| 3-D radiotherapy plan dose-volume histograms (77295) |
$1,443.64 |
$6,562 |
1.1× |
| Abdomen 2 views (74019) |
$46.42 |
$211 |
0.5× |
| Acute gastrointestinal blood loss imaging (78278) |
$421.74 |
$1,917 |
1.1× |
| Angiography extremity bilateral rs&i (75716) |
$944.46 |
$4,293 |
0.3× |
| Angiography extremity unilateral rs&i (75710) |
$944.46 |
$4,293 |
0.3× |
| Angiography internal mammary rs&i (75756) |
$944.46 |
$4,293 |
0.3× |
Angiography pelvic slctv/supraslctv rs&i (75736)
unusually low: confirm this is the full procedure |
$1,574.32 |
$7,156 |
0.3× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$944.46 |
$4,293 |
0.3× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$944.46 |
$4,293 |
0.3× |
Angiography Spinal Selective Rs&I (75705)
unusually low: confirm this is the full procedure |
$1,574.32 |
$7,156 |
0.3× |
Angiography visceral slctv/supraslctv rs&i (75726)
unusually low: confirm this is the full procedure |
$1,574.32 |
$7,156 |
0.3× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$944.46 |
$4,293 |
0.3× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$784.74 |
$3,567 |
0.3× |
| Ankle 2 views (73600) |
$36.74 |
$167 |
0.4× |
| Antegrade urography radiological supvj & interpj (74425) |
$121.66 |
$553 |
0.4× |
Aortogram thoracic (75605)
unusually low: confirm this is the full procedure |
$1,574.32 |
$7,156 |
0.3× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$944.46 |
$4,293 |
0.3× |
| Aortography abdominal serialography rs&i (75625) |
$944.46 |
$4,293 |
0.3× |
| Artery X-Rays Adrenal Gland (75731) |
$791.12 |
$3,596 |
0.3× |
| Arthrogram elbow (73085) |
$227.04 |
$1,032 |
0.7× |
| Arthrogram hip (73525) |
$227.04 |
$1,032 |
0.7× |
| Arthrogram shoulder (73040) |
$236.61 |
$1,075.50 |
0.7× |
| Arthrogram wrist (73115) |
$182.49 |
$829.50 |
0.6× |
| Arthrography knee lt (73580) |
$286.44 |
$1,302 |
0.9× |
| Basic radiation dosimetry calculation (77300) |
$79.64 |
$362 |
0.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$212.30 |
$965 |
0.6× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$300.08 |
$1,364 |
0.8× |
| Bone &/joint imaging whole body (78306) |
$344.96 |
$1,568 |
0.9× |
| Bone age studies (77072) |
$36.08 |
$164 |
0.4× |
| Bone Imaging 3 Phase (78315) |
$416.90 |
$1,895 |
1.1× |
| Bone Marrow Imaging Limited Area (78102) |
$187 |
$850 |
0.5× |
| Bone survey complete (77075) |
$119.90 |
$545 |
1.2× |
| Brachytx isodose complex (77318) |
$307.56 |
$1,398 |
0.9× |
| Brachytx isodose intermed (77317) |
$222.64 |
$1,012 |
0.6× |
| Brachytx isodose pln smpl w/dosimetry cal (77316) |
$154.66 |
$703 |
0.4× |
| Brain image w/flow 4 + views (78606) |
$366.96 |
$1,668 |
0.7× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$1,561.78 |
$7,099 |
1.2× |
| Brain Imaging Vascular Flow Only (78610) |
$161.70 |
$735 |
0.3× |
| Breath Test,Acquire/Analyze - Nm Breath Test Acquire Analyze (78267) |
$22.88 |
$104 |
2.1× |
| Card Bl Pool Gated Spect Rest Wal Motn Ejct Frct (78494) |
$506.22 |
$2,301 |
1.3× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$930.38 |
$4,229 |
2.8× |
| Cardiac shunt detection (78428) |
$219.34 |
$997 |
0.6× |
| Cerebrospinal Fluid Flow W/O Matl Shunt Evaltj (78645) |
$339.24 |
$1,542 |
0.7× |
| Cervical spine 2 or 3 views (72040) |
$47.96 |
$218 |
0.6× |
| Chest 1 view (71045) |
$33.22 |
$151 |
0.4× |
| Chest 3 views (71047) |
$45.76 |
$208 |
0.6× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$106.26 |
$483 |
0.6× |
| Cineradiography/videoradiography (76120) |
$91.74 |
$417 |
0.9× |
| Clavicle complete (73000) |
$57.42 |
$261 |
0.7× |
| Complete single session course of cranial lesion surgery using radiation (77371) |
$4,032.60 |
$18,330 |
0.6× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$89.10 |
$405 |
0.9× |
| Continuing medical physics consltj pr wk (77336) |
$161.70 |
$735 |
1.3× |
| Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) |
$96.80 |
$440 |
0.6× |
| Corpora cavernosography (74445) |
$86.02 |
$391 |
0.9× |
| CT abdomen and pelvis without and with contrast (74178) |
$894.08 |
$4,064 |
2.7× |
| CT abdomen and pelvis without contrast (74176) |
$572.22 |
$2,601 |
