| Acute gi blood loss imaging (78278) |
$812.64 |
$956.05 |
1.9× |
| Ankle 2 views (73600) |
$203.15 |
$239 |
2.2× |
| Clavicle complete (73000) |
$233.75 |
$275 |
2.5× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$1,769.61 |
$2,081.89 |
4.8× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,207.01 |
$1,420.01 |
6.5× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,207.01 |
$1,420.01 |
6.5× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,692.34 |
$1,990.99 |
9.1× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,207.01 |
$1,420.01 |
6.5× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,997.50 |
$2,350 |
10.8× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$912.27 |
$1,073.26 |
8.3× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$926.50 |
$1,090 |
5.0× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,997.50 |
$2,350 |
10.8× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$780.07 |
$917.73 |
4.2× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$768.28 |
$903.86 |
7.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$959.32 |
$1,128.62 |
5.2× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,151.75 |
$1,355 |
10.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,035.54 |
$1,218.29 |
5.6× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,207.01 |
$1,420.01 |
6.5× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,997.50 |
$2,350 |
10.8× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$1,997.50 |
$2,350 |
10.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,482 |
$2,920 |
6.7× |
| CT abdomen and pelvis without contrast (74176) |
$2,188.75 |
$2,575 |
8.7× |
| CT abdomen w & w/o contrast (74170) |
$1,327.44 |
$1,561.69 |
7.2× |
| CT abdomen w/contrast (74160) |
$1,207.01 |
$1,420.01 |
6.5× |
| CT abdomen w/o contrast (74150) |
$963.05 |
$1,133 |
8.7× |
| CT cervical spine w/contrast (72126) |
$1,632 |
$1,920 |
4.4× |
| CT cervical spine w/o contrast (72125) |
$1,551.25 |
$1,825 |
14.1× |
| CT chest w/contrast (71260) |
$1,627.75 |
$1,915 |
8.8× |
| CT extremity upper w & w/o contrast (73202) |
$926.50 |
$1,090 |
5.0× |
| CT extremity upper w/o contrast (73200) |
$563.52 |
$662.96 |
5.1× |
| CT head/brain with contrast (70460) |
$1,513 |
$1,780 |
8.2× |
| CT head/brain without and with contrast (70470) |
$1,827.50 |
$2,150 |
9.9× |
| CT heart no contrast quant eval coronry calcium (75571) |
$85 |
$100 |
0.9× |
| CT l-spine w/contrast (72132) |
$1,632 |
$1,920 |
4.4× |
| CT limited/localized follow up study (76380) |
$402.73 |
$473.80 |
4.4× |
| CT lower extremity w/dye (73701) |
$913.75 |
$1,075 |
4.9× |
| CT lumbar spine w/o contrast (72131) |
$1,496 |
$1,760 |
13.6× |
| CT maxillofacial w/wo contrast (70488) |
$907.32 |
$1,067.44 |
4.9× |
| CT neck w/contrast (70491) |
$864.12 |
$1,016.61 |
4.7× |
| CT neck w/o contrast (70490) |
$563.52 |
$662.96 |
5.1× |
| CT pelvis w & w/o contrast (72194) |
$1,997.50 |
$2,350 |
10.8× |
| CT pelvis w/o contrast (72192) |
$1,496 |
$1,760 |
13.6× |
| CT thoracic spine w/contrast (72129) |
$1,632 |
$1,920 |
8.8× |
| CT thoracic spine w/o contrast (72128) |
$1,483.25 |
$1,745 |
13.4× |
| CT thorax lung cancer scr c- (71271) |
$415.86 |
$489.25 |
3.8× |
| CT thorax w/o contrast (71250) |
$1,513 |
$1,780 |
13.7× |
| CT upper extremity w/dye (73201) |
$1,287.67 |
$1,514.90 |
3.5× |
| CTA head w contrast (70496) |
$1,207.01 |
$1,420.01 |
6.5× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$489.06 |
$575.36 |
4.4× |
| Dxa bone density study axial skeleton (77085) |
$731.04 |
$860.05 |
6.6× |
| Fetal biophys profile w/o nst (76819) |
$275.78 |
$324.45 |
2.5× |
| Fetal biophysical profile non-stress testing (76818) |
$683.77 |
$804.43 |
6.2× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$503.41 |
$592.25 |
2.0× |
| Gated heart planar single (78472) |
$908.24 |
$1,068.52 |
2.2× |
| Heart infarct image (78466) |
$908.24 |
$1,068.52 |
