| 3-D radiotherapy plan dose-volume histograms (77295) |
$14,225 |
$28,450 |
10.6× |
| Abdomen 1 View (74018) |
$202.50 |
$405 |
2.4× |
| Abdomen 2 views (74019) |
$162 |
$324 |
1.6× |
| Ankle 2 views (73600) |
$201.50 |
$403 |
2.4× |
| Basic radiation dosimetry calculation (77300) |
$713.50 |
$1,427 |
5.5× |
| Bone age studies (77072) |
$358.50 |
$717 |
3.5× |
| Bone Imaging 3 Phase (78315) |
$4,113.50 |
$8,227 |
10.6× |
| Bone Imaging Limited Area (78300) |
$2,613 |
$5,226 |
6.7× |
| Bone Imaging Whole Body (78306) |
$3,608 |
$7,216 |
9.3× |
| Bone survey infant (77076) |
$516 |
$1,032 |
5.1× |
| Chest 1 view (71045) |
$179.50 |
$359 |
2.1× |
| Chest 2 views (71046) |
$222 |
$444 |
2.6× |
| Chest 3 views (71047) |
$268 |
$536 |
3.2× |
| Clavicle complete (73000) |
$186.50 |
$373 |
2.2× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$182 |
$364 |
1.8× |
| Continuing medical physics consltj pr wk (77336) |
$1,131 |
$2,262 |
8.7× |
| Contrast X-Ray Bladder (74430) |
$335 |
$670 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,345.50 |
$6,691 |
9.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,895 |
$3,790 |
8.2× |
| CT abdomen w contrast (74160) |
$2,191.50 |
$4,383 |
12.9× |
| CT abdomen w wo contrast (74170) |
$2,487 |
$4,974 |
14.6× |
| CT abdomen w/o contrast (74150) |
$1,422 |
$2,844 |
14.0× |
| CT Angio Abdomen and Pelvis (74174) |
$3,092.50 |
$6,185 |
9.1× |
| CT Angio Chest (71275) |
$1,766 |
$3,532 |
10.4× |
| CT Angio Head (70496) |
$2,066.50 |
$4,133 |
12.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$1,418.50 |
$2,837 |
8.3× |
| CT Angio Neck (70498) |
$2,075.50 |
$4,151 |
12.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$1,370.50 |
$2,741 |
8.1× |
| CT cervical spine w/ contrast (72126) |
$5,409 |
$10,818 |
16.0× |
| CT cervical spine w/o contrast (72125) |
$1,409.50 |
$2,819 |
13.9× |
| CT cervical spine w/wo cont (72127) |
$3,000 |
$6,000 |
17.6× |
| CT chest w contrast (71260) |
$1,473 |
$2,946 |
8.7× |
| CT chest w/wo contrast (71270) |
$1,222 |
$2,444 |
7.2× |
| CT head/brain with contrast (70460) |
$1,640.50 |
$3,281 |
9.6× |
| CT head/brain without and with contrast (70470) |
$1,919.50 |
$3,839 |
11.3× |
| CT iac w contrast (70481) |
$1,499 |
$2,998 |
8.8× |
| CT l-spine w&w/o contrast (72133) |
$1,409 |
$2,818 |
8.3× |
| CT lower ext w/o (73700) |
$1,176 |
$2,352 |
11.6× |
| CT lower extremity w/contrast material (73701) |
$1,481.50 |
$2,963 |
8.7× |
| CT lumbar spine w contrast (72132) |
$2,559.50 |
$5,119 |
7.6× |
| CT lumbar spine w/o contrast (72131) |
$666 |
$1,332 |
6.6× |
| CT maxillofacial w contrast (70487) |
$1,370.50 |
$2,741 |
8.1× |
| CT maxillofacial wo contrast (70486) |
$1,142.50 |
$2,285 |
11.3× |
| CT neck tissue combo (70492) |
$1,898 |
$3,796 |
11.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,638 |
$3,276 |
9.6× |
| CT orbits w/o contrast (70480) |
$1,270 |
$2,540 |
12.5× |
| CT pelvis w&w/o contrast (72194) |
$1,497 |
$2,994 |
8.8× |
| CT pelvis w/o contrast (72192) |
$703.50 |
$1,407 |
6.9× |
| CT scan of leg combo (73702) |
$1,799 |
$3,598 |
10.6× |
| CT scans face/jaw combo (70488) |
$1,679 |
$3,358 |
9.9× |
| CT soft tissue neck w contrast (70491) |
$1,569 |
$3,138 |
9.2× |
| CT soft tissue neck w/o contrast (70490) |
$1,302 |
$2,604 |
12.8× |