2.6× |
| CT abdomen w contrast (74160) |
$503.14 |
$2,287 |
3.1× |
| CT abdomen w wo contrast (74170) |
$595.76 |
$2,708 |
3.6× |
| CT abdomen w/o contrast (74150) |
$381.48 |
$1,734 |
3.9× |
| CT angio hrt w/3d image (75574) |
$532.40 |
$2,420 |
1.6× |
| CT angiography upper extremity lt (73206) |
$596.64 |
$2,712 |
3.6× |
| CT c-spine w/o contrast (72125) |
$380.60 |
$1,730 |
3.9× |
| CT cervical spine w&w/o contrast (72127) |
$597.30 |
$2,715 |
3.6× |
| CT cervical spine with contrast (72126) |
$503.36 |
$2,288 |
1.5× |
| CT chest w/wo contrast (71270) |
$597.30 |
$2,715 |
3.6× |
| CT chest with contrast (71260) |
$503.36 |
$2,288 |
3.1× |
| CT colonography screening (74263) |
$1,166.66 |
$5,303 |
5.2× |
| CT colonography w/dye (74262) |
$587.40 |
$2,670 |
3.6× |
| CT colonography w/o cntrst (74261) |
$386.32 |
$1,756 |
3.9× |
| CT head/brain with contrast (70460) |
$361.24 |
$1,642 |
2.2× |
| CT head/brain without and with contrast (70470) |
$448.36 |
$2,038 |
2.7× |
| CT heart contrast eval cardiac structure&morph (75572) |
$352 |
$1,600 |
1.1× |
| CT heart no contrast quant eval coronry calcium (75571) |
$89.54 |
$407 |
1.1× |
| CT hrt w/3d image congen (75573) |
$498.30 |
$2,265 |
1.5× |
| CT iac w contrast (70481) |
$409.20 |
$1,860 |
2.5× |
| CT limited/localized follow up study (76380) |
$189.20 |
$860 |
2.3× |
| CT lower ext w/o (73700) |
$570.24 |
$2,592 |
5.8× |
| CT lower extremity w wo contrast (73702) |
$893.97 |
$4,063.50 |
5.4× |
| CT lower extremity with contrast (73701) |
$708.18 |
$3,219 |
4.3× |
| CT lumbar spine w & w/o contrast (72133) |
$596.20 |
$2,710 |
3.6× |
| CT lumbar spine w/o contrast (72131) |
$380.60 |
$1,730 |
3.9× |
| CT lumbar spine with contrast (72132) |
$503.36 |
$2,288 |
1.5× |
| CT maxillofacial w contrast (70487) |
$386.76 |
$1,758 |
2.3× |
| CT maxillofacial w/o contrast (70486) |
$317.68 |
$1,444 |
3.2× |
| CT maxillofacial w/wo contrast (70488) |
$482.90 |
$2,195 |
2.9× |
| CT neck soft tissue w contrast (70491) |
$381.26 |
$1,733 |
2.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$496.54 |
$2,257 |
3.0× |
| CT orbits w/o contrast (70480) |
$317.24 |
$1,442 |
3.2× |
| CT pelvis w & w/o contrast (72194) |
$596.20 |
$2,710 |
3.6× |
| CT pelvis w/o contrast (72192) |
$381.48 |
$1,734 |
3.9× |
| CT scan for measuring calcium and other minerals in bone (77078) |
$144.98 |
$659 |
1.8× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$478.06 |
$2,173 |
2.9× |
| CT soft tissue neck w/o contrast (70490) |
$314.60 |
$1,430 |
3.2× |
| CT thoracic spine w/contrast (72129) |
$503.36 |
$2,288 |
3.1× |
| CT thoracic spine w/o contrast (72128) |
$380.60 |
$1,730 |
3.9× |
| CT thoracic spine w/wo contrast (72130) |
$597.30 |
$2,715 |
3.6× |
| CT thorax w/o contrast (71250) |
$380.60 |
$1,730 |
3.9× |
| CT unlisted procedure (76497) |
$141.68 |
$644 |
1.7× |
| CT upper extremity w/o & w/contrast material (73202) |
$893.97 |
$4,063.50 |
5.4× |
| CT upper extremity w/o contrast rt (73200) |
$570.24 |
$2,592 |
5.8× |
| CT upper extremity with contrast (73201) |
$705.87 |
$3,208.50 |
2.2× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$595.10 |
$2,705 |
3.6× |
| Cta Abdomen (74175) |
$596.20 |
$2,710 |
3.6× |
| CTA abdomen pelvis (74174) |
$957 |
$4,350 |
2.9× |
| CTA chest (71275) |
$595.98 |
$2,709 |
3.6× |
| Cta Head (70496) |
$498.52 |
$2,266 |
3.0× |
| CTA lwr ext w&w/o contrast (73706) |
$894.63 |
$4,066.50 |
5.4× |
| Cta Neck (70498) |
$498.52 |
$2,266 |
3.0× |
| Cta Pelvis (72191) |
$596.20 |
$2,710 |
3.6× |
| Cystography minimum 3 views rs&i (74430) |
$121.66 |
$553 |
0.4× |
| Diskogram cervical (72285) |
$506.22 |
$2,301 |
0.3× |
| Diskography lumbar (72295) |
$476.52 |
$2,166 |
0.3× |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
$75.02 |
$341 |
0.8× |
| Doppler Echo Fetal Spectral Display Complete (76827) |
$118.58 |
$539 |
1.2× |
| Doppler Fetal Mid Cerebral Artery (76821) |
$126.28 |
$574 |
1.3× |
| Dx ophthalmic us ant segment immersion uni/bi (76513) |
$36.96 |
$168 |
0.4× |
| Dxa bone density study 1/> sites axial skel (77080) |
$69.30 |
$315 |
0.7× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$37.62 |
