| Abdomen 2 views (74019) |
$230.88 |
$624 |
2.4× |
| Acute gastrointestinal blood loss imaging (78278) |
$512.45 |
$1,385 |
1.4× |
| Ankle 2 views (73600) |
$141.71 |
$383 |
1.8× |
| Arthrogram elbow (73085) |
$543.53 |
$1,469 |
1.7× |
| Arthrogram hip (73525) |
$543.53 |
$1,469 |
1.7× |
| Arthrogram shoulder (73040) |
$543.53 |
$1,469 |
1.7× |
| Arthrogram wrist (73115) |
$543.53 |
$1,469 |
1.7× |
| Arthrography knee lt (73580) |
$543.53 |
$1,469 |
1.7× |
| Bone &/Joint Imaging Limited Area (78300) |
$506.90 |
$1,370 |
1.4× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$666 |
$1,800 |
1.8× |
| Bone &/joint imaging whole body (78306) |
$921.30 |
$2,490 |
2.5× |
| Bone age studies (77072) |
$141.71 |
$383 |
1.5× |
| Bone Imaging 3 Phase (78315) |
$819.18 |
$2,214 |
2.2× |
| Bone survey complete (77075) |
$374.44 |
$1,012 |
3.9× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$21.83 |
$59 |
2.0× |
| Cervical spine 2 or 3 views (72040) |
$170.94 |
$462 |
2.1× |
| Chest 1 view (71045) |
$115.07 |
$311 |
1.4× |
| Chest 3 views (71047) |
$149.85 |
$405 |
1.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$206.09 |
$557 |
1.3× |
| Clavicle complete (73000) |
$144.67 |
$391 |
1.8× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$88.06 |
$238 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,074.48 |
$2,904 |
3.3× |
| CT abdomen and pelvis without contrast (74176) |
$870.61 |
$2,353 |
3.9× |
| CT abdomen w contrast (74160) |
$1,074.48 |
$2,904 |
6.6× |
| CT abdomen w wo contrast (74170) |
$1,177.34 |
$3,182 |
7.2× |
| CT abdomen w/o contrast (74150) |
$1,023.42 |
$2,766 |
10.5× |
| CT angiography upper extremity lt (73206) |
$870.61 |
$2,353 |
5.3× |
| CT c-spine w/o contrast (72125) |
$1,125.91 |
$3,043 |
11.6× |
| CT cervical spine w&w/o contrast (72127) |
$921.30 |
$2,490 |
5.6× |
| CT cervical spine with contrast (72126) |
$608.65 |
$1,645 |
1.9× |
| CT chest w/wo contrast (71270) |
$1,215.45 |
$3,285 |
7.5× |
| CT chest with contrast (71260) |
$1,113.33 |
$3,009 |
6.8× |
| CT head/brain with contrast (70460) |
$1,074.48 |
$2,904 |
6.6× |
| CT head/brain without and with contrast (70470) |
$1,177.34 |
$3,182 |
7.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$104.34 |
$282 |
1.3× |
| CT iac w contrast (70481) |
$921.30 |
$2,490 |
5.6× |
| CT lower ext w/o (73700) |
$958.12 |
$2,589.50 |
9.9× |
| CT lower extremity w wo contrast (73702) |
$1,003.07 |
$2,711 |
6.1× |
| CT lower extremity with contrast (73701) |
$901.32 |
$2,436 |
5.5× |
| CT lumbar spine w & w/o contrast (72133) |
$1,228.40 |
$3,320 |
7.5× |
| CT lumbar spine w/o contrast (72131) |
$1,023.42 |
$2,766 |
10.5× |
| CT lumbar spine with contrast (72132) |
$1,023.42 |
$2,766 |
3.2× |
| CT maxillofacial w contrast (70487) |
$1,023.42 |
$2,766 |
6.3× |
| CT maxillofacial w/o contrast (70486) |
$780.88 |
$2,110.50 |
8.0× |
| CT maxillofacial w/wo contrast (70488) |
$1,125.91 |
$3,043 |
6.9× |
| CT neck soft tissue w contrast (70491) |
$972.73 |
$2,629 |
6.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,074.48 |
$2,904 |
6.6× |
| CT orbits w/o contrast (70480) |
$870.61 |
$2,353 |
9.0× |
| CT pelvis w & w/o contrast (72194) |
$1,125.91 |
$3,043 |
6.9× |
| CT pelvis w/o contrast (72192) |
$921.30 |
$2,490 |
9.5× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$1,074.48 |
$2,904 |
6.6× |
| CT soft tissue neck w/o contrast (70490) |
$870.61 |
$2,353 |
9.0× |
| CT thoracic spine w/contrast (72129) |
$819.18 |
$2,214 |
5.0× |
| CT thoracic spine w/o contrast (72128) |
$717.06 |
$1,938 |
7.4× |
| CT thoracic spine w/wo contrast (72130) |
$921.30 |
$2,490 |
5.6× |
| CT thorax w/o contrast (71250) |
$959.78 |
$2,594 |
9.9× |
| CT upper extremity w/o & w/contrast material (73202) |
$972.73 |
$2,629 |
6.0× |
| CT upper extremity w/o contrast rt (73200) |
$767.38 |
$2,074 |
7.9× |
| CT upper extremity with contrast (73201) |
$921.30 |
$2,490 |
2.8× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,484.07 |
