| Abdomen 1 View (74018) |
$111.15 |
$171 |
1.3× |
| Abdomen 2 views (74019) |
$173.55 |
$267 |
1.6× |
| Ankle 2 views (73600) |
$121.55 |
$187 |
1.4× |
| Bone age studies (77072) |
$148.85 |
$229 |
1.4× |
| Bone Imaging 3 Phase (78315) |
$34.45 |
$53 |
0.1× |
| Bone Imaging Limited Area (78300) |
$1,019.85 |
$1,569 |
2.5× |
| Bone Imaging Whole Body (78306) |
$29.25 |
$45 |
0.1× |
| Bone survey infant (77076) |
$362.70 |
$558 |
3.4× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$3,975.40 |
$6,116 |
2.7× |
| Cat Scan Follow-Up Study (76380) |
$915.85 |
$1,409 |
10.3× |
| Chest 1 view (71045) |
$132.60 |
$204 |
1.5× |
| Chest 2 views (71046) |
$162.50 |
$250 |
1.8× |
| Chest 3 views (71047) |
$163.15 |
$251 |
1.8× |
| Chest 4 or more views (71048) |
$150.15 |
$231 |
1.4× |
| Clavicle complete (73000) |
$121.55 |
$187 |
1.4× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$905.45 |
$1,393 |
8.5× |
| Contrast X-Ray Bladder (74430) |
$504.40 |
$776 |
1.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,613 |
$4,020 |
7.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,075.10 |
$1,654 |
4.4× |
| CT abdomen w contrast (74160) |
$1,816.75 |
$2,795 |
10.1× |
| CT abdomen w wo contrast (74170) |
$2,059.85 |
$3,169 |
11.5× |
| CT abdomen w/o contrast (74150) |
$1,300 |
$2,000 |
12.2× |
| CT Angio Abdomen and Pelvis (74174) |
$2,884.05 |
$4,437 |
8.1× |
| CT Angio Chest (71275) |
$2,404.35 |
$3,699 |
13.4× |
| CT Angio Head (70496) |
$2,005.25 |
$3,085 |
11.2× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$2,486.90 |
$3,826 |
13.9× |
| CT Angio Neck (70498) |
$2,000.70 |
$3,078 |
11.2× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$2,271.10 |
$3,494 |
12.7× |
| CT cervical spine w/ contrast (72126) |
$1,775.80 |
$2,732 |
5.0× |
| CT cervical spine w/o contrast (72125) |
$1,327.95 |
$2,043 |
12.4× |
| CT cervical spine w/wo cont (72127) |
$1,456 |
$2,240 |
8.1× |
| CT chest w contrast (71260) |
$1,645.15 |
$2,531 |
9.2× |
| CT chest w/wo contrast (71270) |
$2,058.55 |
$3,167 |
11.5× |
| CT head/brain with contrast (70460) |
$1,427.40 |
$2,196 |
8.0× |
| CT head/brain without and with contrast (70470) |
$1,644.50 |
$2,530 |
9.2× |
| CT iac w contrast (70481) |
$1,504.75 |
$2,315 |
8.4× |
| CT l-spine w&w/o contrast (72133) |
$1,456 |
$2,240 |
8.1× |
| CT lower ext w/o (73700) |
$1,155.70 |
$1,778 |
10.8× |
| CT lower extremity w/contrast material (73701) |
$1,376.70 |
$2,118 |
7.7× |
| CT lumbar spine w contrast (72132) |
$1,805.70 |
$2,778 |
5.1× |
| CT lumbar spine w/o contrast (72131) |
$1,420.90 |
$2,186 |
13.3× |
| CT maxillofacial w contrast (70487) |
$1,379.95 |
$2,123 |
7.7× |
| CT maxillofacial wo contrast (70486) |
$1,108.90 |
$1,706 |
10.4× |
| CT neck tissue combo (70492) |
$1,653.60 |
$2,544 |
9.2× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,786.20 |
$2,748 |
10.0× |
| CT orbits w/o contrast (70480) |
$1,315.60 |
$2,024 |
12.3× |
| CT pelvis w&w/o contrast (72194) |
$2,066.35 |
$3,179 |
11.5× |
| CT pelvis w/o contrast (72192) |
$1,341.60 |
$2,064 |
12.6× |
| CT scan of leg combo (73702) |
$1,443 |
$2,220 |
8.1× |
| CT scans face/jaw combo (70488) |
$1,329.25 |
$2,045 |
7.4× |
| CT soft tissue neck w contrast (70491) |
$1,435.85 |
$2,209 |
8.0× |
