| Abdomen 1 View (74018) |
$87.04 |
$544 |
1.1× |
| Abdomen 2 views (74019) |
$174.24 |
$1,089 |
1.8× |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
$228 |
$1,425 |
0.6× |
| Angio internal mammary (75756) |
$1,329.28 |
$8,308 |
0.4× |
| Angiography extremity bilateral rs&i (75716) |
$1,408.64 |
$8,804 |
0.5× |
| Angiography extremity unilateral rs&i (75710) |
$1,357.60 |
$8,485 |
0.5× |
| Ankle 2 views (73600) |
$90.08 |
$563 |
1.1× |
| Arthrogram hip (73525) |
$273.92 |
$1,712 |
0.8× |
| Bone age studies (77072) |
$74.08 |
$463 |
0.8× |
| Bone Imaging 3 Phase (78315) |
$515.36 |
$3,221 |
1.4× |
| Bone Imaging Limited Area (78300) |
$207.84 |
$1,299 |
0.6× |
| Bone Imaging Whole Body (78306) |
$391.20 |
$2,445 |
1.0× |
| Bone marrow imaging; whole body (78104) |
$220.80 |
$1,380 |
0.6× |
| Bone survey infant (77076) |
$94.24 |
$589 |
1.0× |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
$264.32 |
$1,652 |
0.5× |
| Chest 1 view (71045) |
$63.68 |
$398 |
0.8× |
| Chest 2 views (71046) |
$96.96 |
$606 |
1.2× |
| Chest 3 views (71047) |
$92.80 |
$580 |
1.1× |
| Chest 4 or more views (71048) |
$77.44 |
$484 |
0.8× |
| Clavicle complete (73000) |
$87.04 |
$544 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$46.88 |
$293 |
0.5× |
| Contrast Exam Abdominl Aorta (75625) |
$1,357.60 |
$8,485 |
0.5× |
| Contrast X-Ray Of Elbow (73085) |
$203.04 |
$1,269 |
0.6× |
| Contrast X-Ray Of Knee Joint (73580) |
$273.92 |
$1,712 |
0.8× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,067.68 |
$6,673 |
3.3× |
| CT abdomen and pelvis without contrast (74176) |
$828.48 |
$5,178 |
3.7× |
| CT abdomen w contrast (74160) |
$163.36 |
$1,021 |
1.0× |
| CT abdomen w wo contrast (74170) |
$850.40 |
$5,315 |
5.2× |
| CT abdomen w/o contrast (74150) |
$74.08 |
$463 |
0.8× |
| CT Angio Abdomen and Pelvis (74174) |
$163.36 |
$1,021 |
0.5× |
| CT Angio Chest (71275) |
$533.60 |
$3,335 |
3.2× |
| CT Angio Head (70496) |
$566.24 |
$3,539 |
3.4× |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
$403.84 |
$2,524 |
2.5× |
| CT Angio Neck (70498) |
$539.68 |
$3,373 |
3.3× |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
$517.28 |
$3,233 |
3.1× |
| CT cervical spine w/ contrast (72126) |
$310.08 |
$1,938 |
0.9× |
| CT cervical spine w/o contrast (72125) |
$651.20 |
$4,070 |
6.6× |
| CT cervical spine w/wo cont (72127) |
$152 |
$950 |
0.9× |
| CT chest w contrast (71260) |
$274.88 |
$1,718 |
1.7× |
| CT chest w/wo contrast (71270) |
$276.80 |
$1,730 |
1.7× |
| CT head/brain with contrast (70460) |
$462.88 |
$2,893 |
2.8× |
| CT head/brain without and with contrast (70470) |
$163.36 |
$1,021 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$37.44 |
$234 |
0.5× |
| CT iac w contrast (70481) |
$523.36 |
$3,271 |
3.2× |
| CT l-spine w&w/o contrast (72133) |
$277.28 |
$1,733 |
1.7× |
| CT lower ext w/o (73700) |
$367.68 |
$2,298 |
3.7× |
| CT lower extremity w/contrast material (73701) |
$130.40 |
$815 |
0.8× |
| CT lumbar spine w contrast (72132) |
$310.08 |
$1,938 |
0.9× |
| CT lumbar spine w/o contrast (72131) |
$651.20 |
$4,070 |
6.6× |
| CT maxillofacial w contrast (70487) |
$389.92 |
$2,437 |
2.4× |
| CT maxillofacial wo contrast (70486) |
$378.56 |
$2,366 |
3.9× |
| CT neck tissue combo (70492) |
$476.96 |
$2,981 |
2.9× |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
$252.48 |
$1,578 |
1.5× |
| CT orbits w/o contrast (70480) |