$171 |
0.5× |
| Dxa bone density study axial skeleton (77085) |
$69.30 |
$315 |
0.7× |
| Echo exam of eye (76529) |
$127.38 |
$579 |
1.6× |
| Echo exam of fetal heart (76825) |
$159.50 |
$725 |
0.3× |
| Echo fetal cardiovasc w/wo m-mode repeat std (76826) |
$76.12 |
$346 |
0.3× |
| Echoencephalography real time imaging (76506) |
$122.76 |
$558 |
1.3× |
| Esophageal motility (78258) |
$261.58 |
$1,189 |
0.7× |
| Esophagus (74220) |
$100.32 |
$456 |
0.6× |
| Fetal biophysical profile non-stress testing (76818) |
$128.04 |
$582 |
1.3× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$115.83 |
$526.50 |
1.2× |
| Fluoroscopy up to 1 hr (76000) |
$122.54 |
$557 |
0.5× |
| Foot 2 views (73620) |
$36.74 |
$167 |
0.4× |
| Forearm 2 views (73090) |
$38.28 |
$174 |
0.5× |
| Functional MRI brain by phys/psych (70555) |
$659.67 |
$2,998.50 |
2.9× |
| Functional MRI brain by tech (70554) |
$826.98 |
$3,759 |
3.7× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$887.92 |
$4,036 |
1.7× |
| Gated Heart Planar Single (78472) |
$420.42 |
$1,911 |
1.1× |
| Hand 2 views (73120) |
$36.74 |
$167 |
0.4× |
| Hand 3 views (73130) |
$40.48 |
$184 |
0.5× |
| Hdr rdncl ntrstl/intrcav brachytx 1 channel (77770) |
$375.54 |
$1,707 |
0.6× |
| Hdr rdncl ntrstl/intrcav brachytx 2-12 channel (77771) |
$683.98 |
$3,109 |
1.0× |
| Hdr rdncl ntrstl/intrcav brachytx >12 channels (77772) |
$1,079.54 |
$4,907 |
1.7× |
| Hdr rdncl sk srf brchytx les >2cm&2chan/mlt les (77768) |
$477.18 |
$2,169 |
1.3× |
| Hdr rdncl skn surf brachytx les </2cm/1 chan (77767) |
$290.40 |
$1,320 |
0.8× |
| Heart Infarct Image (78466) |
$225.94 |
$1,027 |
0.6× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$944.46 |
$4,293 |
0.3× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$848.98 |
$3,859 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$615.56 |
$2,798 |
1.6× |
| Ht muscle image spect sing (78451) |
$430.98 |
$1,959 |
0.4× |
| Humerus Min 2 Views Left (73060) |
$42.90 |
$195 |
0.5× |
| Hysterosalpingogram (74740) |
$104.06 |
$473 |
0.5× |
| Interstitial radiation source applic complex (77778) |
$361.90 |
$1,645 |
0.6× |
| Intracavitary Radiation Source Applic Complex (77763) |
$329.12 |
$1,496 |
0.5× |
| Intracavitary Radiation Source Applic Intermed (77762) |
$260.92 |
$1,186 |
0.5× |
| Intracavitary radiation source applic simple (77761) |
$197.12 |
$896 |
0.4× |
| Joint Survey, Single View - Xr Joint Anteroposterior 2+ Joints (77077) |
$74.58 |
$339 |
0.8× |
| Kidney funcj study non-img radioisotopic study (78725) |
$124.52 |
$566 |
0.3× |
| Kidney imaging morphology (78700) |
$251.24 |
$1,142 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$346.50 |
$1,575 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$310.20 |
$1,410 |
0.6× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$401.50 |
$1,825 |
0.8× |
| Knee 3 views (73562) |
$68.64 |
$312 |
0.8× |
| Liver & spleen imaging static only (78215) |
$247.94 |
$1,127 |
0.7× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$246.62 |
$1,121 |
0.7× |
| Liver imaging static only (78201) |
$350.02 |
$1,591 |
0.7× |
| Liver imaging w/vascular flow (78202) |
$350.02 |
$1,591 |
0.7× |
| Lung perfusion differential (78597) |
$340.78 |
$1,549 |
0.9× |
| Lung Ventilation Imaging (78579) |
$317.90 |
$1,445 |
0.8× |
| Lymphangio Abd/Pelv Bilat - Ir Lymphangiogram Abdomen Pelvis Bilat (75807) |
$944.46 |
$4,293 |
0.3× |
| Lymphangio extrem unilat - ir lymphangiogram extremity (75801) |
$344.74 |
$1,567 |
0.6× |
| Lymphangiography extremity only bilateral rs&i (75803) |
$344.74 |
$1,567 |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$944.46 |
$4,293 |
0.3× |
| Lymphoscintigraphy (78195) |
$377.08 |
$1,714 |
0.7× |
| Mammary ductogram or galactogram multiple (77054) |
$209.88 |
$954 |
0.9× |
| Mammary ductogram or galactogram single (77053) |
$161.70 |
$735 |
0.7× |
| Manual appl stress pfrmd phys/qhp joint films (77071) |
$62.26 |
$283 |
0.8× |
| Meckels Diverticulum (78290) |
$316.14 |
$1,437 |
0.8× |
| Mlc imrt design & construction per imrt plan (77338) |
$415.80 |
$1,890 |
1.2× |
| Mr elastography (76391) |
$439.78 |
