| Abdomen 1 View (74018) |
$97.01 |
$786 |
1.1× |
| Angiography extremity unilateral rs&i (75710) |
$3,467.86 |
$10,412 |
1.1× |
| Ankle 2 views (73600) |
$97.01 |
$571 |
1.1× |
| Aortography thoracic serialography rs&i (75605) |
$5,955.91 |
$17,248 |
1.1× |
| Artery X-Rays Abdomen (75726) |
$5,955.91 |
$17,248 |
1.1× |
| Arthrogram ankle (73615) |
$393.48 |
$2,036 |
1.1× |
| Arthrogram hip (73525) |
$393.48 |
$2,168 |
1.1× |
| Arthrogram Wrist (73115) |
$393.48 |
$1,739 |
1.1× |
| Bone age studies (77072) |
$117.16 |
$410 |
1.1× |
| Bone survey infant (77076) |
$117.16 |
$417 |
1.1× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$393.48 |
$11,928 |
1.1× |
| Cardiac MRI w/w/o contrast w/stress (75563) |
$870.47 |
$15,159 |
1.1× |
| Cat Scan Follow-Up Study (76380) |
$97.01 |
$1,864 |
1.1× |
| Chest 1 view (71045) |
$97.01 |
$641 |
1.1× |
| Chest 2 views (71046) |
$97.01 |
$773 |
1.1× |
| Chest 3 views (71047) |
$97.01 |
$933 |
1.1× |
| Cholecystography Oral Contrast (74290) |
$196.14 |
$745 |
1.1× |
| Cineradiograpy/vidradiograpy xcpt where spec (76120) |
$117.16 |
$658 |
1.1× |
| Clavicle complete (73000) |
$97.01 |
$605 |
1.1× |
| Contrast Exam Abdominl Aorta (75625) |
$3,467.86 |
$10,412 |
1.1× |
| Contrast X-Ray Bladder (74430) |
$393.48 |
$1,184 |
1.1× |
| Contrast X-Ray Of Elbow (73085) |
$393.48 |
$2,111 |
1.1× |
| Contrast X-Ray Of Knee Joint (73580) |
$393.48 |
$2,656 |
1.1× |
| Contrast Xray Throat/Cerv Esopha (74210) |
$196.14 |
$1,041 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$393.48 |
$11,728 |
1.1× |
| CT abdomen and pelvis without contrast (74176) |
$266.32 |
$5,084 |
1.1× |
| CT abdomen w contrast (74160) |
$196.14 |
$10,344 |
1.1× |
| CT abdomen w wo contrast (74170) |
$196.14 |
$12,420 |
1.1× |
| CT abdomen w/o contrast (74150) |
$117.16 |
$7,968 |
1.1× |
| CT Angio Chest (71275) |
$196.14 |
$5,475 |
1.1× |
| CT Angio Head (70496) |
$196.14 |
$5,850 |
1.1× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$196.14 |
$4,009 |
1.1× |
| CT Angio Neck (70498) |
$196.14 |
$5,842 |
1.1× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$196.14 |
$3,922 |
1.1× |
| CT bone density (77078) |
$97.01 |
$2,003 |
1.1× |
| CT cervical spine w/ contrast (72126) |
$393.48 |
$5,028 |
1.1× |
| CT cervical spine w/o contrast (72125) |
$117.16 |
$4,160 |
1.1× |
| CT cervical spine w/wo cont (72127) |
$196.14 |
$6,200 |
1.1× |
| CT chest w contrast (71260) |
$196.14 |
$3,507 |
1.1× |
| CT chest w/wo contrast (71270) |
$196.14 |
$4,449 |
1.1× |
| CT head/brain with contrast (70460) |
$196.14 |
$3,467 |
1.1× |
| CT head/brain without and with contrast (70470) |
$196.14 |
$4,422 |
1.1× |
| CT iac w contrast (70481) |
$196.14 |
$3,533 |
1.1× |
| CT l-spine w&w/o contrast (72133) |
$196.14 |
$5,914 |
1.1× |
| CT lower ext w/o (73700) |
$117.16 |
$2,182 |
1.1× |
| CT lower extremity w/contrast material (73701) |
$196.14 |
$2,468 |
1.1× |
| CT lumbar spine w contrast (72132) |
$393.48 |
$4,888 |
1.1× |
| CT lumbar spine w/o contrast (72131) |
$117.16 |
$4,133 |
1.1× |
| CT maxillofacial w contrast (70487) |
$196.14 |
$3,496 |
1.1× |
| CT maxillofacial wo contrast (70486) |
$117.16 |
$3,040 |
1.1× |
| CT neck tissue combo (70492) |
$196.14 |
$4,372 |
1.1× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$196.14 |
$4,398 |
1.1× |
