| Abdomen 1 View (74018) |
$192 |
$320 |
2.3× |
| Abdomen 2 views (74019) |
$228 |
$380 |
2.3× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$1,068.60 |
$1,781 |
2.8× |
| Ankle 2 views (73600) |
$208.20 |
$347 |
2.5× |
| Arthrogram ankle (73615) |
$465 |
$775 |
1.4× |
| Arthrogram hip (73525) |
$1,358.40 |
$2,264 |
4.1× |
| Arthrogram Wrist (73115) |
$1,210.80 |
$2,018 |
3.7× |
| Bone age studies (77072) |
$360 |
$600 |
3.6× |
| Bone Imaging 3 Phase (78315) |
$1,799.40 |
$2,999 |
4.8× |
| Bone Imaging Limited Area (78300) |
$1,548.60 |
$2,581 |
4.1× |
| Bone Imaging Multiple Areas (78305) |
$1,609.20 |
$2,682 |
4.3× |
| Bone Imaging Whole Body (78306) |
$1,662.60 |
$2,771 |
4.4× |
| Bone survey infant (77076) |
$302.40 |
$504 |
3.1× |
| Cerebrospinal Fluid Scan (78630) |
$850.80 |
$1,418 |
1.7× |
| Chest 1 view (71045) |
$83.40 |
$139 |
1.0× |
| Chest 2 views (71046) |
$72 |
$120 |
0.9× |
| Chest 3 views (71047) |
$189.60 |
$316 |
2.3× |
| Chest 4 or more views (71048) |
$295.20 |
$492 |
3.0× |
| Cholecystography Oral Contrast (74290) |
$297 |
$495 |
1.8× |
| Clavicle complete (73000) |
$206.40 |
$344 |
2.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$208.80 |
$348 |
2.1× |
| Contrast X-Ray Bladder (74430) |
$320.40 |
$534 |
1.0× |
| Contrast X-Ray Of Elbow (73085) |
$442.80 |
$738 |
1.3× |
| Contrast X-Ray Of Knee Joint (73580) |
$1,426.20 |
$2,377 |
4.3× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,753.40 |
$4,589 |
8.3× |
| CT abdomen and pelvis without contrast (74176) |
$1,741.20 |
$2,902 |
7.7× |
| CT abdomen w contrast (74160) |
$1,045.80 |
$1,743 |
6.3× |
| CT abdomen w wo contrast (74170) |
$1,441.80 |
$2,403 |
8.7× |
| CT abdomen w/o contrast (74150) |
$1,045.80 |
$1,743 |
10.6× |
| CT Angio Abdomen and Pelvis (74174) |
$2,615.40 |
$4,359 |
7.9× |
| CT Angio Chest (71275) |
$775.80 |
$1,293 |
4.7× |
| CT Angio Head (70496) |
$1,418.40 |
$2,364 |
8.5× |
| CT Angio Neck (70498) |
$1,065.60 |
$1,776 |
6.4× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$724.80 |
$1,208 |
4.4× |
| CT cervical spine w/ contrast (72126) |
$2,169 |
$3,615 |
6.6× |
| CT cervical spine w/o contrast (72125) |
$931.80 |
$1,553 |
9.4× |
| CT cervical spine w/wo cont (72127) |
$2,494.20 |
$4,157 |
15.0× |
| CT chest w contrast (71260) |
$1,148.40 |
$1,914 |
6.9× |
| CT chest w/wo contrast (71270) |
$1,148.40 |
$1,914 |
6.9× |
| CT head/brain with contrast (70460) |
$1,225.80 |
$2,043 |
7.4× |
| CT head/brain without and with contrast (70470) |
$1,502.40 |
$2,504 |
9.1× |
| CT iac w contrast (70481) |
$1,381.20 |
$2,302 |
8.3× |
| CT l-spine w&w/o contrast (72133) |
$2,271.60 |
$3,786 |
13.7× |
| CT lower ext w/o (73700) |
$887.40 |
$1,479 |
9.0× |
| CT lower extremity w/contrast material (73701) |
$921.60 |
$1,536 |
5.6× |
| CT lumbar spine w contrast (72132) |
$1,975.20 |
$3,292 |
6.0× |
| CT lumbar spine w/o contrast (72131) |
$1,047.60 |
$1,746 |
10.6× |
| CT maxillofacial w contrast (70487) |
$2,343.60 |
$3,906 |
14.1× |
| CT maxillofacial wo contrast (70486) |
$841.80 |
$1,403 |
8.5× |
| CT neck tissue combo (70492) |
$1,418.40 |
$2,364 |
8.5× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$1,588.20 |
$2,647 |
9.6× |
| CT orbits w/o contrast (70480) |
$948.60 |
$1,581 |
9.6× |
| CT pelvis w&w/o contrast (72194) |
$1,089 |