| CT thoracic spine w contrast (72129) |
$2,487.50 |
$4,975 |
14.6× |
| CT thoracic spine w/o contrast (72128) |
$1,168.50 |
$2,337 |
11.5× |
| CT thoracic spine w/wo cont (72130) |
$2,487.50 |
$4,975 |
14.6× |
| CT thorax w/o contrast (71250) |
$663.50 |
$1,327 |
6.5× |
| CT upper ext wo (73200) |
$1,430.50 |
$2,861 |
14.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,216 |
$4,432 |
13.0× |
| CT upper extremity with contrast (73201) |
$1,773.50 |
$3,547 |
5.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,746 |
$3,492 |
10.3× |
| Cta Abdomen (74175) |
$2,444 |
$4,888 |
14.4× |
| Dxa Bone Density Axial (77080) |
$240.50 |
$481 |
2.4× |
| Esophagram (74220) |
$381 |
$762 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$392.50 |
$785 |
3.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$286.50 |
$573 |
2.8× |
| Fluoroscopy up to 1 hr (76000) |
$769 |
$1,538 |
3.3× |
| Foot 2 views (73620) |
$169 |
$338 |
2.0× |
| Forearm 2 views (73090) |
$198 |
$396 |
2.3× |
| Gastric emptying imaging study (78264) |
$3,790 |
$7,580 |
9.8× |
| Hand 2 views (73120) |
$182.50 |
$365 |
1.8× |
| Hepatobil Syst Image W/Drug (78227) |
$1,382.50 |
$2,765 |
2.6× |
| Hepatobiliary System Imaging (78226) |
$1,009.50 |
$2,019 |
2.6× |
| Joint Survey Single View (77077) |
$349 |
$698 |
3.4× |
| K Flow/Funct Image W/Drug (78708) |
$3,062 |
$6,124 |
5.8× |
| K Flow/Funct Image W/O Drug (78707) |
$4,072.50 |
$8,145 |
7.7× |
| Knee 3 Views (73562) |
$202.50 |
$405 |
2.4× |
| Liver & Spleen Imaging Static Only (78215) |
$860 |
$1,720 |
2.2× |
| Lung Ventilat&Perfus Imaging (78582) |
$787.50 |
$1,575 |
1.5× |
| Lymph System Imaging (78195) |
$2,086 |
$4,172 |
4.0× |
| Magnetic Image Jaw Joint (70336) |
$2,108.50 |
$4,217 |
9.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$8,227 |
$16,454 |
22.7× |
| Mr safety determination physician/other qhp (76016) |
$105 |
$210 |
1.2× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$29.50 |
$59 |
1.1× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$109.50 |
$219 |
1.2× |
| Mr safety implt pos&/immoblj (76019) |
$71 |
$142 |
1.2× |
| Mr safety med physics xm customization plng&mntr (76017) |
$287.50 |
$575 |
1.2× |
| Mra Head W/O & W/Contrast Material (70546) |
$2,936 |
$5,872 |
8.7× |
| MRA head w/o contrast (70544) |
$1,578.50 |
$3,157 |
6.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$2,335 |
$4,670 |
6.9× |
| MRA neck w/o contrast (70547) |
$1,261.50 |
$2,523 |
5.5× |
| MRI abdomen w contrast (74182) |
$2,564.50 |
$5,129 |
7.6× |
| MRI abdomen w/o contrast (74181) |
$1,385 |
$2,770 |
6.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$4,966 |
$9,932 |
6.5× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,323 |
$6,646 |
9.8× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$4,986 |
$9,972 |
6.6× |
| MRI Breast W/O Contrast Bilateral (77047) |
$407 |
$814 |
1.8× |
| MRI cervical spine w contrast (72142) |
$2,510.50 |
$5,021 |
7.4× |
| MRI cervical spine w/o cont (72141) |
$1,356.50 |
$2,713 |
5.9× |
| MRI chest w/o contrast (71550) |
$1,295 |
$2,590 |
5.6× |
| MRI chest wo w contrast (71552) |
$2,332.50 |
$4,665 |
6.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$2,199 |
$4,398 |
6.5× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,187.50 |
$2,375 |
5.1× |