| CT orbits w/o contrast (70480) |
$117.16 |
$3,120 |
1.1× |
| CT pelvis w&w/o contrast (72194) |
$196.14 |
$5,246 |
1.1× |
| CT pelvis w/o contrast (72192) |
$117.16 |
$3,679 |
1.1× |
| CT scan of leg combo (73702) |
$196.14 |
$3,206 |
1.1× |
| CT scans face/jaw combo (70488) |
$196.14 |
$4,330 |
1.1× |
| CT soft tissue neck w contrast (70491) |
$196.14 |
$3,492 |
1.1× |
| CT soft tissue neck w/o contrast (70490) |
$117.16 |
$3,080 |
1.1× |
| CT thoracic spine w contrast (72129) |
$196.14 |
$4,981 |
1.1× |
| CT thoracic spine w/o contrast (72128) |
$117.16 |
$4,151 |
1.1× |
| CT thoracic spine w/wo cont (72130) |
$196.14 |
$6,104 |
1.1× |
| CT thorax w/o contrast (71250) |
$117.16 |
$3,133 |
1.1× |
| CT upper ext wo (73200) |
$117.16 |
$2,102 |
1.1× |
| CT upper extremity w/o & w/contrast material (73202) |
$196.14 |
$2,642 |
1.1× |
| CT upper extremity with contrast (73201) |
$393.48 |
$2,425 |
1.1× |
| Cta Abdomen (74175) |
$196.14 |
$14,517 |
1.1× |
| CTA pelvis (72191) |
$196.14 |
$6,673 |
1.1× |
| Discography Cerv/Thor Spine (72285) |
$2,151.52 |
$4,729 |
1.1× |
| Diskography lumbar (72295) |
$2,151.52 |
$4,597 |
1.1× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$117.16 |
$935 |
1.1× |
| Dxa Bone Density Axial (77080) |
$117.16 |
$2,097 |
1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$97.01 |
$534 |
1.1× |
| Echo exam uterus (76831) |
$266.32 |
$1,236 |
1.1× |
| Echo Guide For Artery Repair (76936) |
$343.09 |
$2,963 |
1.6× |
| Echograp Trans R Pros Study (76873) |
$117.16 |
$1,163 |
1.1× |
| Fetal Biophys Profile W/Nst (76818) |
$117.16 |
$893 |
1.1× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$117.16 |
$962 |
1.1× |
| Fluoroscopy up to 1 hr (76000) |
$266.32 |
$742 |
1.1× |
| Foot 2 views (73620) |
$97.01 |
$565 |
1.1× |
| Forearm 2 views (73090) |
$97.01 |
$580 |
1.1× |
| GI Endoscopic US S&I (76975) |
$266.32 |
$1,286 |
1.1× |
| Hand 2 views (73120) |
$117.16 |
$523 |
1.1× |
| Hysterosalpingogram (74740) |
$266.32 |
$1,490 |
1.1× |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
$97.01 |
$1,088 |
1.1× |
| Infant hip ultrasound, limited static exam (76886) |
$97.01 |
$1,016 |
1.1× |
| Infusion Ivp (74410) |
$196.14 |
$2,124 |
1.1× |
| Joint Survey Single View (77077) |
$117.16 |
$630 |
1.1× |
| Knee 3 Views (73562) |
$97.01 |
$704 |
1.1× |
| Mra Head W/O & W/Contrast Material (70546) |
$393.48 |
$9,758 |
1.1× |
| MRA head w/o contrast (70544) |
$266.32 |
$6,764 |
1.1× |
| MRA head with contrast (70545) |
$393.48 |
$7,515 |
1.1× |
| MRA neck w contrast (70548) |
$393.48 |
$7,610 |
1.1× |
| Mra Neck W/O &W/Contrast Material (70549) |
$393.48 |
$9,758 |
1.1× |
| MRA neck w/o contrast (70547) |
$266.32 |
$6,659 |
1.1× |
| MRI abdomen w contrast (74182) |
$393.48 |
$20,230 |
1.1× |
| MRI abdomen w/o contrast (74181) |
$266.32 |
$16,937 |
1.1× |
| MRI any jt lower extrem w/contrast material (73722) |
$870.47 |
$5,799 |
1.1× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$393.48 |
$7,295 |
1.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$870.47 |
$5,358 |
1.1× |
| MRI bone marrow blood supply (77084) |
$266.32 |
$584 |
1.1× |
| MRI cardiac w/o cont stress (75559) |
$604.11 |
$12,107 |
1.1× |
| MRI cardiac w/o contrast (75557) |
$266.32 |
$9,568 |
1.1× |
| MRI cervical spine w contrast (72142) |
$393.48 |
$8,775 |
1.1× |