$1,815 |
6.6× |
| CT pelvis w/o contrast (72192) |
$838.20 |
$1,397 |
8.5× |
| CT scan of leg combo (73702) |
$1,162.20 |
$1,937 |
7.0× |
| CT scans face/jaw combo (70488) |
$2,694 |
$4,490 |
16.2× |
| CT soft tissue neck w contrast (70491) |
$1,225.80 |
$2,043 |
7.4× |
| CT soft tissue neck w/o contrast (70490) |
$1,114.20 |
$1,857 |
11.3× |
| CT thoracic spine w contrast (72129) |
$1,666.20 |
$2,777 |
10.0× |
| CT thoracic spine w/o contrast (72128) |
$1,143.60 |
$1,906 |
11.6× |
| CT thoracic spine w/wo cont (72130) |
$1,915.80 |
$3,193 |
11.5× |
| CT thorax w/o contrast (71250) |
$747.60 |
$1,246 |
7.6× |
| CT upper ext wo (73200) |
$886.80 |
$1,478 |
9.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$1,162.20 |
$1,937 |
7.0× |
| CT upper extremity with contrast (73201) |
$922.20 |
$1,537 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$741.60 |
$1,236 |
4.5× |
| Cta Abdomen (74175) |
$1,507.80 |
$2,513 |
9.1× |
| Dxa Bone Density Axial (77080) |
$201 |
$335 |
2.0× |
| Dxa bone density study (77085) |
$737.40 |
$1,229 |
7.5× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$230.40 |
$384 |
2.8× |
| Esophagram (74220) |
$359.40 |
$599 |
2.2× |
| Fetal Biophys Profile W/Nst (76818) |
$662.40 |
$1,104 |
6.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$638.40 |
$1,064 |
6.5× |
| Fluoroscopy up to 1 hr (76000) |
$218.40 |
$364 |
1.0× |
| Foot 2 views (73620) |
$208.20 |
$347 |
2.5× |
| Forearm 2 views (73090) |
$202.80 |
$338 |
2.5× |
| Gastric emptying imaging study (78264) |
$1,068.60 |
$1,781 |
2.8× |
| Gastroesophageal Reflux Exam (78262) |
$949.80 |
$1,583 |
2.5× |
| Gated Heart Planar Single (78472) |
$1,824.60 |
$3,041 |
4.8× |
| Hand 2 views (73120) |
$192 |
$320 |
1.9× |
| Hepatobil Syst Image W/Drug (78227) |
$1,449 |
$2,415 |
2.8× |
| Hepatobiliary System Imaging (78226) |
$1,449 |
$2,415 |
3.8× |
| Ht Muscle Image Spect Sing (78451) |
$2,170.20 |
$3,617 |
1.8× |
| Hysterosalpingogram (74740) |
$539.40 |
$899 |
2.4× |
| Knee 3 Views (73562) |
$325.80 |
$543 |
4.0× |
| Liver & Spleen Imaging Static Only (78215) |
$1,300.20 |
$2,167 |
3.4× |
| Lung Ventilat&Perfus Imaging (78582) |
$3,003.60 |
$5,006 |
5.8× |
| Magnetic Image Jaw Joint (70336) |
$778.20 |
$1,297 |
3.4× |
| Mr safety determination physician/other qhp (76016) |
$132 |
$220 |
1.6× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$36.60 |
$61 |
1.3× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$137.40 |
$229 |
1.5× |
| Mr safety implt pos&/immoblj (76019) |
$89.40 |
$149 |
1.6× |
| Mr safety med physics xm customization plng&mntr (76017) |
$362.40 |
$604 |
1.6× |
| Mra Head W/O & W/Contrast Material (70546) |
$1,624.80 |
$2,708 |
4.9× |
| MRA head w/o contrast (70544) |
$1,089 |
$1,815 |
4.8× |
| MRA head with contrast (70545) |
$1,360.20 |
$2,267 |
4.1× |
| MRA neck w contrast (70548) |
$1,584 |
$2,640 |
4.8× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,672.20 |
$2,787 |
5.1× |
| MRA neck w/o contrast (70547) |
$1,360.20 |
$2,267 |
6.0× |
| MRI abdomen w contrast (74182) |
$1,536 |
$2,560 |
4.7× |
| MRI abdomen w/o contrast (74181) |
$1,396.20 |
$2,327 |
6.2× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,768.20 |
$2,947 |
2.4× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,968.60 |
$3,281 |