$4,011 |
9.1× |
| Cta Abdomen (74175) |
$1,125.91 |
$3,043 |
6.9× |
| CTA abdomen pelvis (74174) |
$1,216.93 |
$3,289 |
3.8× |
| CTA chest (71275) |
$1,381.58 |
$3,734 |
8.5× |
| Cta Head (70496) |
$1,228.40 |
$3,320 |
7.5× |
| CTA lwr ext w&w/o contrast (73706) |
$870.61 |
$2,353 |
5.3× |
| Cta Neck (70498) |
$1,381.58 |
$3,734 |
8.5× |
| Cystography minimum 3 views rs&i (74430) |
$352.24 |
$952 |
1.1× |
| Dxa bone density study 1/> sites axial skel (77080) |
$256.41 |
$693 |
2.6× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$60.68 |
$164 |
0.7× |
| Esophagus (74220) |
$206.09 |
$557 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$216.08 |
$584 |
2.2× |
| Fluoroscopy up to 1 hr (76000) |
$176.12 |
$476 |
0.8× |
| Foot 2 views (73620) |
$144.67 |
$391 |
1.8× |
| Forearm 2 views (73090) |
$154.66 |
$418 |
1.9× |
| Gated Heart Planar Single (78472) |
$767.38 |
$2,074 |
2.1× |
| Hand 2 views (73120) |
$129.13 |
$349 |
1.3× |
| Hand 3 views (73130) |
$180.56 |
$488 |
2.2× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$666 |
$1,800 |
1.3× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$870.61 |
$2,353 |
2.3× |
| Humerus Min 2 Views Left (73060) |
$152.07 |
$411 |
1.9× |
| Hysterosalpingogram (74740) |
$431.05 |
$1,165 |
1.9× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$141.71 |
$383 |
1.5× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$666.37 |
$1,801 |
1.3× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$666.37 |
$1,801 |
1.3× |
| Knee 3 views (73562) |
$149.85 |
$405 |
1.9× |
| Lymphoscintigraphy (78195) |
$691.53 |
$1,869 |
1.4× |
| Meckels Diverticulum (78290) |
$648.98 |
$1,754 |
1.7× |
| MRA head w & w/o contrast (70546) |
$1,330.52 |
$3,596 |
4.1× |
| MRA head with contrast (70545) |
$1,228.40 |
$3,320 |
3.8× |
| MRA neck w contrast (70548) |
$1,494.43 |
$4,039 |
4.6× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,647.61 |
$4,453 |
5.1× |
| MRA neck w/o contrast (70547) |
$1,391.94 |
$3,762 |
6.3× |
| MRI abdomen w contrast (74182) |
$1,484.07 |
$4,011 |
4.6× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,586.56 |
$4,288 |
4.9× |
| MRI abdomen w/o contrast (74181) |
$1,381.58 |
$3,734 |
6.2× |
| MRI any jnt lwr ext with con lt (73722) |
$1,561.03 |
$4,219 |
2.1× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$1,586.56 |
$4,288 |
2.2× |
| MRI c-spine with contrast (72142) |
$1,210.64 |
$3,272 |
3.7× |
| MRI chest w/o & w/contrast material (71552) |
$1,484.07 |
$4,011 |
4.6× |
| MRI chest w/o contrast (71550) |
$1,279.46 |
$3,458 |
5.8× |
| MRI chest with contrast (71551) |
$1,381.58 |
$3,734 |
1.9× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$1,274.65 |
$3,445 |
3.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$1,402.30 |
$3,790 |
4.3× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,300.55 |
$3,515 |
5.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,479.26 |
$3,998 |
6.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,683.87 |
$4,551 |
5.2× |
| MRI orbit/face/neck w/contrast (70542) |
$1,581.01 |
$4,273 |
4.9× |
| MRI pelvis w contrast (72196) |
$1,394.53 |
$3,769 |
4.3× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,509.60 |
$4,080 |
4.7× |
| MRI pelvis w/o contrast (72195) |
$1,304.99 |
$3,527 |
5.9× |
| MRI scan of arm joint before and after contrast (73223) |
$1,534.76 |
$4,148 |
4.7× |
| MRI scan of leg joint before and after contrast (73723) |
$1,687.94 |
$4,562 |
5.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,312.39 |
$3,547 |
4.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$1,637.25 |
$4,425 |
5.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,739.74 |
$4,702 |
5.4× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$1,356.05 |
$3,665 |
4.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,484.07 |
$4,011 |
4.6× |
| MRI thoracic spine w/o contrast (72146) |
$1,279.46 |
$3,458 |
5.8× |
| MRI upper ext joint w/o contrast (73221) |
$2,225.55 |
$6,015 |