| MRI cervical spine w/o cont (72141) |
$266.32 |
$7,821 |
1.1× |
| MRI chest w/o contrast (71550) |
$266.32 |
$6,659 |
1.1× |
| MRI chest with contrast (71551) |
$870.47 |
$7,360 |
1.1× |
| MRI chest wo w contrast (71552) |
$393.48 |
$10,275 |
1.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$393.48 |
$12,834 |
1.1× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$393.48 |
$7,424 |
1.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$266.32 |
$5,151 |
1.1× |
| MRI lumbar spine w contrast (72149) |
$393.48 |
$9,169 |
1.1× |
| Mri Neck Spine W/O & W/Dye (72156) |
$393.48 |
$11,381 |
1.1× |
| MRI orbit face &/neck w/o contrast (70540) |
$266.32 |
$7,530 |
1.1× |
| MRI orbit face neck w contrast (70542) |
$393.48 |
$8,739 |
1.1× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$393.48 |
$10,945 |
1.1× |
| MRI pelvis w contrast (72196) |
$393.48 |
$9,121 |
1.1× |
| MRI pelvis w/o & w contrast (72197) |
$393.48 |
$11,622 |
1.1× |
| MRI pelvis w/o contrast (72195) |
$266.32 |
$7,895 |
1.1× |
| MRI spectroscopy (76390) |
$97.01 |
$5,791 |
1.1× |
| MRI thoracic spine w/o contrast (72146) |
$266.32 |
$8,496 |
1.1× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$393.48 |
$4,434 |
1.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$266.32 |
$4,084 |
1.1× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$393.48 |
$5,602 |
1.1× |
| MRI, abdomen, combo (74183) |
$393.48 |
$23,880 |
1.1× |
| MRI, dorsal spine combo (72157) |
$393.48 |
$11,991 |
1.1× |
| MRI, dorsal spine contrast (72147) |
$393.48 |
$9,300 |
1.1× |
| MRI, joint upper extrem (73221) |
$266.32 |
$4,634 |
1.1× |
| MRI, joint upper extrem combo (73223) |
$393.48 |
$6,899 |
1.1× |
| MRI, lumbar spine combo (72158) |
$393.48 |
$11,925 |
1.1× |
| Myelogram cervical (72240) |
$870.47 |
$2,816 |
1.1× |
| Myelogram Lumbar (72265) |
$870.47 |
$2,619 |
1.1× |
| Myelography thoracic (72255) |
$870.47 |
$2,646 |
1.1× |
| Myelograpy 2/more regions rs&i (72270) |
$870.47 |
$3,720 |
1.1× |
| Neck soft tissue (70360) |
$97.01 |
$510 |
1.1× |
| Nonvascular Shunt X-Ray (75809) |
$117.16 |
$714 |
1.1× |
| Ob us nuchal meas 1 gest (76813) |
$117.16 |
$842 |
1.1× |
| Optic foramina (70190) |
$97.01 |
$626 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$117.16 |
$407 |
1.1× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$117.16 |
$1,097 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$604.11 |
$555 |
1.1× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$97.01 |
$647 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$97.01 |
$545 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$97.01 |
$663 |
1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$117.16 |
$813 |
1.1× |
| Radex fingr minimum 2 views (73140) |
$97.01 |
$456 |
1.1× |
| Radex foot complete minimum 3 views (73630) |
$97.01 |
$635 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$97.01 |
$608 |
1.1× |
| Radex lower extremity infant minimum 2 views (73592) |
$97.01 |
$545 |
1.1× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$117.16 |
$824 |
1.1× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$97.01 |
$476 |
1.1× |
| Radex Pharynx/Larx W/Fluor&/Magnification Tq (70370) |
$97.01 |
$1,371 |
1.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$97.01 |
$738 |
1.1× |
| Radex shoulder complete minimum 2 views (73030) |