$432 |
$2,700 |
4.4× |
| CT pelvis w&w/o contrast (72194) |
$163.36 |
$1,021 |
1.0× |
| CT pelvis w/o contrast (72192) |
$516.32 |
$3,227 |
5.3× |
| CT scan of leg combo (73702) |
$240.16 |
$1,501 |
1.5× |
| CT scans face/jaw combo (70488) |
$297.60 |
$1,860 |
1.8× |
| CT soft tissue neck w contrast (70491) |
$387.36 |
$2,421 |
2.4× |
| CT soft tissue neck w/o contrast (70490) |
$74.08 |
$463 |
0.8× |
| CT thoracic spine w contrast (72129) |
$310.08 |
$1,938 |
1.9× |
| CT thoracic spine w/o contrast (72128) |
$651.20 |
$4,070 |
6.6× |
| CT thoracic spine w/wo cont (72130) |
$276.80 |
$1,730 |
1.7× |
| CT thorax w/o contrast (71250) |
$156.32 |
$977 |
1.6× |
| CT unlisted procedure (76497) |
$98.40 |
$615 |
1.2× |
| CT upper ext wo (73200) |
$273.44 |
$1,709 |
2.8× |
| CT upper extremity w/o & w/contrast material (73202) |
$310.08 |
$1,938 |
1.9× |
| CT upper extremity with contrast (73201) |
$380.64 |
$2,379 |
1.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$163.36 |
$1,021 |
1.0× |
| Cta Abdomen (74175) |
$310.08 |
$1,938 |
1.9× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$54.24 |
$339 |
0.6× |
| Dxa Bone Density Axial (77080) |
$133.12 |
$832 |
1.4× |
| Echocardiography, fetal, cardiovascular system, real time with image documentation (2D), with or without M-mode… (76826) |
$126.24 |
$789 |
0.6× |
| Echograp Trans R Pros Study (76873) |
$67.68 |
$423 |
0.7× |
| Esophagram (74220) |
$163.36 |
$1,021 |
1.0× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$72.80 |
$455 |
0.7× |
| Fluoroscopy up to 1 hr (76000) |
$149.92 |
$937 |
0.7× |
| Foot 2 views (73620) |
$90.08 |
$563 |
1.1× |
| Forearm 2 views (73090) |
$93.76 |
$586 |
1.1× |
| Gastric emptying imaging study (78264) |
$331.04 |
$2,069 |
0.9× |
| Gastric Mucosa Imaging (78261) |
$212.16 |
$1,326 |
0.6× |
| Gated Heart Planar Single (78472) |
$202.72 |
$1,267 |
0.5× |
| Gstrc Emptng Imag Std W/Sm Bwl Col Trnst Mlt Day (78266) |
$292.32 |
$1,827 |
0.6× |
| Hand 2 views (73120) |
$87.04 |
$544 |
0.9× |
| Hepatobil Syst Image W/Drug (78227) |
$339.20 |
$2,120 |
0.7× |
| Hepatobiliary System Imaging (78226) |
$375.84 |
$2,349 |
1.0× |
| Ht Musc Image Planar Mult (78454) |
$887.36 |
$5,546 |
0.7× |
| Ht Muscle Image Spect Sing (78451) |
$866.88 |
$5,418 |
0.7× |
| K Flow/Funct Image W/Drug (78708) |
$293.92 |
$1,837 |
0.6× |
| Kidney Funcj Study Non-Img Radioisotopic Study (78725) |
$220.80 |
$1,380 |
0.6× |
| Kidney Imaging Morphol (78700) |
$247.52 |
$1,547 |
0.7× |
| Kidney Imaging Morphoogy W/Vascular Flow (78701) |
$220.80 |
$1,380 |
0.6× |
| Knee 3 Views (73562) |
$125.76 |
$786 |
1.5× |
| Lung Perf&Ventilat Diferentl (78598) |
$273.44 |
$1,709 |
0.5× |
| Lung perfusion differential (78597) |
$332.32 |
$2,077 |
0.9× |
| Lung Ventilat&Perfus Imaging (78582) |
$498.08 |
$3,113 |
1.0× |
| Magnetic Image Jaw Joint (70336) |
$269.92 |
$1,687 |
1.2× |
| Mr safety determination physician/other qhp (76016) |
$42.24 |
$264 |
0.5× |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
$11.68 |
$73 |
0.4× |
| Mr safety implt electronics prepj supvj phys/qhp (76018) |
$44 |
$275 |
0.5× |
| Mr safety implt pos&/immoblj (76019) |
$28.48 |
$178 |
0.5× |
| Mr safety med physics xm customization plng&mntr (76017) |
$116 |
$725 |
0.5× |
| MRA head w/o contrast (70544) |
$697.12 |
$4,357 |
3.1× |
| MRA neck w contrast (70548) |
$644.80 |
$4,030 |
