| Abdomen 1 View (74018) |
— |
$2,341 |
— |
| Abdomen 2 views (74019) |
— |
$2,712 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$2,331 |
— |
| Angio internal mammary (75756) |
— |
$6,545 |
— |
| Angio pulmonary bilat (75743) |
— |
$14,184 |
— |
| Angiography Adrenal Bilateral Slctv Rs&I (75733) |
— |
$5,215 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$6,028 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$5,903 |
— |
| Angiography pulmonary unilateral slctv rs&i (75741) |
— |
$6,816 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$6,202 |
— |
| Ankle 2 views (73600) |
— |
$3,835 |
— |
| Aortography thoracic serialography rs&i (75605) |
— |
$8,210 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$5,783 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$14,423 |
— |
| Arthrogram ankle (73615) |
— |
$5,201 |
— |
| Arthrogram hip (73525) |
— |
$4,641 |
— |
| Arthrogram Wrist (73115) |
— |
$2,806 |
— |
| Bone age studies (77072) |
— |
$478 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$7,478 |
— |
| Bone Imaging Limited Area (78300) |
— |
$3,262 |
— |
| Bone Imaging Whole Body (78306) |
— |
$9,815 |
— |
| Bone survey infant (77076) |
— |
$741 |
— |
| Brain Flow Imaging Only (78610) |
— |
$2,303 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$2,158 |
— |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
— |
$1,167 |
— |
| Cerebrospinal Fluid Scan (78630) |
— |
$3,332 |
— |
| Chest 1 view (71045) |
— |
$1,554 |
— |
| Chest 2 views (71046) |
— |
$1,897 |
— |
| Chest 3 views (71047) |
— |
$1,994 |
— |
| Chest 4 or more views (71048) |
— |
$2,090 |
— |
| Cholecystography Oral Contrast (74290) |
— |
$2,461 |
— |
| Clavicle complete (73000) |
— |
$1,072 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$390 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$8,210 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$1,100 |
— |
| Contrast X-Ray Of Elbow (73085) |
— |
$5,708 |
— |
| Contrast X-Ray Of Knee Joint (73580) |
— |
$6,953 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$19,113 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$11,496 |
— |
| CT abdomen w contrast (74160) |
— |
$5,066 |
— |
| CT abdomen w wo contrast (74170) |
— |
$6,149 |
— |
| CT abdomen w/o contrast (74150) |
— |
$3,698 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$12,623 |
— |
| CT Angio Chest (71275) |
— |
$9,017 |
— |
| CT Angio Head (70496) |
— |
$7,257 |
— |
| CT angio hrt w/3d image (75574) |
— |
$1,767 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$6,865 |
— |
| CT Angio Neck (70498) |
— |
$7,257 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$7,257 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$3,842 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$3,494 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$6,354 |
— |
| CT chest w contrast (71260) |
— |
$3,824 |
— |
| CT chest w/wo contrast (71270) |
— |
$6,149 |
— |
| CT head/brain with contrast (70460) |
— |
$3,885 |
— |
| CT head/brain without and with contrast (70470) |
— |
$5,776 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$1,767 |
— |
| CT hrt w/3d image congen (75573) |
— |
$1,767 |
— |
| CT iac w contrast (70481) |
— |
$3,349 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$4,313 |
— |
| CT lower ext w/o (73700) |
— |
$5,047 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$3,824 |
— |
| CT lumbar spine w contrast (72132) |
— |
$3,698 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$3,572 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,483 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,346 |
— |
| CT neck tissue combo (70492) |
— |
$5,776 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$5,776 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,130 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$5,641 |
— |
| CT pelvis w/o contrast (72192) |
— |
$3,579 |
— |
| CT scan of leg combo (73702) |
— |
$5,326 |
— |
| CT scans face/jaw combo (70488) |
— |
$3,724 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$3,799 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$3,494 |
— |
| CT thoracic spine w contrast (72129) |
— |
$7,271 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$7,151 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$10,666 |
— |
| CT thorax w/o contrast (71250) |
— |
$3,494 |
— |
| CT upper ext wo (73200) |
— |
$2,526 |
— |
| CT upper extremity w/o & w/contrast material (73202) |
— |
$5,855 |
— |
| CT upper extremity with contrast (73201) |
— |
$3,824 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$13,711 |
— |
| Cta Abdomen (74175) |
— |
$10,225 |
— |
| CTA pelvis (72191) |
— |
$7,257 |
— |
| Dilation ureters/urethra rs&i (74485) |
— |
$4,379 |
— |
| Dxa Bone Density Axial (77080) |
— |
$378 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$446 |
— |
| Echo exam uterus (76831) |
— |
$929 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$1,877 |
— |
| Esophagram (74220) |
— |
$1,879 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$887 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,446 |
— |
| Follow-Up Angiography (75898) |
— |
$2,020 |
— |
| Foot 2 views (73620) |
— |
$3,835 |
— |
| Forearm 2 views (73090) |
— |
$3,835 |
— |
| Gastric emptying imaging study (78264) |
— |
$2,419 |
— |
| Gastric Emptyng Imag Std W/Sm Bwl Transit (78265) |
— |
$7,294 |
— |
| Gated Heart Planar Single (78472) |
— |
$2,736 |
— |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
— |
$9,115 |
— |
| Hand 2 views (73120) |
— |
$2,924 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$16,147 |
— |
| Hepatc Vngrph Wdg/Fr W/O Hemodyn Eval Rs&I (75891) |
— |