$97.01 |
$740 |
1.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$97.01 |
$561 |
1.1× |
| Radex Spine 1 View Specify Level (72020) |
$97.01 |
$482 |
1.1× |
| Radex Sternum Minimum 2 Views (71120) |
$97.01 |
$803 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
$97.01 |
$525 |
1.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$117.16 |
$491 |
1.1× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$97.01 |
$614 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$117.16 |
$660 |
1.1× |
| Radiologic exam colon double contrast study (74280) |
$196.14 |
$2,305 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$196.14 |
$1,664 |
1.1× |
| Radiologic exam knee complete 4/more views (73564) |
$117.16 |
$812 |
1.1× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$117.16 |
$524 |
1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$196.14 |
$1,221 |
1.1× |
| Radiologic exam swallow function contrast study (74230) |
$196.14 |
$1,171 |
1.1× |
| Radiologic exam upr gi trc double contrast study (74246) |
$196.14 |
$1,447 |
1.1× |
| Radiologic examination femur 1 view (73551) |
$97.01 |
$575 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$97.01 |
$663 |
1.1× |
| Radiologic examination knee 1/2 views (73560) |
$97.01 |
$609 |
1.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$117.16 |
$578 |
1.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$97.01 |
$603 |
1.1× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$604.11 |
$662 |
1.1× |
| Scapula (73010) |
$117.16 |
$671 |
1.1× |
| Sella turcica (70240) |
$97.01 |
$415 |
1.1× |
| Shoulder 1 view (73020) |
$97.01 |
$511 |
1.1× |
| Shoulder Arthrography (73040) |
$393.48 |
$2,085 |
1.1× |
| Skull less than 4 views (70250) |
$117.16 |
$618 |
1.1× |
| Speech evaluation, complex (70371) |
$266.32 |
$2,071 |
1.1× |
| Sternoclavicular joints (71130) |
$97.01 |
$892 |
1.1× |
| Thoracic spine 2 views (72070) |
$117.16 |
$721 |
1.1× |
| Thoracic spine 3 views (72072) |
$117.16 |
$851 |
1.1× |
| Thoracolumbar 2 views (72080) |
$97.01 |
$780 |
1.1× |
| Ultrasound Breast Limited (76642) |
$97.01 |
$829 |
1.1× |
| Ultrasound Exam Aaa Screen (76706) |
$117.16 |
$1,206 |
1.1× |
| Ultrasound, abdomen limited (76705) |
$117.16 |
$896 |
1.1× |
| Umbilical-artery Doppler (OB) (76820) |
$117.16 |
$856 |
1.1× |
| Unlisted Dx Radiographic Procedure (76499) |
$97.01 |
$148.42 |
1.1× |
| Unlisted fluoroscopic procedure (76496) |
$97.01 |
$883 |
1.1× |
| Upper gi w/o kub (74240) |
$196.14 |
$1,425 |
1.1× |
| Urethrocystogram voiding (74455) |
$266.32 |
$1,872 |
1.1× |
| Urethrocystography retrograde (74450) |
$266.32 |
$1,607 |
1.1× |
| Us bone density measurement (76977) |
$117.16 |
$700 |
1.1× |
| Us breast unilateral complete (76641) |
$117.16 |
$1,187 |
1.1× |
| Us chest (76604) |
$117.16 |
$1,206 |
1.1× |
| Us complete joint (76881) |
$117.16 |
$1,217 |
1.1× |
| Us exam, pelvic, limited (76857) |
$117.16 |
$1,143 |
1.1× |
| Us head (76506) |
$117.16 |
$1,001 |
1.1× |
| Us kidney transplant (76776) |
$117.16 |
$1,247 |
1.1× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$117.16 |
$158 |
1.1× |
| Us ob detailed single fetus (76811) |
$266.32 |
$1,670 |
1.1× |
| Us ob limited 1 or more fetuses (76815) |
$117.16 |
$742 |
1.1× |
| Us ob transvaginal (76817) |
$117.16 |
$835 |
1.1× |