| MRI lumbar spine w contrast (72149) |
$2,703 |
$5,406 |
8.0× |
| Mri Neck Spine W/O & W/Dye (72156) |
$2,510.50 |
$5,021 |
7.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,286.50 |
$2,573 |
5.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,382 |
$4,764 |
7.0× |
| MRI pelvis w/o & w contrast (72197) |
$2,454.50 |
$4,909 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$1,326 |
$2,652 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,436.50 |
$2,873 |
6.2× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$984 |
$1,968 |
4.3× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$1,822 |
$3,644 |
5.4× |
| MRI, abdomen, combo (74183) |
$2,564.50 |
$5,129 |
7.6× |
| MRI, dorsal spine combo (72157) |
$2,660 |
$5,320 |
7.9× |
| MRI, dorsal spine contrast (72147) |
$2,659.50 |
$5,319 |
7.9× |
| MRI, joint upper extrem (73221) |
$1,794 |
$3,588 |
7.8× |
| MRI, joint upper extrem combo (73223) |
$3,336 |
$6,672 |
9.9× |
| MRI, lumbar spine combo (72158) |
$2,703 |
$5,406 |
8.0× |
| Myocardial Spect Multiple Studies (78452) |
$2,789 |
$5,578 |
2.2× |
| N-invas est c ffr sw aly CTA (75580) |
$3,110.50 |
$6,221 |
3.7× |
| Neck soft tissue (70360) |
$190 |
$380 |
2.3× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$22,804.50 |
$45,609 |
17.0× |
| Ob us nuchal meas 1 gest (76813) |
$213.50 |
$427 |
2.1× |
| Ophthalmic ultrasound dx b-scan w/wo a-scan (76512) |
$175.50 |
$351 |
1.7× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$4,437 |
$8,874 |
8.4× |
| Parathyroid Planar Imaging (78070) |
$2,673.50 |
$5,347 |
6.9× |
| Parathyroid planar imaging w/wo subtraction (78071) |
$3,815.50 |
$7,631 |
9.8× |
| Pelvis 1 or 2 views (72170) |
$426.50 |
$853 |
4.2× |
| PET image w/CT, full body (78816) |
$2,969.50 |
$5,939 |
2.1× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$3,621 |
$7,242 |
2.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$560.50 |
$1,121 |
1.4× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$176.50 |
$353 |
1.7× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$184 |
$368 |
2.2× |
| Radex Calcaneus Minimum 2 Views (73650) |
$165.50 |
$331 |
2.0× |
| Radex elbow complete minimum 3 views (73080) |
$219 |
$438 |
2.6× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$263.50 |
$527 |
2.6× |
| Radex fingr minimum 2 views (73140) |
$154 |
$308 |
1.8× |
| Radex foot complete minimum 3 views (73630) |
$190.50 |
$381 |
2.3× |
| Radex Hand Minimum 3 Views (73130) |
$205 |
$410 |
2.4× |
| Radex lower extremity infant minimum 2 views (73592) |
$349 |
$698 |
4.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$184.50 |
$369 |
2.2× |
| Radex Ribs Unilateral 2 Views (71100) |
$246 |
$492 |
2.9× |
| Radex shoulder complete minimum 2 views (73030) |
$233 |
$466 |
2.8× |
| Radex Sinuses Paransl < 3 Views (70210) |
$232.50 |
$465 |
2.8× |
| Radex Spine 1 View Specify Level (72020) |
$159.50 |
$319 |
1.9× |
| Radex Sternum Minimum 2 Views (71120) |
$171 |
$342 |
2.0× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$148.50 |
$297 |
1.8× |
| Radex Toe Minimum 2 Views (73660) |
$156 |
$312 |
1.8× |
| Radex upper extremity infant minimum 2 views (73092) |
$93.50 |
$187 |
0.9× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$208.50 |
$417 |
2.5× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$362 |