| CT soft tissue neck w/o contrast (70490) |
$1,132.30 |
$1,742 |
10.6× |
| CT thoracic spine w/o contrast (72128) |
$1,371.50 |
$2,110 |
12.8× |
| CT thoracic spine w/wo cont (72130) |
$1,464.45 |
$2,253 |
8.2× |
| CT thorax w/o contrast (71250) |
$1,366.95 |
$2,103 |
12.8× |
| CT upper ext wo (73200) |
$1,225.90 |
$1,886 |
11.5× |
| CT upper extremity w/o & w/contrast material (73202) |
$2,063.75 |
$3,175 |
11.5× |
| CT upper extremity with contrast (73201) |
$1,565.20 |
$2,408 |
4.4× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$3,116.75 |
$4,795 |
17.4× |
| Cta Abdomen (74175) |
$2,283.45 |
$3,513 |
12.7× |
| CTA pelvis (72191) |
$2,288.65 |
$3,521 |
12.8× |
| Diskography lumbar (72295) |
$1,378 |
$2,120 |
0.7× |
| Dxa Bone Density Axial (77080) |
$148.85 |
$229 |
1.4× |
| Dxa bone density study (77085) |
$172.25 |
$265 |
1.6× |
| Echo exam uterus (76831) |
$474.50 |
$730 |
1.9× |
| Echograp Trans R Pros Study (76873) |
$505.70 |
$778 |
4.7× |
| Esophagram (74220) |
$358.15 |
$551 |
2.0× |
| Fetal Biophys Profile W/Nst (76818) |
$424.45 |
$653 |
4.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$306.15 |
$471 |
2.9× |
Fluoroscopy up to 1 hr (76000)
range across 2 matching MRF lines |
$52–$165.10 |
$80–$254 |
varies |
| Foot 2 views (73620) |
$114.40 |
$176 |
1.3× |
| Forearm 2 views (73090) |
$122.85 |
$189 |
1.4× |
| Gated Heart Planar Single (78472) |
$926.90 |
$1,426 |
2.3× |
| Hand 2 views (73120) |
$148.85 |
$229 |
1.4× |
| Heart Image (Pet) Multiple (78492) |
$4,065.10 |
$6,254 |
2.8× |
| Hepatobil Syst Image W/Drug (78227) |
$30.55 |
$47 |
0.1× |
| Hepatobiliary System Imaging (78226) |
$24.70 |
$38 |
0.1× |
| Ht Muscle Image Spect Sing (78451) |
$1,405.30 |
$2,162 |
1.1× |
| Hysterosalpingogram (74740) |
$427.05 |
$657 |
1.8× |
| Joint Survey Single View (77077) |
$150.15 |
$231 |
1.4× |
| Knee 3 Views (73562) |
$156 |
$240 |
1.8× |
| Lung Ventilat&Perfus Imaging (78582) |
$35.75 |
$55 |
0.1× |
| Magnetic Image Jaw Joint (70336) |
$2,182.05 |
$3,357 |
9.0× |
| Mra Head W/O & W/Contrast Material (70546) |
$4,225.65 |
$6,501 |
11.9× |
| MRA head w/o contrast (70544) |
$2,719.60 |
$4,184 |
11.2× |
| MRA head with contrast (70545) |
$2,692.30 |
$4,142 |
7.6× |
| MRA neck w contrast (70548) |
$2,839.20 |
$4,368 |
8.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$4,236.70 |
$6,518 |
11.9× |
| MRA neck w/o contrast (70547) |
$2,713.75 |
$4,175 |
11.1× |
| MRI abdomen w contrast (74182) |
$2,990 |
$4,600 |
8.4× |
| MRI abdomen w/o contrast (74181) |
$2,414.10 |
$3,714 |
9.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$2,652 |
$4,080 |
3.3× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$3,191.50 |
$4,910 |
9.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$2,860 |
$4,400 |
3.6× |
| MRI cervical spine w contrast (72142) |
$2,849.60 |
$4,384 |
8.0× |
| MRI cervical spine w/o cont (72141) |
$2,237.95 |
$3,443 |
9.2× |
| MRI chest w/o contrast (71550) |
$3,001.05 |
$4,617 |
12.3× |
| MRI chest with contrast (71551) |
$3,252.60 |
$5,004 |
4.1× |
| MRI chest wo w contrast (71552) |
$4,097.60 |
$6,304 |
11.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$2,684.50 |
$4,130 |
7.5× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$3,406 |
$5,240 |