$5,890 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$9,993 |
— |
| Ht Musc Image Planar Mult (78454) |
— |
$7,109 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$6,303 |
— |
| Hysterosalpingogram (74740) |
— |
$1,435 |
— |
| Infant hip ultrasound with hip movement (dynamic) (76885) |
— |
$1,306 |
— |
| K Flow/Funct Image Multiple (78709) |
— |
$5,768 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$3,193 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$2,561 |
— |
| Kidney Imaging Morphol (78700) |
— |
$1,702 |
— |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
— |
$2,185 |
— |
| Knee 3 Views (73562) |
— |
$5,057 |
— |
| Leveen/Shunt Patency Exam (78291) |
— |
$2,410 |
— |
| Liver & Spleen Imaging Static Only (78215) |
— |
$6,869 |
— |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
— |
$6,414 |
— |
| Lung Perf&Ventilat Diferentl (78598) |
— |
$1,289 |
— |
| Lung perfusion differential (78597) |
— |
$826 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$1,289 |
— |
| Lung Ventilation Imaging (78579) |
— |
$826 |
— |
| Lymph System Imaging (78195) |
— |
$2,091 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$6,602 |
— |
| Mammary ductogram or galactogram multiple (77054) |
— |
$4,347 |
— |
| Mammary ductogram or galactogram single (77053) |
— |
$4,347 |
— |
| Meckels Divert Exam (78290) |
— |
$1,179 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$5,662 |
— |
| MRA head w/o contrast (70544) |
— |
$5,149 |
— |
| MRA neck w contrast (70548) |
— |
$3,782 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$7,396 |
— |
| MRA neck w/o contrast (70547) |
— |
$3,696 |
— |
| MRI abdomen w contrast (74182) |
— |
$2,590 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$9,070 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$3,717 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$8,284 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$7,175 |
— |
| MRI cervical spine w contrast (72142) |
— |
$7,856 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$5,448 |
— |
| MRI chest w/o contrast (71550) |
— |
$6,264 |
— |
| MRI chest with contrast (71551) |
— |
$7,856 |
— |
| MRI chest wo w contrast (71552) |
— |
$9,070 |
— |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
— |
$2,590 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$8,284 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$5,149 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$7,856 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$9,070 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$5,496 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$8,284 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$6,706 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$5,459 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$5,471 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$4,316 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$8,284 |
— |
| MRI, abdomen, combo (74183) |
— |
$10,225 |
— |
| MRI, dorsal spine combo (72157) |
— |
$9,070 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$7,140 |
— |
| MRI, joint upper extrem (73221) |
— |
$6,602 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$8,284 |
— |
| MRI, lumbar spine combo (72158) |
— |
$9,085 |
— |
| Myelogram cervical (72240) |
— |
$2,755 |
— |
| Myelogram Lumbar (72265) |
— |
$2,925 |
— |
| Myelography thoracic (72255) |
— |
$1,630 |
— |
| Myelograpy 2/more regions rs&i (72270) |
— |
$2,020 |
— |
| Myocardial Perfusion Planar 1 Study Rest/Stress (78453) |
— |
$6,303 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$7,380 |
— |
| Neck soft tissue (70360) |
— |
$1,777 |
— |
| Nm csf leak detection (78650) |
— |
$3,337 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$2,020 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$2,024 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$1,505 |
— |
| Parathyroid planar imaging w/wo subtraction (78071) |
— |
$1,877 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$1,832 |
— |
| Peritoneogram Rs&I (74190) |
— |
$1,413 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$3,981 |
— |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
— |
$4,357 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$1,375 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$4,667 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$1,031 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$4,321 |
— |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
— |
$641 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$1,603 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$4,667 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$3,556 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$510 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$1,897 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$4,970 |
— |
| Radex Sinuses Paransl < 3 Views (70210) |
— |
$1,709 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$2,012 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$1,897 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$899 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$912 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$3,556 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$3,477 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$796 |
— |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
— |
$3,082 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,526 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$4,171 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$6,742 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$2,079 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$3,885 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$806 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$3,405 |