$1,999 |
2.0× |
| MRA head w & w/o contrast (70546) |
$829.18 |
$3,769 |
2.5× |
| MRA head w/o contrast (70544) |
$582.78 |
$2,649 |
2.6× |
| MRA head with contrast (70545) |
$628.98 |
$2,859 |
1.9× |
| MRA neck w contrast (70548) |
$628.32 |
$2,856 |
1.9× |
| Mra Neck W/O &W/Contrast Material (70549) |
$829.18 |
$3,769 |
2.5× |
| MRA neck w/o contrast (70547) |
$582.78 |
$2,649 |
2.6× |
| MRI abdomen w contrast (74182) |
$626.78 |
$2,849 |
1.9× |
| MRI abdomen w/o & w/contrast material (74183) |
$831.16 |
$3,778 |
2.5× |
| MRI abdomen w/o contrast (74181) |
$581.46 |
$2,643 |
2.6× |
| MRI any jnt lwr ext with con lt (73722) |
$939.51 |
$4,270.50 |
1.3× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$940.83 |
$4,276.50 |
1.3× |
| MRI bone marrow blood supply (77084) |
$467.50 |
$2,125 |
2.1× |
| MRI breast w/o contrast bilateral (77047) |
$439.78 |
$1,999 |
2.0× |
| MRI breast w/o contrast unilat (77046) |
$439.78 |
$1,999 |
2.0× |
| MRI c-spine with contrast (72142) |
$628.76 |
$2,858 |
1.9× |
| MRI cardiac w/o cont stress (75559) |
$606.98 |
$2,759 |
1.2× |
| MRI cardiac w/o contrast (75557) |
$610.72 |
$2,776 |
2.7× |
| MRI cervical spine w/o contrast (72141) |
$583.22 |
$2,651 |
2.6× |
| MRI chest w/o & w/contrast material (71552) |
$828.96 |
$3,768 |
2.5× |
| MRI chest w/o contrast (71550) |
$580.58 |
$2,639 |
2.6× |
| MRI chest with contrast (71551) |
$626.78 |
$2,849 |
0.9× |
| MRI fetal sngl/1st gestation (74712) |
$460.68 |
$2,094 |
2.1× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$940.50 |
$4,275 |
2.9× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$939.51 |
$4,270.50 |
2.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$870.87 |
$3,958.50 |
3.9× |
| MRI orbit face &/neck w/o contrast (70540) |
$580.58 |
$2,639 |
2.6× |
| MRI orbit/face/neck w&w/o cont (70543) |
$831.16 |
$3,778 |
2.5× |
| MRI orbit/face/neck w/contrast (70542) |
$626.34 |
$2,847 |
1.9× |
| MRI pelvis w contrast (72196) |
$626.78 |
$2,849 |
1.9× |
| MRI pelvis w/o & w/contrast material (72197) |
$831.16 |
$3,778 |
2.5× |
| MRI pelvis w/o contrast (72195) |
$581.46 |
$2,643 |
2.6× |
| MRI scan of arm joint before and after contrast (73223) |
$1,245.75 |
$5,662.50 |
3.8× |
| MRI scan of heart before and after contrast with stress imaging (75563) |
$927.74 |
$4,217 |
1.3× |
| MRI scan of leg joint before and after contrast (73723) |
$1,245.75 |
$5,662.50 |
3.8× |
| MRI spectroscopy (76390) |
$668.58 |
$3,039 |
8.2× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$835.12 |
$3,796 |
2.6× |
| MRI spinal canal lumbar w/contrast material (72149) |
$628.76 |
$2,858 |
1.9× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$835.12 |
$3,796 |
2.6× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$629.64 |
$2,862 |
1.9× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$835.34 |
$3,797 |
2.6× |
| MRI thoracic spine w/o contrast (72146) |
$582.56 |
$2,648 |
2.6× |
| MRI tmj (70336) |
$467.72 |
$2,126 |
2.1× |
| MRI upper ext joint w/o contrast (73221) |
$871.20 |
$3,960 |
3.9× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$1,246.74 |
$5,667 |
3.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$870.87 |
$3,958.50 |
3.9× |
| Myelogram Cervical (72240) |
$314.16 |
$1,428 |
0.4× |
| Myelogram Lumbar (72265) |
$275 |
$1,250 |
0.4× |
| Myelogram thoracic (72255) |
$285.12 |
$1,296 |
0.4× |
| Myelography 2 or more regions (72270) |
$315.48 |
$1,434 |
0.4× |
| Myocardial Imaging Pet Metabolic Evaluation (78459) |
$1,910.70 |
$8,685 |
1.6× |
| Myocardial infarct spect (78469) |
$350.02 |
$1,591 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$430.98 |
$1,959 |
0.4× |
| Myocrd img PET metab eval single study cncrnt CT (78429) |
$2,371.82 |
$10,781 |
1.8× |
| Myocrd img PET prfuj 1std rest/stress cncrnt CT (78430) |
$1,581.36 |
$7,188 |
1.2× |
| Myocrd img PET prfuj mlt std rst&strs cncrnt CT (78431) |
$2,465.76 |
$11,208 |
1.2× |
| Myocrd img PET prfuj w/metab 2rtracer cncrnt CT (78433) |
$3,013.56 |
$13,698 |
1.5× |
| Myocrd img PET prfuj w/metab dual radiotracer (78432) |
$3,013.56 |
$13,698 |
2.1× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$602.80 |