9.6× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$2,425.80 |
$3,732 |
10.0× |
| MRI lumbar spine w contrast (72149) |
$2,688.40 |
$4,136 |
7.5× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,233.75 |
$4,975 |
9.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,385.50 |
$3,670 |
9.8× |
| MRI orbit face neck w contrast (70542) |
$2,648.75 |
$4,075 |
7.4× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$3,326.05 |
$5,117 |
9.3× |
| MRI pelvis w contrast (72196) |
$2,692.30 |
$4,142 |
7.6× |
| MRI pelvis w/o & w contrast (72197) |
$3,378.70 |
$5,198 |
9.5× |
| MRI pelvis w/o contrast (72195) |
$2,453.75 |
$3,775 |
10.1× |
| MRI thoracic spine w/o contrast (72146) |
$2,400.45 |
$3,693 |
9.8× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,838.55 |
$4,367 |
8.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,665 |
$4,100 |
10.9× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$3,456.70 |
$5,318 |
9.7× |
| MRI, abdomen, combo (74183) |
$3,487.90 |
$5,366 |
9.8× |
| MRI, dorsal spine combo (72157) |
$3,334.50 |
$5,130 |
9.4× |
| MRI, dorsal spine contrast (72147) |
$2,849.60 |
$4,384 |
8.0× |
| MRI, joint upper extrem (73221) |
$1,708.85 |
$2,629 |
7.0× |
| MRI, joint upper extrem combo (73223) |
$3,201.90 |
$4,926 |
9.0× |
| MRI, lumbar spine combo (72158) |
$3,352.05 |
$5,157 |
9.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$3,630.90 |
$5,586 |
2.7× |
| Myocardial Spect Multiple Studies (78452) |
$1,102.40 |
$1,696 |
0.8× |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
$5,959.85 |
$9,169 |
2.6× |
| Myocrd Img Pet Prfuj W/Metab 2rtracer Cncrnt CT (78433) |
$5,236.40 |
$8,056 |
2.3× |
| Myocrd Img Pet Prfuj W/Metab Dual Radiotracer (78432) |
$4,960.80 |
$7,632 |
3.2× |
| Neck soft tissue (70360) |
$146.90 |
$226 |
1.7× |
| Optic foramina (70190) |
$137.80 |
$212 |
1.5× |
| Parathyroid imaging w/tomographic spect & CT (78072) |
$1,392.30 |
$2,142 |
2.5× |
| Pelvis 1 or 2 views (72170) |
$148.85 |
$229 |
1.4× |
| Pet Image Skull-Thigh (78812) |
$4,030.65 |
$6,201 |
2.8× |
| Pet Image W/Ct Lmtd (78814) |
$4,065.10 |
$6,254 |
2.8× |
| PET image w/CT, full body (78816) |
$4,096.30 |
$6,302 |
2.8× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$4,092.40 |
$6,296 |
2.8× |
| Pet Imaging Limited Area Chest Head/Neck (78811) |
$3,630.90 |
$5,586 |
2.7× |
| Pet Myocardial Sngl Study (78491) |
$4,030.65 |
$6,201 |
2.8× |
| PET whole body (78813) |
$4,037.80 |
$6,212 |
2.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$230.75 |
$355 |
2.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$179.40 |
$276 |
0.3× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$140.40 |
$216 |
1.6× |
| Radex Calcaneus Minimum 2 Views (73650) |
$113.10 |
$174 |
1.3× |
| Radex elbow complete minimum 3 views (73080) |
$150.80 |
$232 |
1.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$182.65 |
$281 |
1.7× |
| Radex fingr minimum 2 views (73140) |
$151.45 |
$233 |
1.7× |
| Radex foot complete minimum 3 views (73630) |
$133.90 |
$206 |
1.5× |
| Radex Hand Minimum 3 Views (73130) |
$138.45 |
$213 |
1.6× |
| Radex lower extremity infant minimum 2 views (73592) |
$121.55 |
$187 |
1.4× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$230.75 |
$355 |