$724 |
3.6× |
| Radiation treatment delivery level 3 (77412) |
$1,239 |
$2,478 |
2.3× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$155.50 |
$311 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$145.50 |
$291 |
1.4× |
| Radiologic exam colon double contrast study (74280) |
$701.50 |
$1,403 |
4.1× |
| Radiologic exam colon single contrast study (74270) |
$500.50 |
$1,001 |
2.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$461 |
$922 |
2.7× |
| Radiologic exam knee complete 4/more views (73564) |
$224.50 |
$449 |
2.2× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$223.50 |
$447 |
2.2× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$441 |
$882 |
2.6× |
| Radiologic exam swallow function contrast study (74230) |
$323 |
$646 |
1.9× |
| Radiologic exam upr gi trc double contrast study (74246) |
$407.50 |
$815 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$362 |
$724 |
4.3× |
| Radiologic examination femur minimum 2 views (73552) |
$103 |
$206 |
1.2× |
| Radiologic examination knee 1/2 views (73560) |
$176.50 |
$353 |
2.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$195.50 |
$391 |
2.3× |
| Ribs bilateral 3 views (71110) |
$295 |
$590 |
2.9× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$2,746 |
$5,492 |
5.2× |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
$1,963.50 |
$3,927 |
1.6× |
| Scapula (73010) |
$162.50 |
$325 |
1.6× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$66 |
$132 |
2.8× |
| Shoulder 1 view (73020) |
$182 |
$364 |
2.2× |
| Skull less than 4 views (70250) |
$221.50 |
$443 |
2.2× |
| Special dosimetry (77331) |
$590 |
$1,180 |
4.5× |
| Special Physics Consult (77370) |
$1,651 |
$3,302 |
12.7× |
| Special teletherapy port plan (77321) |
$414.50 |
$829 |
1.1× |
| Special treatment procedure (77470) |
$2,829.50 |
$5,659 |
5.3× |
| Sternoclavicular joints (71130) |
$209 |
$418 |
2.5× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$1,381 |
$2,762 |
3.8× |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
$4,017 |
$8,034 |
11.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$2,290.50 |
$4,581 |
17.6× |
| Thoracic spine 2 views (72070) |
$225.50 |
$451 |
2.2× |
| Thoracic spine 3 views (72072) |
$224 |
$448 |
2.2× |
| Thoracolumbar 2 views (72080) |
$216.50 |
$433 |
2.6× |
| Thyroid Imaging With Vascular Flow (78013) |
$2,214.50 |
$4,429 |
5.7× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$2,768 |
$5,536 |
7.1× |
| Tx Devices Design & Construction Complex (77334) |
$2,153.50 |
$4,307 |
5.9× |
| Tx devices design & construction intermediate (77333) |
$754.50 |
$1,509 |
5.8× |
| Tx devices design & construction simple (77332) |
$1,501 |
$3,002 |
11.5× |
| Ultrasound Breast Limited (76642) |
$215 |
$430 |
2.5× |
| Ultrasound Exam Aaa Screen (76706) |
$177.50 |
$355 |
1.8× |
| Ultrasound, abdomen limited (76705) |
$381.50 |
$763 |
3.8× |
| Umbilical-artery Doppler (OB) (76820) |
$239.50 |
$479 |
2.4× |
| Upper gi w/o kub (74240) |
$425.50 |
$851 |
2.5× |
| Urethrocystogram voiding (74455) |
$531 |
$1,062 |
2.3× |
| Urethrocystography retrograde (74450) |
$531 |
$1,062 |
2.3× |
| Us breast unilateral complete (76641) |
$262 |
$524 |
2.6× |
| Us chest (76604) |
$303.50 |
$607 |
3.0× |
| Us complete joint (76881) |
$694.50 |
$1,389 |