$2,740 |
0.7× |
| Neck soft tissue (70360) |
$33.22 |
$151 |
0.4× |
| Njx Rp Loclzj Non-Img Probe Study Intravenous (78808) |
$124.52 |
$566 |
0.3× |
| Nm adrenal scan (78075) |
$430.98 |
$1,959 |
0.4× |
| Nm cisternogram (78630) |
$430.76 |
$1,958 |
0.8× |
| Nm csf leak detection (78650) |
$430.98 |
$1,959 |
0.4× |
| Nm gastric emptying study (78264) |
$357.06 |
$1,623 |
1.0× |
| Nm gastroesophageal reflux study (78262) |
$344.30 |
$1,565 |
0.9× |
| Nm peritoneal-venous shunt patency (78291) |
$277.64 |
$1,262 |
0.7× |
| Nm red cell sequestration (78140) |
$274.12 |
$1,246 |
0.7× |
| Nm whole blood volume (78122) |
$100.98 |
$459 |
0.2× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,170.08 |
$9,864 |
1.7× |
| Nuclear medicine of blood flow in heart muscle at rest and with stress (78492) |
$1,910.70 |
$8,685 |
1.4× |
| Nuclear medicine of heart muscle at rest with stress (78454) |
$430.98 |
$1,959 |
0.4× |
| Nuclear medicine of heart pumping function (78473) |
$603.02 |
$2,741 |
1.6× |
| Nuclear medicine study from skull base to mid-thigh (78812) |
$1,719.08 |
$7,814 |
1.3× |
| Nuclear medicine study of blood flow in heart muscle at rest with stress (78491) |
$1,910.70 |
$8,685 |
1.4× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$430.98 |
$1,959 |
0.4× |
| Nuclear medicine study of kidney and blood flow (78701) |
$294.36 |
$1,338 |
0.8× |
| Nuclear medicine study of limited area for thyroid cancer (78015) |
$238.04 |
$1,082 |
0.6× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$671.88 |
$3,054 |
1.8× |
| Nuclear medicine study to assess blood clot in vein of both sides (78458) |
$298.10 |
$1,355 |
0.8× |
| Nuclear Rx Oral Admin (79005) |
$174.46 |
$793 |
0.8× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$102.52 |
$466 |
1.0× |
| Oph US Dx B-Scan&Quan a-Scan Sm Pt Enctr (76510) |
$95.70 |
$435 |
0.8× |
| Ophthalmic us dx quantitative a-scan only (76511) |
$65.67 |
$298.50 |
0.7× |
| Orthopantogram (70355) |
$38.72 |
$176 |
0.5× |
| Osseous survey infant (77076) |
$74.36 |
$338 |
0.8× |
| Osseous survey limited (77074) |
$80.30 |
$365 |
0.8× |
| Parathyrd planar w/spect&CT (78072) |
$980.10 |
$4,455 |
1.9× |
| Parathyrd planar w/wo subtrj (78071) |
$708.40 |
$3,220 |
1.9× |
| Parathyroid imaging (78070) |
$290.84 |
$1,322 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$37.62 |
$171 |
0.4× |
| Perineogram (74775) |
$111.32 |
$506 |
0.5× |
| PET image w/CT, skull-thigh (78815) |
$1,699.06 |
$7,723 |
1.3× |
| PET imaging CT for attenuation limited area (78814) |
$1,699.06 |
$7,723 |
1.3× |
| PET imaging for CT attenuation whole body (78816) |
$1,699.06 |
$7,723 |
1.3× |
| PET imaging limited area chest head/neck (78811) |
$1,719.08 |
$7,814 |
1.4× |
| PET whole body (78813) |
$1,719.08 |
$7,814 |
1.3× |
| Pr gi endoscopic ultrasound (76975) |
$117.48 |
$534 |
0.5× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,246.74 |
$5,667 |
3.8× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$944.46 |
$4,293 |
0.3× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$780.34 |
$3,547 |
0.3× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$282.26 |
$1,283 |
0.8× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$570.02 |
$2,591 |
1.1× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$159.50 |
$725 |
0.3× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$51.70 |
$235 |
0.6× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$93.72 |
$426 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$57.42 |
$261 |
0.6× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$96.69 |
$439.50 |
1.0× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$122.10 |
$555 |
1.2× |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
$25,294.06 |
$114,973 |
3.7× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$297 |
$1,350 |
0.6× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$149.16 |
$678 |
1.6× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$183.26 |
$833 |
0.5× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$49.28 |
$224 |
0.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$36.74 |
$167 |