2.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$552 |
$3,450 |
1.7× |
| MRA neck w/o contrast (70547) |
$474.88 |
$2,968 |
2.1× |
| MRI abdomen w contrast (74182) |
$231.68 |
$1,448 |
0.7× |
| MRI abdomen w/o contrast (74181) |
$545.12 |
$3,407 |
2.4× |
| MRI any jt lower extrem w/contrast material (73722) |
$605.92 |
$3,787 |
0.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$294.40 |
$1,840 |
0.9× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$550.72 |
$3,442 |
0.7× |
| MRI cardiac w/o contrast (75557) |
$140 |
$875 |
0.6× |
| MRI cervical spine w/o cont (72141) |
$579.52 |
$3,622 |
2.6× |
| MRI chest w/o contrast (71550) |
$139.52 |
$872 |
0.6× |
| MRI chest wo w contrast (71552) |
$491.04 |
$3,069 |
1.5× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$464.96 |
$2,906 |
1.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$898.40 |
$5,615 |
2.7× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$770.88 |
$4,818 |
3.4× |
| MRI lumbar spine w contrast (72149) |
$513.44 |
$3,209 |
1.6× |
| Mri Neck Spine W/O & W/Dye (72156) |
$294.40 |
$1,840 |
0.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$351.04 |
$2,194 |
1.6× |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
$294.40 |
$1,840 |
0.9× |
| MRI pelvis w contrast (72196) |
$519.20 |
$3,245 |
1.6× |
| MRI pelvis w/o & w contrast (72197) |
$798.56 |
$4,991 |
2.4× |
| MRI pelvis w/o contrast (72195) |
$493.44 |
$3,084 |
2.2× |
| MRI thoracic spine w/o contrast (72146) |
$568.48 |
$3,553 |
2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$149.92 |
$937 |
0.7× |
| Mri Uppr Extremity W/O&W/Dye (73220) |
$898.40 |
$5,615 |
2.7× |
| MRI, abdomen, combo (74183) |
$1,077.92 |
$6,737 |
3.3× |
| MRI, dorsal spine combo (72157) |
$976.64 |
$6,104 |
3.0× |
| MRI, dorsal spine contrast (72147) |
$456.80 |
$2,855 |
1.4× |
| MRI, joint upper extrem (73221) |
$694.56 |
$4,341 |
3.1× |
| MRI, joint upper extrem combo (73223) |
$294.40 |
$1,840 |
0.9× |
| MRI, lumbar spine combo (72158) |
$294.40 |
$1,840 |
0.9× |
| Musculoskeletal Nuclear Exam (78399) |
$203.84 |
$1,274 |
0.5× |
| Myelogram cervical (72240) |
$415.20 |
$2,595 |
0.6× |
| Myelogram Lumbar (72265) |
$446.40 |
$2,790 |
0.6× |
| Myocardial Spect Multiple Studies (78452) |
$1,038.24 |
$6,489 |
0.9× |
| Neck soft tissue (70360) |
$109.92 |
$687 |
1.3× |
| Nonvascular Shunt X-Ray (75809) |
$67.68 |
$423 |
0.7× |
| Ob us nuchal meas 1 gest (76813) |
$62.08 |
$388 |
0.6× |
| Parathyroid Planar Imaging (78070) |
$289.44 |
$1,809 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$132.80 |
$830 |
1.4× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$290.40 |
$1,815 |
0.8× |
| Radex Abd Compl Aqt Abd W/S/E/D Views 1 View Ch (74022) |
$127.04 |
$794 |
1.3× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$289.12 |
$1,807 |
0.6× |
| Radex Ankle Complete Minimum 3 Views (73610) |
$91.20 |
$570 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$90.08 |
$563 |
1.1× |
| Radex elbow complete minimum 3 views (73080) |
$90.08 |
$563 |
1.1× |
| Radex Facial Bones Complete Minimum 3 Views (70150) |
$120 |
$750 |
1.2× |
| Radex fingr minimum 2 views (73140) |
$60.96 |
$381 |
0.7× |
| Radex foot complete minimum 3 views (73630) |
$91.84 |
$574 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$99.52 |
$622 |
1.2× |
| Radex lower extremity infant minimum 2 views (73592) |
$40.48 |
$253 |
0.5× |