10.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,376.40 |
$3,720 |
4.2× |
| Myocardial Spect Multiple Studies (78452) |
$1,587.67 |
$4,291 |
1.3× |
| Neck soft tissue (70360) |
$147.63 |
$399 |
1.8× |
| Nm gastric emptying study (78264) |
$666 |
$1,800 |
1.8× |
| Osseous survey infant (77076) |
$177.60 |
$480 |
1.8× |
| Osseous survey limited (77074) |
$180.56 |
$488 |
1.9× |
| Parathyroid imaging (78070) |
$512.45 |
$1,385 |
1.4× |
| Pelvis 1 or 2 views (72170) |
$147.63 |
$399 |
1.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,504.42 |
$4,066 |
4.6× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$512.45 |
$1,385 |
1.4× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$972.73 |
$2,629 |
1.9× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$431.05 |
$1,165 |
0.8× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$206.09 |
$557 |
2.5× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$308.21 |
$833 |
3.2× |
| Radex hips bilateral with pelvis 2 views (73521) |
$269.73 |
$729 |
2.8× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$174.27 |
$471 |
1.8× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$384.06 |
$1,038 |
3.9× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$190.55 |
$515 |
2.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$159.84 |
$432 |
2.0× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$104.34 |
$282 |
1.1× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$196.10 |
$530 |
2.4× |
| Radiologic exam colon single contrast study (74270) |
$308.21 |
$833 |
1.9× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$201.65 |
$545 |
1.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$348.91 |
$943 |
2.1× |
| Radiologic exam upr gi trc single contrast study (74240) |
$359.27 |
$971 |
2.2× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$144.67 |
$391 |
1.8× |
| Radiologic Examination Salivary Gland Calculus (70380) |
$103.60 |
$280 |
1.3× |
| Radiological examination surgical specimen (76098) |
$773.67 |
$2,091 |
1.5× |
| Ribs bilateral 3 views (71110) |
$201.28 |
$544 |
2.1× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$1,045.99 |
$2,827 |
2.8× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$2,052.76 |
$5,548 |
4.1× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$1,045.99 |
$2,827 |
2.1× |
| Scanogram (77073) |
$201.28 |
$544 |
2.1× |
| Scapula complete (73010) |
$149.85 |
$405 |
1.5× |
| Screening digital breast tomosynthesis (77063) |
$42.18 |
$114 |
1.8× |
| Small bowel series (74250) |
$333.37 |
$901 |
2.0× |
| Spine thoracic 3 views (72072) |
$230.88 |
$624 |
2.4× |
| Thoracolumbar 2 views (72080) |
$149.85 |
$405 |
1.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$410.33 |
$1,109 |
1.1× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$594.96 |
$1,608 |
1.6× |
| Ultrasound, abdomen limited (76705) |
$348.91 |
$943 |
3.6× |
| Unlisted Ultrasound Procedure (76999) |
$210.90 |
$570 |
2.6× |
| Upper Extremity Infant (73092) |
$109.15 |
$295 |
1.1× |
| Urethrocystography retrograde rs&i (74450) |
$352.24 |
$952 |
1.6× |
| Urethrocystography voiding (74455) |
$352.24 |
$952 |
1.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$352.24 |
$952 |
2.2× |
| Us abdl aorta screen aaa (76706) |
$199.80 |
$540 |
2.1× |
| Us breast unilateral complete (76641) |
$328.38 |
$887.50 |
3.4× |
| Us breast unilateral limited (76642) |
$206.09 |
$557 |
2.5× |
| Us chest (76604) |
$236.80 |
$640 |
2.4× |
| Us compl joint r-t w/image documentation (76881) |
$199.80 |
$540 |
2.1× |
| Us ob transvaginal (76817) |
$241.98 |
$654 |
2.5× |
| Us pelvic non ob complete (76856) |
$371.85 |
$1,005 |
3.8× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$219.04 |
$592 |
2.3× |
| Us pregnancy ltd (76815) |
$157.62 |
$426 |
1.6× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$303.03 |
$819 |
3.1× |
| Us retroperitoneal complete (76770) |
$451.40 |
$1,220 |
4.6× |
| Us retroperitoneal limited (76775) |
$348.91 |
$943 |
3.6× |
