$359 |
— |
Radex lower extremity infant minimum 2 views (73592) range across 3 matching MRF lines |
— |
$276–$440 |
— |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
— |
$390 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$276 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$252 |
— |
Radex shoulder complete minimum 2 views (73030) range across 3 matching MRF lines |
— |
$260–$390 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$276 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$276 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$158 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$311 |
— |
Radex Toe Minimum 2 Views (73660) range across 3 matching MRF lines |
— |
$181–$272 |
— |
Radex upper extremity infant minimum 2 views (73092) range across 3 matching MRF lines |
— |
$227–$339 |
— |
Radex Wrist Complete Minimum 3 Views (73110) range across 3 matching MRF lines |
— |
$243–$365 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$530 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$238 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$862 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$1,035 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$771 |
— |
Radiologic exam knee complete 4/more views (73564) range across 3 matching MRF lines |
— |
$267–$401 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$264 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$554 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$521 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$501 |
— |
Radiologic examination femur 1 view (73551) range across 3 matching MRF lines |
— |
$155–$232 |
— |
Radiologic examination femur minimum 2 views (73552) range across 3 matching MRF lines |
— |
$235–$267 |
— |
Radiologic examination knee 1/2 views (73560) range across 3 matching MRF lines |
— |
$204–$306 |
— |
| Radiologic Examination Osseous Survey Limited (77074) |
— |
$339 |
— |
Radiologic examination tibia & fibula 2 views (73590) range across 3 matching MRF lines |
— |
$255–$383 |
— |
| Ribs bilateral 3 views (71110) |
— |
$616 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$2,481 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$2,693 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$2,693 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$3,055 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$3,694 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$1,299 |
— |
Scapula (73010) range across 3 matching MRF lines |
— |
$215–$323 |
— |
Screening Digital Breast Tomosynthesis Bi (77063) range across 5 matching MRF lines |
— |
$119–$124 |
— |
| Shoulder 1 view (73020) |
— |
$175 |
— |
Shoulder Arthrography (73040) range across 3 matching MRF lines |
— |
$512–$768 |
— |
| Skull less than 4 views (70250) |
— |
$488 |
— |
| Sternoclavicular joints (71130) |
— |
$311 |
— |
Temporomandble Jt Arthrography Rs&I (70332) range across 3 matching MRF lines |
— |
$482–$771 |
— |
| Thoracic spine 2 views (72070) |
— |
$271 |
— |
| Thoracic spine 3 views (72072) |
— |
$271 |
— |
| Thoracolumbar 2 views (72080) |
— |
$428 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,133 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$2,500 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$1,721 |
— |
Ultrasound Breast Limited (76642) range across 6 matching MRF lines |
— |
$334–$372 |
— |
| Ultrasound Elastography Parenchyma (76981) |
— |
$352 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$412 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$663 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$326 |
— |
| Upper gi w/o kub (74240) |
— |
$612 |
— |
| Urea Breath Test C-14 Isotopic Acquisj Analysis (78267) |
— |
$247 |
— |
| Ureteral Reflux Study (78740) |
— |
$1,312 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,075 |
— |
| Urethrocystography retrograde (74450) |
— |
$959 |
— |
Us breast unilateral complete (76641) range across 11 matching MRF lines |
— |
$711–$1,067 |
— |
| Us chest (76604) |
— |
$453 |
— |
| Us exam, pelvic, limited (76857) |
— |
$407 |
— |
| Us kidney transplant (76776) |
— |
$903 |
— |
Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) range across 6 matching MRF lines |
— |
$500–$750 |
— |
| Us ob detailed single fetus (76811) |
— |
$724 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$545 |
— |
| Us ob transvaginal (76817) |
— |
$511 |
— |
Us pelvic non ob complete (76856) range across 2 matching MRF lines |
— |
$475–$700 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$376 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$344 |
— |
| Us retroperitoneal complete (76770) |
— |
$681 |
— |
| Us retroperitoneal limited (76775) |
— |
$544 |
— |
| Us scrotum and contents (76870) |
— |
$554 |
— |
| Us spinal canal and contents (76800) |
— |
$311 |
— |
| Us thyroid (76536) |
— |
$499 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$1,985 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$1,703 |
— |
Wrist 2 views (73100) range across 3 matching MRF lines |
— |
$221–$332 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$245 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$597 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$469 |
— |
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) range across 3 matching MRF lines |
— |
$270–$405 |
— |
X-Ray Exam Breast Specimen (76098) range across 8 matching MRF lines |
— |
$645–$968 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$193 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$265 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$499 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$155 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$276 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$297 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$309 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$373 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$406 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$455 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$271 |
— |
X-Ray Exam Neck Spine 6/>Vws (72052) range across 5 matching MRF lines |
— |
$263–$862 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$300 |
— |
X-ray eye for foreign body (70030) range across 3 matching MRF lines |
— |
$183–$275 |
— |
X-ray humerus (73060) range across 3 matching MRF lines |
— |
$233–$350 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$777 |
— |
| X-ray IV pyelogram+tomography (74415) |
— |
$959 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$276 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$241 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$290 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$276 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$469 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$488 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$224 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$254 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$270 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$390 |
— |
| X-Ray Stress View (77071) |
— |
$190 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$440 |
— |
| X-Ray Tmj Unilat (70328) |
— |
$276 |
— |
X-Ray Urinary Tract Exam With Contrast Material (74420) range across 6 matching MRF lines |
— |
$959–$1,672 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$469 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$769 |
— |
Xr c-spine 4 or 5 views (72050) range across 5 matching MRF lines |
— |
$407–$469 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$390 |
— |
| Xr orbits complete 4 views (70200) |
— |
$390 |
— |