6.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,606.80 |
$2,678 |
2.2× |
| MRI bone marrow blood supply (77084) |
$373.80 |
$623 |
1.7× |
| MRI Breast W/O Contrast Bilateral (77047) |
$2,139 |
$3,565 |
9.5× |
| MRI Breast Without Contrast Material Unilateral (77046) |
$1,060.80 |
$1,768 |
4.7× |
| MRI cervical spine w contrast (72142) |
$2,406.60 |
$4,011 |
7.3× |
| MRI cervical spine w/o cont (72141) |
$1,109.40 |
$1,849 |
4.9× |
| MRI chest w/o contrast (71550) |
$816.60 |
$1,361 |
3.6× |
| MRI chest with contrast (71551) |
$1,161.60 |
$1,936 |
1.6× |
| MRI chest wo w contrast (71552) |
$1,449.60 |
$2,416 |
4.4× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,623.60 |
$2,706 |
4.9× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,969.80 |
$3,283 |
6.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,551 |
$2,585 |
6.9× |
| MRI lumbar spine w contrast (72149) |
$3,038.40 |
$5,064 |
9.2× |
| Mri Neck Spine W/O & W/Dye (72156) |
$3,294 |
$5,490 |
10.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$2,100.60 |
$3,501 |
9.3× |
| MRI orbit face neck w contrast (70542) |
$2,309.40 |
$3,849 |
7.0× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$2,519.40 |
$4,199 |
7.6× |
| MRI pelvis w contrast (72196) |
$1,471.80 |
$2,453 |
4.5× |
| MRI pelvis w/o & w contrast (72197) |
$1,692.60 |
$2,821 |
5.1× |
| MRI pelvis w/o contrast (72195) |
$1,280.40 |
$2,134 |
5.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,916.40 |
$3,194 |
8.5× |
| MRI upper extremity oth than jt w/contr matrl (73219) |
$2,191.20 |
$3,652 |
6.6× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,904.40 |
$3,174 |
8.4× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$2,519.40 |
$4,199 |
7.6× |
| MRI, abdomen, combo (74183) |
$2,068.20 |
$3,447 |
6.3× |
| MRI, dorsal spine combo (72157) |
$3,315.60 |
$5,526 |
10.0× |
| MRI, dorsal spine contrast (72147) |
$2,107.20 |
$3,512 |
6.4× |
| MRI, joint upper extrem (73221) |
$948.60 |
$1,581 |
4.2× |
| MRI, joint upper extrem combo (73223) |
$1,722 |
$2,870 |
5.2× |
| MRI, lumbar spine combo (72158) |
$3,315.60 |
$5,526 |
10.0× |
| Myocardial Spect Multiple Studies (78452) |
$4,011 |
$6,685 |
3.3× |
| Neck soft tissue (70360) |
$196.20 |
$327 |
2.4× |
| Nonvascular Shunt X-Ray (75809) |
$214.20 |
$357 |
2.2× |
| Pelvis 1 or 2 views (72170) |
$280.80 |
$468 |
2.8× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$1,394.40 |
$2,324 |
3.7× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$388.20 |
$647 |
3.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$469.80 |
$783 |
0.9× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$222.60 |
$371 |
2.7× |
| Radex Calcaneus Minimum 2 Views (73650) |
$222.60 |
$371 |
2.7× |
| Radex elbow complete minimum 3 views (73080) |
$226.20 |
$377 |
2.7× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$359.40 |
$599 |
3.6× |
| Radex fingr minimum 2 views (73140) |
$192 |
$320 |
2.3× |
| Radex foot complete minimum 3 views (73630) |
$311.40 |
$519 |
3.8× |
| Radex Hand Minimum 3 Views (73130) |
$303.60 |
$506 |
3.7× |
| Radex lower extremity infant minimum 2 views (73592) |
$192 |
$320 |
2.3× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$457.80 |
$763 |
4.6× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$230.40 |
$384 |
2.8× |
| Radex Ribs Unilateral 2 Views (71100) |