2.2× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$1,309.97 |
$1,541.14 |
2.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,170.93 |
$1,377.56 |
2.8× |
| Ht muscle image spect sing (78451) |
$2,099.63 |
$2,470.15 |
1.5× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$812.64 |
$956.05 |
1.9× |
| Kidney imaging morphol - nm kidney cortex (78700) |
$784.14 |
$922.52 |
1.9× |
| Kidney imaging morphology; with vascular flow Age Under 21 (78701) |
$784.14 |
$922.52 |
1.9× |
| Kidney imaging morphology; with vascular flow and function, multiple studies, with and without pharmacological… (78709) |
$1,111.18 |
$1,307.27 |
1.9× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$810.80 |
$953.88 |
1.4× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$1,202.75 |
$1,415 |
2.1× |
| Liver and spleen imaging (78215) |
$936.74 |
$1,102.05 |
2.2× |
| Liver and spleen imaging; with vascular flow Age Under 21 (78216) |
$936.74 |
$1,102.05 |
2.2× |
| Lung perfusion imaging (78580) |
$717.03 |
$843.57 |
1.7× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,851.68 |
$2,178.45 |
5.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,608.74 |
$1,892.63 |
4.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,367.88 |
$1,609.27 |
5.4× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,769.61 |
$2,081.89 |
4.8× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,367.88 |
$1,609.27 |
5.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,286.99 |
$1,514.10 |
3.5× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,544.38 |
$1,816.92 |
4.2× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,507.61 |
$1,773.66 |
4.1× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$2,720 |
$3,200 |
7.4× |
| Mandible min 4v (70110) |
$285.60 |
$336 |
2.6× |
| MRA head w/o contrast (70544) |
$1,367.88 |
$1,609.27 |
5.4× |
| MRA neck w/ contrast (70548) |
$2,477.75 |
$2,915 |
6.7× |
| MRA neck w/o contrast (70547) |
$2,341.75 |
$2,755 |
9.3× |
| MRI abdomen w/contrast (74182) |
$2,337.50 |
$2,750 |
6.4× |
| MRI abdomen w/o contrast (74181) |
$2,125 |
$2,500 |
8.4× |
| MRI abdomen w/wo contrast (74183) |
$2,635 |
$3,100 |
7.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,415.68 |
$1,665.51 |
1.7× |
| MRI c-spine w&w/o cont (72156) |
$2,635 |
$3,100 |
7.2× |
| MRI cervical spine w/contrast (72142) |
$2,125 |
$2,500 |
5.8× |
| MRI chest w/contrast (71551) |
$1,286.99 |
$1,514.10 |
1.6× |
| MRI chest w/o contrast (71550) |
$781.39 |
$919.28 |
3.1× |
| MRI chest w/wo contrast (71552) |
$1,415.68 |
$1,665.51 |
3.8× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,769.61 |
$2,081.89 |
4.8× |
| MRI joint upr extrem w/dye (73222) |
$1,608.74 |
$1,892.63 |
1.9× |
| MRI joint upr extrem w/o dye (73221) |
$1,373.66 |
$1,616.07 |
5.5× |
| MRI lumbar spine w/contrast (72149) |
$2,125 |
$2,500 |
5.8× |
| MRI lumbar spine w/wo contrast (72158) |
$2,635 |
$3,100 |
7.2× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,507.61 |
$1,773.66 |
4.1× |
| MRI pelvis w & w/o contrast (72197) |
$2,635 |
$3,100 |
7.2× |
| MRI pelvis w/contrast (72196) |
$2,380 |
$2,800 |
6.5× |
| MRI pelvis w/o contrast (72195) |
$1,870 |
$2,200 |
7.4× |
| MRI spine cervical w/o contrast (72141) |
$1,955 |
$2,300 |
7.8× |
| MRI t-spine w&w/o cont (72157) |
$2,635 |
$3,100 |
7.2× |
| MRI thoracic spine w/o contrst (72146) |
$1,955 |
$2,300 |
7.8× |
| MRI tmj (70336) |
$1,093.94 |
$1,286.99 |
4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,235.68 |
$2,630.21 |
8.9× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78453) |
$1,143.40 |
$1,345.18 |
0.8× |
| Myocardial perfusion imaging, planar (including qualitative or quantitative wall motion, ejection fraction by first… (78454) |
$1,143.40 |
$1,345.18 |
0.8× |
| Myocardial spect multiple studies (78452) |
$2,805.10 |
$3,300.12 |
2.1× |
| Nm bone 3 phase (78315) |
$1,406.75 |
$1,655 |
3.3× |
| Nm bone imaging whole body (78306) |
$1,228.25 |
$1,445 |
2.9× |
| Nm gastric emptying (78264) |