| Us scrotum and contents (76870) |
$348.91 |
$943 |
3.6× |
| Us soft tissue head/neck (76536) |
$315.98 |
$854 |
3.2× |
| Us spinal canal and contents (76800) |
$199.80 |
$540 |
2.1× |
| Us transrectal (76872) |
$295.63 |
$799 |
3.0× |
| Us xtr non-vasc lmtd (76882) |
$251.97 |
$681 |
2.6× |
| Wrist 2 views (73100) |
$124.69 |
$337 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$239.39 |
$647 |
2.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$133.94 |
$362 |
1.7× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$141.71 |
$383 |
1.8× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$448.81 |
$1,213 |
2.8× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$141.71 |
$383 |
1.8× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$144.67 |
$391 |
1.8× |
| X-ray exam entire spi 4/5 vw (72083) |
$256.41 |
$693 |
2.6× |
| X-ray exam hip uni 1 view (73501) |
$173.16 |
$468 |
2.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$167.24 |
$452 |
2.1× |
| X-ray exam hip uni 4/> views (73503) |
$206.09 |
$557 |
2.1× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$320.79 |
$867 |
3.3× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$346.32 |
$936 |
3.6× |
| X-ray exam of femur 1 (73551) |
$113.59 |
$307 |
1.4× |
| X-ray eye for foreign body (70030) |
$98.79 |
$267 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$196.10 |
$530 |
2.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$154.66 |
$418 |
1.9× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$216.08 |
$584 |
2.7× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$139.49 |
$377 |
1.7× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$98.79 |
$267 |
1.2× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$154.66 |
$418 |
1.6× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$141.71 |
$383 |
1.8× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$93.24 |
$252 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$228.66 |
$618 |
2.4× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$251.97 |
$681 |
2.6× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$251.97 |
$681 |
2.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$136.53 |
$369 |
1.7× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$144.67 |
$391 |
1.8× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$154.66 |
$418 |
1.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$154.66 |
$418 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$167.24 |
$452 |
1.7× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$230.88 |
$624 |
2.4× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$154.66 |
$418 |
1.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$154.66 |
$418 |
1.9× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$180.56 |
$488 |
2.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$226.44 |
$612 |
2.8× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$103.60 |
$280 |
1.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$164.65 |
$445 |
1.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$144.67 |
$391 |
1.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$154.66 |
$418 |
1.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$154.66 |
$418 |
1.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$133.94 |
$362 |
1.7× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$180.56 |
$488 |
1.9× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$133.94 |
$362 |
1.7× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$167.24 |
$452 |
2.1× |
| Xr c-spine 6 or more views (72052) |
$282.31 |
$763 |
2.9× |
| Xr chest 4+ views (71048) |
$132.09 |
$357 |
1.4× |
| Xr finger(s) 2+ views (73140) |
$133.94 |
$362 |
1.7× |
| Xr optic foramina (70190) |
$109.15 |
$295 |
1.3× |
| Xr spine cervical 4 or 5 views (72050) |
$251.97 |
$681 |
2.6× |
| Xr tibia/fibula 2 views (73590) |
$231.44 |
$625.50 |
2.9× |
| Xr tmj bilateral (70330) |
$167.24 |
$452 |
2.1× |
| Xray knee 1 or 2 views rt (73560) |
$149.85 |
$405 |
1.9× |