— |
| Radiologic examination femur 1 view (73551) |
— |
$1,038 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$1,513 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$4,443 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$992 |
— |
| Ribs bilateral 3 views (71110) |
— |
$3,267 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,867 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$5,210 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$6,451 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$3,545 |
— |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
— |
$6,450 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$7,318 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$6,450 |
— |
| Rp Therapy Intravenous Administration (79101) |
— |
$1,365 |
— |
| Scapula (73010) |
— |
$3,126 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$396 |
— |
| Shoulder 1 view (73020) |
— |
$3,837 |
— |
| Shoulder Arthrography (73040) |
— |
$4,641 |
— |
| Skull less than 4 views (70250) |
— |
$491 |
— |
| Speech evaluation, complex (70371) |
— |
$771 |
— |
| Thoracic spine 2 views (72070) |
— |
$2,869 |
— |
| Thoracic spine 3 views (72072) |
— |
$3,265 |
— |
| Thoracolumbar 2 views (72080) |
— |
$2,291 |
— |
| Thyroid Imaging With Vascular Flow (78013) |
— |
$1,044 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$6,055 |
— |
| Thyroid Uptake Measurement (78012) |
— |
$1,996 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$3,038 |
— |
| Ultrasound Breast Limited (76642) |
— |
$3,439 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$205.25 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$3,187 |
— |
| Unlisted us procedure (76999) |
— |
$704 |
— |
| Upper gi w/o kub (74240) |
— |
$4,083 |
— |
| Urethrocystogram voiding (74455) |
— |
$2,632 |
— |
| Urethrocystography retrograde (74450) |
— |
$1,408 |
— |
| Us breast unilateral complete (76641) |
— |
$3,637 |
— |
| Us chest (76604) |
— |
$1,052 |
— |
| Us complete joint (76881) |
— |
$1,305 |
— |
| Us exam, pelvic, limited (76857) |
— |
$2,145 |
— |
| Us head (76506) |
— |
$869 |
— |
| Us kidney transplant (76776) |
— |
$4,448 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$920 |
— |
| Us ob detailed single fetus (76811) |
— |
$2,331 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$1,993 |
— |
| Us ob transvaginal (76817) |
— |
$3,885 |
— |
| Us pelvic non ob complete (76856) |
— |
$3,582 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$2,908 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$1,723 |
— |
| Us retroperitoneal complete (76770) |
— |
$3,960 |
— |
| Us retroperitoneal limited (76775) |
— |
$2,178 |
— |
| Us scrotum and contents (76870) |
— |
$899 |
— |
| Us spinal canal and contents (76800) |
— |
$959 |
— |
| Us thyroid (76536) |
— |
$2,600 |
— |
| Us transrectal (76872) |
— |
$683 |
— |
| Vein X-Ray Chest (75827) |
— |
$4,680 |
— |
| Venography Adrenal Unilateral (75840) |
— |
$6,431 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$8,210 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$3,552 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$3,221 |
— |
| Venography Renal Bilateral (75833) |
— |
$6,816 |
— |
| Venography Renal Unilateral (75831) |
— |
$6,431 |
— |
| Venous sampling by catheter (75893) |
— |
$7,322 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$6,314 |
— |
| Wrist 2 views (73100) |
— |
$2,924 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$1,553 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,467 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$8,210 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$2,800 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$3,757 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$919 |
— |
| X-Ray Exam Entire Spi 1 Vw (72081) |
— |
$3,000 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$3,160 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$3,320 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$1,220 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$2,031 |
— |
| X-Ray Exam Hip Uni 4/> Views (73503) |
— |
$2,417 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$2,031 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$2,417 |
— |
| X-Ray Exam Hips Bi 5/> Views (73523) |
— |
$2,818 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$4,392 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$2,336 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$4,980 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$2,511 |
— |
| X-ray humerus (73060) |
— |
$1,068 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,532 |
— |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
— |
$758 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$2,341 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$3,064 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$1,557 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$3,267 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$518 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$543 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$2,243 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$591 |
— |
| X-ray thoracic spine 4 vw (72074) |
— |
$605 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,533 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$794 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,223 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$3,914 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$549 |
— |
| Xr orbits complete 4 views (70200) |
— |
$765 |
— |