$330.60 |
$551 |
4.0× |
| Radex shoulder complete minimum 2 views (73030) |
$361.80 |
$603 |
4.4× |
| Radex Sinuses Paransl < 3 Views (70210) |
$223.80 |
$373 |
2.7× |
| Radex Spine 1 View Specify Level (72020) |
$168.60 |
$281 |
2.0× |
| Radex Sternum Minimum 2 Views (71120) |
$276 |
$460 |
3.4× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$513.60 |
$856 |
6.2× |
| Radex Toe Minimum 2 Views (73660) |
$279 |
$465 |
3.4× |
| Radex upper extremity infant minimum 2 views (73092) |
$219.60 |
$366 |
2.2× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$219.60 |
$366 |
2.7× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$319.80 |
$533 |
3.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$388.20 |
$647 |
3.9× |
| Radiologic exam colon double contrast study (74280) |
$627 |
$1,045 |
3.8× |
| Radiologic exam colon single contrast study (74270) |
$538.20 |
$897 |
3.2× |
| Radiologic exam knee complete 4/more views (73564) |
$394.80 |
$658 |
4.0× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$330.60 |
$551 |
3.3× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$327 |
$545 |
2.0× |
| Radiologic exam swallow function contrast study (74230) |
$550.80 |
$918 |
3.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$644.40 |
$1,074 |
3.9× |
| Radiologic examination femur minimum 2 views (73552) |
$296.40 |
$494 |
3.6× |
| Radiologic examination knee 1/2 views (73560) |
$247.80 |
$413 |
3.0× |
| Radiologic Examination Osseous Survey Limited (77074) |
$658.80 |
$1,098 |
6.7× |
| Radiologic examination tibia & fibula 2 views (73590) |
$192 |
$320 |
2.3× |
| Ribs bilateral 3 views (71110) |
$425.40 |
$709 |
4.3× |
| Scapula (73010) |
$299.40 |
$499 |
3.0× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$30 |
$50 |
1.3× |
| Shoulder 1 view (73020) |
$276 |
$460 |
3.4× |
| Shoulder Arthrography (73040) |
$1,426.20 |
$2,377 |
4.3× |
| Skull less than 4 views (70250) |
$359.40 |
$599 |
3.6× |
| Sternoclavicular joints (71130) |
$251.40 |
$419 |
3.1× |
| Therapeutic Enema Rdctj Intussusception/Obstrcj (74283) |
$348.60 |
$581 |
2.1× |
| Thoracic spine 2 views (72070) |
$279.60 |
$466 |
2.8× |
| Thoracic spine 3 views (72072) |
$307.80 |
$513 |
3.1× |
| Thoracolumbar 2 views (72080) |
$336.60 |
$561 |
4.1× |
| Thyroid Imaging With Vascular Flow (78013) |
$966.60 |
$1,611 |
2.6× |
| Thyroid Uptake Measurement (78012) |
$1,438.80 |
$2,398 |
3.8× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$1,438.80 |
$2,398 |
3.8× |
| Ultrasound Breast Limited (76642) |
$84.60 |
$141 |
1.0× |
| Ultrasound Exam Aaa Screen (76706) |
$222.60 |
$371 |
2.3× |
| Ultrasound, abdomen limited (76705) |
$132.60 |
$221 |
1.3× |
| Unlisted us procedure (76999) |
$741 |
$1,235 |
9.0× |
| Upper gi w/o kub (74240) |
$567 |
$945 |
3.4× |
| Urethrocystogram voiding (74455) |
$532.80 |
$888 |
2.4× |
| Urethrocystography retrograde (74450) |
$340.80 |
$568 |
1.5× |
| Us breast unilateral complete (76641) |
$84.60 |
$141 |
0.9× |
| Us chest (76604) |
$607.20 |
$1,012 |
6.1× |
| Us complete joint (76881) |
$668.40 |
$1,114 |
6.8× |
| Us exam, pelvic, limited (76857) |
$196.20 |
$327 |
2.0× |
| Us kidney transplant (76776) |
$571.80 |
$953 |
5.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$446.40 |
$744 |
4.5× |
| Us ob detailed single fetus (76811) |
$662.40 |