2.2× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$146.90 |
$226 |
1.7× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$410.15 |
$631 |
4.6× |
| Radex Ribs Unilateral 2 Views (71100) |
$145.60 |
$224 |
1.6× |
| Radex shoulder complete minimum 2 views (73030) |
$142.35 |
$219 |
1.6× |
| Radex Sinuses Paransl < 3 Views (70210) |
$136.50 |
$210 |
1.5× |
| Radex Spine 1 View Specify Level (72020) |
$111.80 |
$172 |
1.3× |
| Radex Sternum Minimum 2 Views (71120) |
$148.20 |
$228 |
1.7× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$208.65 |
$321 |
2.3× |
| Radex Toe Minimum 2 Views (73660) |
$121.55 |
$187 |
1.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$148.85 |
$229 |
1.4× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$158.60 |
$244 |
1.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$386.10 |
$594 |
3.6× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$160.55 |
$247 |
1.5× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$173.55 |
$267 |
1.6× |
| Radiologic exam knee complete 4/more views (73564) |
$175.50 |
$270 |
1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$171.60 |
$264 |
1.6× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$434.20 |
$668 |
2.4× |
| Radiologic examination femur 1 view (73551) |
$128.70 |
$198 |
1.4× |
| Radiologic examination femur minimum 2 views (73552) |
$131.30 |
$202 |
1.5× |
| Radiologic examination knee 1/2 views (73560) |
$270.40 |
$416 |
3.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$307.45 |
$473 |
2.9× |
| Radiologic examination tibia & fibula 2 views (73590) |
$130 |
$200 |
1.5× |
| Ribs bilateral 3 views (71110) |
$174.85 |
$269 |
1.6× |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
$1,717.95 |
$2,643 |
3.1× |
| Scapula (73010) |
$148.85 |
$229 |
1.4× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$136.50 |
$210 |
5.8× |
| Shoulder 1 view (73020) |
$121.55 |
$187 |
1.4× |
| Skull less than 4 views (70250) |
$159.90 |
$246 |
1.5× |
| Sternoclavicular joints (71130) |
$163.15 |
$251 |
1.8× |
| Thoracic spine 2 views (72070) |
$162.50 |
$250 |
1.5× |
| Thoracic spine 3 views (72072) |
$198.25 |
$305 |
1.9× |
| Thoracolumbar 2 views (72080) |
$153.40 |
$236 |
1.7× |
| Ultrasound Breast Limited (76642) |
$297.70 |
$458 |
3.3× |
| Ultrasound Exam Aaa Screen (76706) |
$441.35 |
$679 |
4.1× |
| Ultrasound, abdomen limited (76705) |
$388.70 |
$598 |
3.6× |
| Umbilical-artery Doppler (OB) (76820) |
$130.65 |
$201 |
1.2× |
| Unlisted magnetic resonance procedure (76498) |
$158.60 |
$244 |
1.8× |
| Unlisted us procedure (76999) |
$196.30 |
$302 |
2.2× |
| Ureteral Reflux Study (78740) |
$763.10 |
$1,174 |
1.9× |
| Urethrocystography retrograde (74450) |
$315.25 |
$485 |
1.3× |
| Us breast unilateral complete (76641) |
$383.50 |
$590 |
3.6× |
| Us chest (76604) |
$313.30 |
$482 |
2.9× |
| Us complete joint (76881) |
$294.45 |
$453 |
2.8× |
| Us exam, pelvic, limited (76857) |
$148.85 |
$229 |
1.4× |
| Us head (76506) |
$431.60 |
$664 |
4.0× |
| Us kidney transplant (76776) |
$482.30 |
$742 |
4.5× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$168.35 |
$259 |
1.6× |
| Us ob limited 1 or more fetuses (76815) |
$347.75 |
$535 |
3.3× |
| Us ob transvaginal (76817) |
$333.45 |
$513 |
3.1× |
| Us pelvic non ob complete (76856) |