0.4× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$48.62 |
$221 |
0.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$45.76 |
$208 |
0.6× |
| Radiologic exam colon single contrast study (74270) |
$157.52 |
$716 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$160.60 |
$730 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$140.36 |
$638 |
0.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$119.90 |
$545 |
0.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$69.96 |
$318 |
0.9× |
| Radiological examination surgical specimen (76098) |
$159.50 |
$725 |
0.3× |
| Radiopharm Dacryocystography (78660) |
$193.38 |
$879 |
0.5× |
| Red Cell Volume Determination Spx 1 Sampling (78120) |
$124.52 |
$566 |
0.3× |
| Review by radiologist of adrenal gland vein image (75840) |
$1,428.24 |
$6,492 |
0.5× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$944.46 |
$4,293 |
0.3× |
| Ribs bilateral 3 views (71110) |
$58.08 |
$264 |
0.6× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$344.30 |
$1,565 |
0.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$430.98 |
$1,959 |
0.8× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$430.98 |
$1,959 |
0.8× |
| Rp loclzj tum spect 2 area/sep acquisj img (78831) |
$1,385.12 |
$6,296 |
1.1× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,828.42 |
$8,311 |
1.4× |
| Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) |
$932.80 |
$4,240 |
0.8× |
| Rp Ther Radiolbld Monoclonal Antibody IV Infus (79403) |
$278.52 |
$1,266 |
1.3× |
| Rp therapy intra-arterial particulate admn (79445) |
$195.80 |
$890 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$177.32 |
$806 |
0.8× |
| Sacroiliac Joints < 3 Views (72200) |
$38.94 |
$177 |
0.4× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$134.64 |
$612 |
0.6× |
| Salivary gland function study (78232) |
$249.26 |
$1,133 |
0.7× |
| Scanogram (77073) |
$55.88 |
$254 |
0.6× |
| Scapula complete (73010) |
$58.41 |
$265.50 |
0.6× |
| Screening digital breast tomosynthesis (77063) |
$21.56 |
$98 |
0.9× |
| Sella turcica (70240) |
$33.88 |
$154 |
0.4× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$80.96 |
$368 |
0.8× |
| Sialogram (70390) |
$142.56 |
$648 |
0.6× |
| Simulation intermediate (77285) |
$385.44 |
$1,752 |
1.1× |
| Small bowel series (74250) |
$115.50 |
$525 |
0.7× |
| Spec medical radj physics consltj (77370) |
$214.28 |
$974 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$213.62 |
$971 |
0.6× |
| Special dosimetry (77331) |
$42.02 |
$191 |
0.3× |
| Special treatment procedure (77470) |
$559.24 |
$2,542 |
1.1× |
| Speech evaluation complex (70371) |
$144.10 |
$655 |
0.6× |
| Spine thoracic 3 views (72072) |
$55.22 |
$251 |
0.6× |
| Spleen imaging only (78185) |
$223.52 |
$1,016 |
0.6× |
| Splenoportograpy rs&i (75810) |
$959.42 |
$4,361 |
0.3× |
| Stereotactic body radiation delivery (77373) |
$2,558.16 |
$11,628 |
1.5× |
| Superior sagittal sinus venogram (75870) |
$771.76 |
$3,508 |
0.3× |
| Surface Applic Low Dose Rate Radionuclide Source (77789) |
$46.86 |
$213 |
0.5× |
| Tbs Technical Calculation Only (77091) |
$23.98 |
$109 |
0.3× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$152.46 |
$693 |
0.4× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$100.98 |
$459 |
0.3× |
| Testicular Imaging With Vascular Flow (78761) |
$264.88 |
$1,204 |
0.7× |
| Ther rad simulaj-aided field setting complex (77290) |
$508.64 |
$2,312 |
1.4× |
| Ther rad simulaj-aided field setting simple (77280) |
$231 |
$1,050 |
1.8× |
| Therapeutic Enema (74283) |
$177.10 |
$805 |
1.1× |
| Thoracolumbar 2 views (72080) |
$49.94 |
$227 |
0.6× |
| Thyroid carcinoma metastases img whole body (78018) |
$444.62 |
$2,021 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$445.72 |
$2,026 |
1.2× |
| Thyroid uptake measurement (78012) |
$171.38 |
$779 |
0.5× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$508.42 |
$2,311 |
1.4× |
| Tmj unilateral (70328) |
$37.62 |
$171 |
0.5× |
| Tomogram (76100) |
$130.46 |
$593 |
1.3× |
| Treatment device intermediate (77333) |
$96.14 |
$437 |
0.8× |
| Treatment devices simple (77332) |
$85.58 |
$389 |
0.7× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$725.78 |