$1,104 |
2.9× |
| Us ob limited 1 or more fetuses (76815) |
$342 |
$570 |
3.5× |
| Us ob transvaginal (76817) |
$668.40 |
$1,114 |
6.8× |
| Us pelvic non ob complete (76856) |
$202.80 |
$338 |
2.1× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$677.40 |
$1,129 |
6.8× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$127.80 |
$213 |
1.3× |
| Us retroperitoneal complete (76770) |
$948.60 |
$1,581 |
9.6× |
| Us retroperitoneal limited (76775) |
$771 |
$1,285 |
7.8× |
| Us scrotum and contents (76870) |
$795.60 |
$1,326 |
8.0× |
| Us thyroid (76536) |
$446.40 |
$744 |
4.5× |
| Us transrectal (76872) |
$1,176.60 |
$1,961 |
11.9× |
| Vertebral fracture assessment via dxa (77086) |
$134.40 |
$224 |
1.6× |
| Wrist 2 views (73100) |
$192 |
$320 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$289.80 |
$483 |
3.5× |
| X-ray antegrade pyelogram tube (74425) |
$546 |
$910 |
1.7× |
| X-Ray Bend Only L-S Spine (72120) |
$247.20 |
$412 |
2.5× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$151.20 |
$252 |
1.8× |
| X-Ray Exam Breast Specimen (76098) |
$383.40 |
$639 |
0.7× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$242.40 |
$404 |
2.9× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$274.80 |
$458 |
2.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$362.40 |
$604 |
3.7× |
| X-Ray Exam Hip Uni 1 View (73501) |
$268.20 |
$447 |
3.3× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$316.80 |
$528 |
3.8× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$531.60 |
$886 |
5.4× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$848.40 |
$1,414 |
8.6× |
| X-Ray Exam L-S Spine Bending (72114) |
$460.20 |
$767 |
4.7× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$254.40 |
$424 |
3.1× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$416.40 |
$694 |
4.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$402 |
$670 |
4.1× |
| X-ray humerus (73060) |
$230.40 |
$384 |
2.8× |
| X-ray IV pyelogram (ivp) (74400) |
$577.80 |
$963 |
3.5× |
| X-ray IV pyelogram+tomography (74415) |
$772.80 |
$1,288 |
4.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$298.20 |
$497 |
3.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$153.60 |
$256 |
1.9× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$304.20 |
$507 |
3.1× |
| X-ray nose-rectum child f.b. (76010) |
$151.80 |
$253 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$627.60 |
$1,046 |
6.3× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$241.80 |
$403 |
2.4× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$208.20 |
$347 |
2.1× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$304.20 |
$507 |
3.7× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$359.40 |
$599 |
4.4× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$416.40 |
$694 |
4.2× |
| X-ray thoracic spine 4 vw (72074) |
$347.40 |
$579 |
3.5× |
| X-Ray Tmj Unilat (70328) |
$218.40 |
$364 |
2.7× |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
$541.20 |
$902 |
1.6× |
| X-Rays Bone Survey Complete (77075) |
$1,197.60 |
$1,996 |
12.1× |
| Xr c-spine 4 or 5 views (72050) |
$359.40 |
$599 |
3.6× |
| Xr facial bones less than 3 views (70140) |
$223.80 |
$373 |
2.7× |
| Xr orbits complete 4 views (70200) |
$376.80 |
$628 |
3.8× |
| Xr Tomogram Single Plane (76100) |
$439.20 |
$732 |
4.4× |