$992.80 |
$1,168 |
2.4× |
| Nm salivary gland (78230) |
$812.64 |
$956.05 |
1.9× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$938.40 |
$1,104 |
2.2× |
| Nuclear medicine study of bone and/or joint multiple areas (78305) |
$869.64 |
$1,023.10 |
2.1× |
| Nuclear medicine study of stomach lining (78261) |
$812.64 |
$956.05 |
1.9× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$449.52 |
$528.85 |
1.1× |
| Ob us limited fetus(s) (76815) |
$485.03 |
$570.62 |
4.4× |
| Optic foramina (70190) |
$170.07 |
$200.08 |
1.9× |
| Parathyroid planar imaging (78070) |
$1,138.15 |
$1,339 |
2.7× |
| Pulmonary ventilation & perfusion imaging (78582) |
$1,166.56 |
$1,372.42 |
2.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$941.59 |
$1,107.75 |
1.6× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$281.35 |
$331 |
3.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$486.29 |
$572.11 |
4.4× |
| Radex hip unilateral with pelvis 1 view (73501) |
$284.98 |
$335.27 |
3.1× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$400.80 |
$471.53 |
4.4× |
| Radex hips bilateral with pelvis 2 views (73521) |
$601.21 |
$707.30 |
5.5× |
| Radex spine cervical 2 or 3 views (72040) |
$394.40 |
$464 |
4.3× |
| Radex spine cervical 4 or 5 views (72050) |
$483.65 |
$569 |
4.4× |
| Radex spine cervical 6 or more views (72052) |
$708.28 |
$833.27 |
6.4× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$241.40 |
$284 |
2.6× |
| Radiologic exam abdomen 3+ views (74021) |
$317.73 |
$373.80 |
2.9× |
| Radiologic exam chest 3 views (71047) |
$250.04 |
$294.17 |
2.7× |
| Radiologic exam chest 4+ views (71048) |
$285.90 |
$336.35 |
2.6× |
| Radiologic exam swallow function contrast study (74230) |
$258.57 |
$304.20 |
1.4× |
| Radiologic exam upr gi trc double contrast study (74246) |
$249.90 |
$294 |
1.4× |
| Radiologic examination femur minimum 2 views (73552) |
$299.23 |
$352.03 |
3.3× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$260.10 |
$306 |
2.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$408.85 |
$481 |
3.7× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$203.15 |
$239 |
2.2× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$334.05 |
$393 |
3.6× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$203.15 |
$239 |
2.2× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$317.90 |
$374 |
3.5× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$233.75 |
$275 |
2.5× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$319.46 |
$375.83 |
3.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$483.65 |
$569 |
4.4× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$170.07 |
$200.08 |
1.9× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$280.38 |
$329.86 |
2.5× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$215.73 |
$253.80 |
2.4× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$487.22 |
$573.20 |
4.4× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$470.14 |
$553.11 |
4.3× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$258.60 |
$304.24 |
2.3× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$251.60 |
$296 |
2.7× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$273.95 |
$322.29 |
3.0× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$471.89 |
$555.17 |
4.3× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$360.40 |
$424 |
3.3× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$525.30 |
$618 |
4.8× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$251.60 |
$296 |
2.7× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$236.39 |
$278.10 |
2.6× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$228.65 |
$269 |
2.5× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$170.07 |
$200.08 |
1.9× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$300.90 |
$354 |
2.7× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$170.07 |
$200.08 |
1.9× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$203.15 |
$239 |