$3,299 |
1.4× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$267.08 |
$1,214 |
0.7× |
| Tx devices design & construction complex (77334) |
$192.28 |
$874 |
0.5× |
| Ultrasound elastography first target lesion (76982) |
$163.46 |
$743 |
1.7× |
| Ultrasound scan of cornea to determine thickness (76514) |
$6.38 |
$29 |
0.2× |
| Ultrasound scan to determine eye length and lens power (76519) |
$67.65 |
$307.50 |
0.7× |
| Ultrasound trgt dynamic microbubble 1st lesion (76978) |
$266.64 |
$1,212 |
0.8× |
| Ultrasound, abdomen limited (76705) |
$119.90 |
$545 |
1.2× |
| Umbilical-artery Doppler (OB) (76820) |
$104.28 |
$474 |
1.1× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$64.90 |
$295 |
0.8× |
| Unlisted fluoroscopic procedure (76496) |
$128.48 |
$584 |
1.6× |
| Unlisted magnetic resonance procedure (76498) |
$376.42 |
$1,711 |
4.6× |
| Unlisted miscellaneous px dx nuclear medicine (78999) |
$56.76 |
$258 |
0.2× |
| Unlisted Procedure Clinical Brachytherapy (77799) |
$690.14 |
$3,137 |
7.2× |
| Unlisted Ultrasound Procedure (76999) |
$88.44 |
$402 |
1.1× |
| Upper Extremity Infant (73092) |
$56.43 |
$256.50 |
0.6× |
| Urethrocystography retrograde rs&i (74450) |
$111.32 |
$506 |
0.5× |
| Urethrocystography voiding (74455) |
$128.92 |
$586 |
0.6× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$141.24 |
$642 |
0.9× |
| Us abdl aorta screen aaa (76706) |
$135.74 |
$617 |
1.4× |
| Us breast unilateral complete (76641) |
$140.91 |
$640.50 |
1.4× |
| Us breast unilateral limited (76642) |
$140.91 |
$640.50 |
1.7× |
| Us chest (76604) |
$104.06 |
$473 |
1.1× |
| Us compl joint r-t w/image documentation (76881) |
$182.16 |
$828 |
1.9× |
| Us elastography parenchyma (76981) |
$169.84 |
$772 |
1.7× |
| Us fetal nuchal translucency 1st gestation (76813) |
$135.96 |
$618 |
1.4× |
| Us guided compression repair (76936) |
$259.60 |
$1,180 |
1.3× |
| Us infant hips dynamic (76885) |
$122.98 |
$559 |
1.5× |
| Us infant hips limited static (76886) |
$119.24 |
$542 |
1.5× |
| Us kidney transplant (76776) |
$168.30 |
$765 |
1.7× |
| Us ob detailed single fetus (76811) |
$270.82 |
$1,231 |
1.2× |
| Us ob transvaginal (76817) |
$117.48 |
$534 |
1.2× |
| Us pelvic non ob complete (76856) |
$134.64 |
$612 |
1.4× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$121.66 |
$553 |
1.2× |
| Us pregnancy ltd (76815) |
$110.66 |
$503 |
1.1× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$160.60 |
$730 |
1.6× |
| Us retroperitoneal complete (76770) |
$161.04 |
$732 |
1.6× |
| Us retroperitoneal limited (76775) |
$119.90 |
$545 |
1.2× |
| Us scrotum and contents (76870) |
$134.64 |
$612 |
1.4× |
| Us soft tissue head/neck (76536) |
$125.62 |
$571 |
1.3× |
| Us spinal canal and contents (76800) |
$118.58 |
$539 |
1.2× |
| Us transrectal (76872) |
$172.26 |
$783 |
1.8× |
| Us transrectal prostate volume (76873) |
$177.76 |
$808 |
1.8× |
| Us xtr non-vasc lmtd (76882) |
$36.08 |
$164 |
0.4× |
| Us, eye b-scan (76512) |
$85.14 |
$387 |
0.9× |
| Vascular flow imaging (78445) |
$183.92 |
$836 |
0.5× |
| Venogram extremity bilateral (75822) |
$464.20 |
$2,110 |
0.3× |
| Venogram orbital (75880) |
$178.86 |
$813 |
0.3× |
| Venography caval inferior serialography rs&i (75825) |
$944.46 |
$4,293 |
0.3× |
| Venography caval superior serialography rs&i (75827) |
$776.16 |
$3,528 |
0.5× |
| Venography extremity unilateral rs&i (75820) |
$464.20 |
$2,110 |
0.3× |
| Venography Renal Bilateral (75833) |
$944.46 |
$4,293 |
0.3× |
| Venography renal unilateral selective rs&i (75831) |
$944.46 |
$4,293 |
0.3× |
| Venography venous sinus/jugular cath rs&i (75860) |
$944.46 |
$4,293 |
0.3× |
Venous sampling thru cath w/wo angiography rs& (75893)
unusually low: confirm this is the full procedure |
$1,574.32 |
$7,156 |
0.3× |
| Vertebral fracture assessment via dxa (77086) |
$50.82 |
$231 |
0.6× |
| Wrist 2 views (73100) |
$37.62 |
$171 |
0.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$58.08 |
$264 |
0.6× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$50.82 |
$231 |
0.6× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$41.14 |
$187 |