| Radex Mastoids Compl Minimum 3 Views PR Side (70130) |
$67.68 |
$423 |
0.7× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$90.08 |
$563 |
1.1× |
| Radex Ribs Unilateral 2 Views (71100) |
$120 |
$750 |
1.5× |
| Radex shoulder complete minimum 2 views (73030) |
$109.28 |
$683 |
1.3× |
| Radex Sinuses Paransl < 3 Views (70210) |
$80.48 |
$503 |
1.0× |
| Radex sm int w/mlt srl imges via enteroclss tube (74251) |
$90.40 |
$565 |
0.5× |
| Radex Spine 1 View Specify Level (72020) |
$47.84 |
$299 |
0.6× |
| Radex Sternum Minimum 2 Views (71120) |
$116.16 |
$726 |
1.4× |
| Radex Toe Minimum 2 Views (73660) |
$90.08 |
$563 |
1.1× |
| Radex upper extremity infant minimum 2 views (73092) |
$72.80 |
$455 |
0.7× |
| Radex Wrist Complete Minimum 3 Views (73110) |
$90.72 |
$567 |
1.1× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$118.24 |
$739 |
1.2× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$58.88 |
$368 |
0.6× |
| Radiologic exam colon double contrast study (74280) |
$240.48 |
$1,503 |
1.5× |
| Radiologic exam colon single contrast study (74270) |
$130.40 |
$815 |
0.8× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$117.60 |
$735 |
0.7× |
| Radiologic exam knee complete 4/more views (73564) |
$152.64 |
$954 |
1.6× |
| Radiologic exam pelvis compl minimum 3 views (72190) |
$112.80 |
$705 |
1.1× |
| Radiologic Exam Small Int Single Contrast Study (74250) |
$215.52 |
$1,347 |
1.3× |
| Radiologic exam swallow function contrast study (74230) |
$173.76 |
$1,086 |
1.1× |
| Radiologic examination femur 1 view (73551) |
$44.64 |
$279 |
0.5× |
| Radiologic examination femur minimum 2 views (73552) |
$94.40 |
$590 |
1.2× |
| Radiologic examination knee 1/2 views (73560) |
$86.24 |
$539 |
1.1× |
| Radiologic Examination Osseous Survey Limited (77074) |
$139.52 |
$872 |
1.4× |
| Radiologic examination tibia & fibula 2 views (73590) |
$100.16 |
$626 |
1.2× |
| Radiologic examination, internal auditory meati, complete Non-Facility (70134) |
$260.80 |
$1,630 |
0.5× |
| Ribs bilateral 3 views (71110) |
$165.60 |
$1,035 |
1.7× |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
$763.20 |
$4,770 |
1.5× |
| Scapula (73010) |
$87.04 |
$544 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$21.60 |
$135 |
0.9× |
| Shoulder 1 view (73020) |
$84.48 |
$528 |
1.0× |
| Shoulder Arthrography (73040) |
$294.40 |
$1,840 |
0.9× |
| Skull less than 4 views (70250) |
$94.08 |
$588 |
1.0× |
| Speech evaluation, complex (70371) |
$149.92 |
$937 |
0.7× |
| Srs Multisource (77371) |
$8,773.76 |
$54,836 |
1.3× |
| Sternoclavicular joints (71130) |
$37.44 |
$234 |
0.5× |
| Thoracic spine 2 views (72070) |
$127.04 |
$794 |
1.3× |
| Thoracic spine 3 views (72072) |
$132.96 |
$831 |
1.4× |
| Thoracolumbar 2 views (72080) |
$40.32 |
$252 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$225.60 |
$1,410 |
0.6× |
| Ultrasound Breast Limited (76642) |
$65.92 |
$412 |
0.8× |
| Ultrasound Elastography Parenchyma (76981) |
$198.56 |
$1,241 |
2.0× |
| Ultrasound Exam Aaa Screen (76706) |
$84.96 |
$531 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$146.56 |
$916 |
1.5× |
| Umbilical-artery Doppler (OB) (76820) |
$54.24 |
$339 |
0.6× |
| Upper gi w/o kub (74240) |
$215.20 |
$1,345 |
1.3× |
| Us breast unilateral complete (76641) |
$89.76 |
$561 |
0.9× |
| Us chest (76604) |
$144.96 |
$906 |
1.5× |
| Us complete joint (76881) |
$128 |