| Us pelvic non ob complete (76856) |
$117.16 |
$1,023 |
1.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$117.16 |
$1,018 |
1.1× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$117.16 |
$576 |
1.1× |
| Us retroperitoneal complete (76770) |
$117.16 |
$1,187 |
1.1× |
| Us retroperitoneal limited (76775) |
$117.16 |
$890 |
1.1× |
| Us scrotum and contents (76870) |
$117.16 |
$975 |
1.1× |
| Us spinal canal and contents (76800) |
$117.16 |
$1,011 |
1.1× |
| Us thyroid (76536) |
$117.16 |
$1,012 |
1.1× |
| Us transrectal (76872) |
$117.16 |
$965 |
1.1× |
| Venogram Sinus/Jugular (75860) |
$3,467.86 |
$10,408 |
1.1× |
| Venography caval inferior serialography rs&i (75825) |
$3,467.86 |
$10,214 |
1.1× |
| Venography extremity unilateral rs&i (75820) |
$1,711.56 |
$1,170 |
1.1× |
| Wrist 2 views (73100) |
$97.01 |
$535 |
1.1× |
| X-ray antegrade pyelogram tube (74425) |
$393.48 |
$1,291 |
1.1× |
| X-Ray Aorta Leg Arteries (75630) |
$3,467.86 |
$10,412 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$117.16 |
$1,027 |
1.1× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$97.01 |
$576 |
1.1× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$97.01 |
$1,182 |
1.1× |
| X-Ray Exam Hip Uni 1 View (73501) |
$97.01 |
$529 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$97.01 |
$669 |
1.1× |
| X-Ray Exam Hip Uni 4/> Views (73503) |
$117.16 |
$786 |
1.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$117.16 |
$1,330 |
1.1× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$117.16 |
$1,534 |
1.1× |
| X-Ray Exam L-S Spine Bending (72114) |
$117.16 |
$1,319 |
1.1× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$97.01 |
$695 |
1.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$117.16 |
$1,182 |
1.1× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$117.16 |
$854 |
1.1× |
| X-ray eye for foreign body (70030) |
$97.01 |
$650 |
1.1× |
| X-ray humerus (73060) |
$97.01 |
$688 |
1.1× |
| X-ray IV pyelogram (ivp) (74400) |
$196.14 |
$1,872 |
1.1× |
| X-ray IV pyelogram+tomography (74415) |
$196.14 |
$2,383 |
1.1× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$97.01 |
$471 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$97.01 |
$583 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$117.16 |
$733 |
1.1× |
| X-ray nose-rectum child f.b. (76010) |
$97.01 |
$383 |
1.1× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$117.16 |
$507 |
1.1× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$117.16 |
$384 |
1.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$97.01 |
$450 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$97.01 |
$947 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$117.16 |
$894 |
1.1× |
| X-Ray Stress View (77071) |
$97.01 |
$426 |
1.1× |
| X-ray thoracic spine 4 vw (72074) |
$117.16 |
$1,027 |
1.1× |
| X-Ray Tmj Unilat (70328) |
$97.01 |
$639 |
1.1× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$393.48 |
$1,503 |
1.1× |
| X-Rays Bone Length Studies (77073) |
$117.16 |
$576 |
1.1× |
| X-Rays Bone Survey Complete (77075) |
$117.16 |
$994 |
1.1× |
| Xr c-spine 4 or 5 views (72050) |
$117.16 |
$991 |
1.1× |
| Xr facial bones less than 3 views (70140) |
$97.01 |
$678 |
1.1× |
| XR Mastoids < 3 Views Bilateral (70120) |
$117.16 |
$561 |
1.1× |
| Xr orbits complete 4 views (70200) |
$117.16 |
$812 |
1.1× |