2.2× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$280.38 |
$329.86 |
2.5× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$459.64 |
$540.75 |
1.8× |
| Scapula complete (73010) |
$234.41 |
$275.78 |
2.1× |
| Screening digital breast tomosynthesis bi (77063) |
$55.16 |
$64.89 |
— |
| Ultrasound breast limited (76642) |
$242.51 |
$285.31 |
2.6× |
| Ultrasound, abdomen limited (76705) |
$574.55 |
$675.94 |
5.2× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$482.62 |
$567.79 |
4.4× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$536.35 |
$631 |
4.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$584.80 |
$688 |
5.3× |
| Unlisted CT procedure (76497) |
$402.73 |
$473.80 |
4.4× |
| Unlisted magnetic resonance procedure (eg, diagnostic, interventional) Age Under 21 (76498) |
$781.39 |
$919.28 |
8.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$718.46 |
$845.25 |
3.9× |
| Us breast uni real time with image complete (76641) |
$295.04 |
$347.11 |
2.7× |
| Us chest (76604) |
$344.73 |
$405.56 |
3.1× |
| Us exam, pelvic, limited (76857) |
$187.85 |
$221 |
1.7× |
| US OB Follow-Up/Repeat (76816) |
$252.80 |
$297.41 |
2.3× |
| Us ob transvaginal (76817) |
$557.69 |
$656.11 |
5.1× |
| Us retroperitoneal complete (76770) |
$684.86 |
$805.72 |
6.2× |
| Us scrotum (76870) |
$552.50 |
$650 |
5.0× |
| Us soft tissue head/neck (76536) |
$702.10 |
$826 |
6.4× |
| Us unlstd proc (76999) |
$344.73 |
$405.56 |
3.8× |
| Venography deep dorsal vein penis radiolgicl supervision interpretation (76499) |
$165.11 |
$194.25 |
1.8× |
| Venography, extremity, unilateral, radiological supervision and interpretation Age Under 21 (75820) |
$1,789.46 |
$2,105.25 |
1.1× |
| Venous thrombosis imaging - nm extremity veins thrombosis right (78457) |
$449.52 |
$528.85 |
0.8× |
| X-ray exam of finger(s) (73140) |
$203.15 |
$239 |
2.2× |
| X-ray exam of knee 1 or 2 (73560) |
$343.50 |
$404.12 |
3.7× |
| X-ray exam ribs uni 2 views (71100) |
$308.55 |
$363 |
3.4× |
| X-ray heel (73650) |
$233.75 |
$275 |
2.5× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$367.20 |
$432 |
3.3× |
| Xr abdomen 1 view (74018) |
$249.44 |
$293.45 |
2.7× |
| Xr abdomen 2 views (74019) |
$320.41 |
$376.95 |
2.9× |
| Xr bone age studies (77072) |
$280.38 |
$329.86 |
2.5× |
| Xr bone length study (77073) |
$300.90 |
$354 |
2.7× |
| Xr bone survey infant (77076) |
$238.51 |
$280.60 |
2.2× |
| Xr chest 1 view (71045) |
$194.65 |
$229 |
2.1× |
| Xr chest 2 views (71046) |
$272.94 |
$321.10 |
3.0× |
| Xr eye foreign body (70030) |
$153 |
$180 |
1.7× |
| Xr facial bones 3+ views (70150) |
$219.30 |
$258 |
2.0× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$203.15 |
$239 |
2.2× |
| Xr forearm 2 views (73090) |
$233.75 |
$275 |
2.5× |
| Xr hand 2v (73120) |
$204 |
$240 |
1.8× |
| Xr hysterosalpingogram (74740) |
$941.59 |
$1,107.75 |
3.7× |
| Xr neck soft tissue (70360) |
$291.54 |
$342.99 |
3.2× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$277.10 |
$326 |
3.0× |
| Xr osseous survey complete (77075) |
$490.89 |
$577.52 |
4.5× |
| Xr pelvis 1-2 views (72170) |
$295.09 |
$347.16 |
2.7× |
| Xr pelvis min 3 view (72190) |
$312.77 |
$367.97 |
2.8× |
| Xr sacrum/coccyx 2+ views (72220) |
$299.20 |
$352 |
3.3× |
| Xr shoulder 1 view (73020) |
$266.59 |
$313.64 |
2.9× |
| Xr sinuses 3+ views (70220) |
$368.59 |
$433.63 |
4.0× |
| Xr skull min 4 view (70260) |
$315.31 |
$370.95 |
2.9× |
| Xr spine 1 view (72020) |
$216.18 |
$254.32 |
2.4× |
| Xr spine thoracic 3v (72072) |
$298.58 |
$351.27 |
2.7× |
| Xr sternum 2+ views (71120) |
$252.80 |
$297.40 |
2.8× |
| Xr surgical specimen (76098) |
$969.83 |
$1,140.98 |
1.7× |
| Xr t-spine 2 views (72070) |
$281.35 |
$331 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$299.20 |
$352 |
3.3× |
| Xr tmj bilateral (70330) |
$315.31 |
$370.95 |
3.4× |
| Xr tmj unilateral (70328) |
$165.11 |
$194.25 |
1.8× |
| Xr wrist 2 views (73100) |
$204 |
$240 |
2.2× |