$800 |
1.3× |
| Us exam, pelvic, limited (76857) |
$109.28 |
$683 |
1.1× |
| Us kidney transplant (76776) |
$179.84 |
$1,124 |
1.8× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$124.32 |
$777 |
1.3× |
| Us ob detailed single fetus (76811) |
$148.80 |
$930 |
0.7× |
| Us ob limited 1 or more fetuses (76815) |
$107.04 |
$669 |
1.1× |
| Us ob transvaginal (76817) |
$151.84 |
$949 |
1.5× |
| Us pelvic non ob complete (76856) |
$140.64 |
$879 |
1.4× |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
$158.72 |
$992 |
1.6× |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
$72.48 |
$453 |
0.7× |
| Us retroperitoneal complete (76770) |
$144.96 |
$906 |
1.5× |
| Us retroperitoneal limited (76775) |
$176.48 |
$1,103 |
1.8× |
| Us scrotum and contents (76870) |
$205.44 |
$1,284 |
2.1× |
| Us thyroid (76536) |
$163.04 |
$1,019 |
1.7× |
| Us transrectal (76872) |
$72.80 |
$455 |
0.7× |
| Wrist 2 views (73100) |
$99.52 |
$622 |
1.2× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$90.56 |
$566 |
1.1× |
| X-Ray Bend Only L-S Spine (72120) |
$132.64 |
$829 |
1.4× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$90.08 |
$563 |
1.1× |
| X-Ray Exam Breast Specimen (76098) |
$260.80 |
$1,630 |
0.5× |
| X-Ray Exam Entire Spi 1 Vw (72081) |
$37.44 |
$234 |
0.5× |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
$74.08 |
$463 |
0.8× |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
$123.84 |
$774 |
1.3× |
| X-Ray Exam Hip Uni 1 View (73501) |
$94.08 |
$588 |
1.2× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$109.92 |
$687 |
1.3× |
| X-Ray Exam Hips Bi 2 Views (73521) |
$183.84 |
$1,149 |
1.9× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$136.32 |
$852 |
1.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$147.04 |
$919 |
1.5× |
| X-Ray Exam L-S Spine Bending (72114) |
$74.08 |
$463 |
0.8× |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
$129.76 |
$811 |
1.6× |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
$212.32 |
$1,327 |
2.2× |
| X-Ray Exam Unilat Ribs/Chest (71101) |
$121.28 |
$758 |
1.2× |
| X-ray eye for foreign body (70030) |
$41.60 |
$260 |
0.5× |
| X-ray humerus (73060) |
$96.96 |
$606 |
1.2× |
| X-ray IV pyelogram (ivp) (74400) |
$273.60 |
$1,710 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$76.32 |
$477 |
0.9× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$49.12 |
$307 |
0.6× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$129.76 |
$811 |
1.3× |
| X-ray nose-rectum child f.b. (76010) |
$40.32 |
$252 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$158.88 |
$993 |
1.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$72.48 |
$453 |
0.7× |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
$54.08 |
$338 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$127.04 |
$794 |
1.6× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$183.84 |
$1,149 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$112.48 |
$703 |
1.1× |
| X-ray thoracic spine 4 vw (72074) |
$201.60 |
$1,260 |
2.1× |
| X-Ray Tmj Unilat (70328) |
$44.64 |
$279 |
0.5× |
| X-Rays Bone Length Studies (77073) |
$67.68 |
$423 |
0.7× |
| X-Rays Bone Survey Complete (77075) |
$72.80 |
$455 |
0.7× |
| Xr c-spine 4 or 5 views (72050) |
$165.60 |
$1,035 |
1.7× |
| Xr facial bones less than 3 views (70140) |
$111.68 |
$698 |
1.4× |
| Xr orbits complete 4 views (70200) |
$131.52 |
$822 |
1.3× |