0.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$208.56 |
$948 |
1.3× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$57.42 |
$261 |
0.7× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$46.42 |
$211 |
0.6× |
| X-ray exam entire spi 4/5 vw (72083) |
$101.64 |
$462 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$41.58 |
$189 |
0.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$61.16 |
$278 |
0.7× |
| X-ray exam hip uni 4/> views (73503) |
$75.68 |
$344 |
0.8× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$68.42 |
$311 |
0.7× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$82.06 |
$373 |
0.8× |
| X-ray exam of femur 1 (73551) |
$59.07 |
$268.50 |
0.7× |
| X-ray eye for foreign body (70030) |
$50.82 |
$231 |
0.6× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$59.40 |
$270 |
0.6× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$45.10 |
$205 |
0.6× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$40.48 |
$184 |
0.5× |
| X-ray guide gu dilation - ir nephrostomy dilation (74485) |
$591.80 |
$2,690 |
0.3× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$54.12 |
$246 |
0.7× |
| X-ray IV pyelogram+drip infusn (74410) |
$157.52 |
$716 |
1.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$39.60 |
$180 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$76.23 |
$346.50 |
0.8× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$38.28 |
$174 |
0.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$56.43 |
$256.50 |
0.7× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$52.14 |
$237 |
0.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$93.94 |
$427 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$70.40 |
$320 |
0.7× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$40.48 |
$184 |
0.5× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$38.28 |
$174 |
0.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$59.40 |
$270 |
0.6× |
| X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) |
$52.80 |
$240 |
0.5× |
| X-Ray Renal Cyst Xlumbar+Contrst - Xr Renal Cyst Lumbar W Contrast (74470) |
$95.48 |
$434 |
0.2× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$200.20 |
$910 |
0.6× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$43.56 |
$198 |
0.5× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$50.82 |
$231 |
0.5× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$69.74 |
$317 |
0.7× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$48.62 |
$221 |
0.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$42.90 |
$195 |
0.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$64.35 |
$292.50 |
0.8× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$57.42 |
$261 |
0.7× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$45.76 |
$208 |
0.6× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$66 |
$300 |
0.7× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$47.96 |
$218 |
0.5× |
| X-Ray Spine One View - Xr Spine (72020) |
$31.24 |
$142 |
0.4× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$53.68 |
$244 |
0.7× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$47.96 |
$218 |
0.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$47.96 |
$218 |
0.5× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$68.86 |
$313 |
0.7× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$52.14 |
$237 |
0.6× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$42.46 |
$193 |
0.5× |
| Xr arthrogram ankle (73615) |
$182.49 |
$829.50 |
0.6× |
| Xr c-spine 6 or more views (72052) |
$87.56 |
$398 |
0.9× |
| Xr chest 4+ views (71048) |
$60.28 |
$274 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$35.42 |
$161 |
0.4× |
| Xr internal auditory meati complete (70134) |
$159.50 |
$725 |
0.3× |
| XR Mastoids < 3 Views Bilateral (70120) |
$71.94 |
$327 |
0.7× |
| Xr myelogram posterior fossa (70010) |
$306.24 |
$1,392 |
0.9× |
| Xr shoulder 1 view (73020) |
$50.82 |
$231 |
0.6× |
| Xr spine cervical 4 or 5 views (72050) |
$69.74 |
$317 |
0.7× |
| Xr tibia/fibula 2 views (73590) |
$57.42 |
$261 |
0.7× |
| Xr tmj bilateral (70330) |
$65.12 |
$296 |
0.8× |
| Xray knee 1 or 2 views rt (73560) |
$58.41 |
$265.50 |
0.7× |