$453.05 |
$697 |
4.2× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$441.35 |
$679 |
4.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$365.30 |
$562 |
3.4× |
| Us retroperitoneal complete (76770) |
$495.30 |
$762 |
4.6× |
| Us retroperitoneal limited (76775) |
$430.95 |
$663 |
4.0× |
| Us scrotum and contents (76870) |
$460.85 |
$709 |
4.3× |
| Us spinal canal and contents (76800) |
$428.35 |
$659 |
4.0× |
| Us thyroid (76536) |
$653.90 |
$1,006 |
6.1× |
| Us transrectal (76872) |
$231.40 |
$356 |
2.2× |
| Wrist 2 views (73100) |
$128.05 |
$197 |
1.4× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$159.90 |
$246 |
1.8× |
| X-Ray Bend Only L-S Spine (72120) |
$226.85 |
$349 |
2.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$121.55 |
$187 |
1.4× |
| X-Ray Exam Breast Specimen (76098) |
$106.60 |
$164 |
0.2× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$187.20 |
$288 |
2.1× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$273 |
$420 |
2.6× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$307.45 |
$473 |
2.9× |
| X-Ray Exam Hip Uni 1 View (73501) |
$217.75 |
$335 |
2.4× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$177.45 |
$273 |
2.0× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$226.20 |
$348 |
2.1× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$161.20 |
$248 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$194.35 |
$299 |
1.8× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$230.75 |
$355 |
2.2× |
| X-Ray Exam L-S Spine Bending (72114) |
$307.45 |
$473 |
2.9× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$156.65 |
$241 |
1.8× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$282.75 |
$435 |
2.6× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$177.45 |
$273 |
1.7× |
| X-ray eye for foreign body (70030) |
$116.35 |
$179 |
1.3× |
| X-ray humerus (73060) |
$130.65 |
$201 |
1.5× |
| X-ray IV pyelogram (ivp) (74400) |
$562.90 |
$866 |
3.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$146.90 |
$226 |
1.7× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$167.05 |
$257 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$173.55 |
$267 |
1.6× |
| X-ray nose-rectum child f.b. (76010) |
$115.05 |
$177 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$256.75 |
$395 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$156.65 |
$241 |
1.5× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$148.85 |
$229 |
1.4× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$133.90 |
$206 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$173.55 |
$267 |
2.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$198.25 |
$305 |
1.9× |
| X-ray thoracic spine 4 vw (72074) |
$211.90 |
$326 |
2.0× |
| X-Ray Tmj Unilat (70328) |
$128.05 |
$197 |
1.4× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$504.40 |
$776 |
1.4× |
| X-Rays Bone Length Studies (77073) |
$158.60 |
$244 |
1.5× |
| X-Rays Bone Survey Complete (77075) |
$358.15 |
$551 |
3.4× |
| Xr c-spine 4 or 5 views (72050) |
$221.65 |
$341 |
2.1× |
| Xr facial bones less than 3 views (70140) |
$135.20 |
$208 |
1.5× |
| XR Mastoids < 3 Views Bilateral (70120) |
$150.80 |
$232 |
1.4× |
| Xr orbits complete 4 views (70200) |
$210.60 |
$324 |
2.0× |