6.8× |
| Us exam, pelvic, limited (76857) |
$551 |
$1,102 |
5.4× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$392.50 |
$785 |
3.9× |
| Us ob detailed single fetus (76811) |
$500 |
$1,000 |
2.2× |
| Us ob limited 1 or more fetuses (76815) |
$255 |
$510 |
2.5× |
| Us ob transvaginal (76817) |
$227.50 |
$455 |
2.2× |
| Us pelvic non ob complete (76856) |
$551 |
$1,102 |
5.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$310.50 |
$621 |
3.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$271.50 |
$543 |
2.7× |
| Us retroperitoneal complete (76770) |
$476 |
$952 |
4.7× |
| Us retroperitoneal limited (76775) |
$243 |
$486 |
2.4× |
| Us scrotum and contents (76870) |
$432 |
$864 |
4.3× |
| Us thyroid (76536) |
$448 |
$896 |
4.4× |
| Vertebral fracture assessment via dxa (77086) |
$39 |
$78 |
0.5× |
| Wrist 2 views (73100) |
$188 |
$376 |
2.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$265.50 |
$531 |
3.1× |
| X-Ray Bend Only L-S Spine (72120) |
$257 |
$514 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$188.50 |
$377 |
2.2× |
| X-Ray Exam Breast Specimen (76098) |
$229 |
$458 |
0.4× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$160.50 |
$321 |
1.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$258 |
$516 |
2.5× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$313 |
$626 |
3.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$173 |
$346 |
2.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$236.50 |
$473 |
2.8× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$296 |
$592 |
2.9× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$117.50 |
$235 |
1.2× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$279 |
$558 |
2.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$316 |
$632 |
3.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$388.50 |
$777 |
3.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$233.50 |
$467 |
2.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$394 |
$788 |
3.9× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$283 |
$566 |
2.8× |
| X-ray eye for foreign body (70030) |
$104 |
$208 |
1.2× |
| X-ray humerus (73060) |
$168 |
$336 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$135 |
$270 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$521 |
$1,042 |
6.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$221.50 |
$443 |
2.2× |
| X-ray nose-rectum child f.b. (76010) |
$78.50 |
$157 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$349 |
$698 |
3.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$416.50 |
$833 |
4.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$359 |
$718 |
3.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$359 |
$718 |
4.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$294 |
$588 |
3.5× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$276 |
$552 |
2.7× |
| X-ray thoracic spine 4 vw (72074) |
$259.50 |
$519 |
2.6× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$417.50 |
$835 |
1.2× |
| X-Rays Bone Length Studies (77073) |
$274.50 |
$549 |
2.7× |
| X-Rays Bone Survey Complete (77075) |
$468 |
$936 |
4.6× |
| Xr c-spine 4 or 5 views (72050) |
$319.50 |
$639 |
3.2× |
| Xr facial bones less than 3 views (70140) |
$184 |
$368 |
2.2× |
| Xr orbits complete 4 views (70200) |
$191 |
$382 |
1.9× |