| Abdomen 2 views (74019) |
$133 |
$702.63 |
1.3× |
| Acute gastrointestinal blood loss imaging (78278) |
$398 |
$2,094.96 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$1,419 |
$7,471.75 |
0.4× |
| Angiography extremity unilateral rs&i (75710) |
$1,258 |
$6,623.21 |
0.4× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,332 |
$17,541.80 |
1.1× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$2,777 |
$14,618.20 |
0.9× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$2,777 |
$14,618.20 |
0.9× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,865 |
$9,818.61 |
0.6× |
| Aortography abdominal serialography rs&i (75625) |
$3,296 |
$17,350.80 |
1.0× |
| Aortography thoracic w/o serialography rs&i (75600) |
$1,198 |
$6,310 |
0.4× |
| Arthrogram hip (73525) |
$199 |
$1,049 |
0.6× |
| Arthrogram shoulder (73040) |
$403 |
$2,122.25 |
1.1× |
| Arthrography knee lt (73580) |
$209 |
$1,102 |
0.6× |
| Bone &/Joint Imaging Limited Area (78300) |
$353 |
$1,859.44 |
0.9× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$282 |
$1,487.55 |
0.7× |
| Bone &/joint imaging whole body (78306) |
$499 |
$2,629 |
1.2× |
| Bone age studies (77072) |
$100 |
$529.37 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$533 |
$2,807.75 |
1.3× |
| Bone survey complete (77075) |
$253 |
$1,333.89 |
2.4× |
| Brain image w/flow 4 + views (78606) |
$448 |
$2,359.90 |
0.8× |
| Cervical spine 2 or 3 views (72040) |
$111 |
$587.41 |
1.3× |
| Chest 1 view (71045) |
$87 |
$459.05 |
1.0× |
| Chest 3 views (71047) |
$80 |
$422 |
0.9× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$176 |
$914.42 |
1.0× |
| Clavicle complete (73000) |
$94 |
$495 |
1.1× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$101 |
$531.70 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,532 |
$8,065.75 |
4.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,038 |
$5,467 |
4.3× |
| CT abdomen w contrast (74160) |
$649 |
$3,417.94 |
3.7× |
| CT abdomen w wo contrast (74170) |
$880 |
$4,636.50 |
5.0× |
| CT abdomen w/o contrast (74150) |
$583 |
$3,072.23 |
5.6× |
| CT angiography upper extremity lt (73206) |
$515 |
$2,965 |
2.9× |
| CT c-spine w/o contrast (72125) |
$643 |
$3,386.63 |
6.1× |
| CT cervical spine with contrast (72126) |
$651 |
$3,427.88 |
1.9× |
| CT chest w/wo contrast (71270) |
$1,084 |
$5,706.25 |
6.2× |
| CT chest with contrast (71260) |
$701 |
$3,691.88 |
4.0× |
| CT head/brain with contrast (70460) |
$623 |
$3,280.41 |
3.5× |
| CT head/brain without and with contrast (70470) |
$733 |
$3,859 |
4.2× |
| CT heart no contrast quant eval coronry calcium (75571) |
$119 |
$626.90 |
1.4× |
| CT iac w contrast (70481) |
$505 |
$2,660 |
2.9× |
| CT lower ext w/o (73700) |
$531 |
$2,798.24 |
5.1× |
| CT lower extremity w wo contrast (73702) |
$636 |
$4,140 |
3.6× |
| CT lower extremity with contrast (73701) |
$598 |
$3,147.57 |
3.4× |
| CT lumbar spine w & w/o contrast (72133) |
$756 |
$3,983.34 |
4.3× |
| CT lumbar spine w/o contrast (72131) |
$675 |
$3,557.13 |
6.4× |
| CT lumbar spine with contrast (72132) |
$738 |
$3,886.91 |
2.1× |
| CT maxillofacial w contrast (70487) |
$620 |
$2,990 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$535 |
$2,817.38 |
5.1× |
| CT maxillofacial w/wo contrast (70488) |
$672 |
$3,255 |
3.8× |
| CT neck soft tissue w contrast (70491) |
$625 |
$3,294.50 |
3.5× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$524 |
$2,761 |
3.0× |
| CT orbits w/o contrast (70480) |
$448 |
$2,363 |
4.3× |
| CT pelvis w & w/o contrast (72194) |
$745 |
$3,923.75 |
4.2× |
| CT pelvis w/o contrast (72192) |
$563 |
$2,965.59 |
5.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$643 |
$3,386.63 |
3.6× |
| CT soft tissue neck w/o contrast (70490) |
$542 |
$2,853.13 |
5.2× |
| CT thoracic spine w/contrast (72129) |
$557 |
$2,936 |
3.2× |
| CT thoracic spine w/o contrast (72128) |
$605 |
$3,187.25 |
5.8× |
| CT thorax w/o contrast (71250) |
$562 |
$2,960.77 |
5.4× |
| CT upper extremity w/o & w/contrast material (73202) |
$456 |
$2,905 |
2.6× |
| CT upper extremity w/o contrast rt (73200) |
$526 |
$2,772.42 |
5.0× |
| CT upper extremity with contrast (73201) |
$540 |
$2,561.62 |
1.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$973 |
$5,126 |
5.5× |
| Cta Abdomen (74175) |
$651 |
$3,429.06 |
3.7× |
| CTA abdomen pelvis (74174) |
$814 |
$4,288.38 |
2.3× |
| CTA chest (71275) |
$579 |
$3,623.87 |
3.3× |
| Cta Head (70496) |
$755 |
$3,978.57 |
4.3× |
| CTA lwr ext w&w/o contrast (73706) |
$724 |
$3,812.03 |
4.1× |
| Cta Neck (70498) |
$758 |
$3,994.16 |
4.3× |
| Cta Pelvis (72191) |
$717 |
$3,774.57 |
4.1× |
| Cystography minimum 3 views rs&i (74430) |
$282 |
$1,489 |
0.8× |
| Dxa bone density study 1/> sites axial skel (77080) |
$117 |
$618.81 |
1.1× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$84 |
$443.75 |
1.0× |
| Echo exam of fetal heart (76825) |
$98 |
$519.74 |
0.2× |
| Echoencephalography real time imaging (76506) |
$101 |
$533 |
1.0× |
| Esophagus (74220) |
$210 |
$1,109.57 |
1.2× |
| Fetal biophysical profile non-stress testing (76818) |
$201 |
$1,058.75 |
1.9× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$155 |
$817.50 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$127 |
$519.70 |
0.5× |
| Forearm 2 views (73090) |
$93 |
$492.25 |
1.1× |
| Gated Heart Planar Single (78472) |
$452 |
$2,382.50 |
1.1× |
| Hand 3 views (73130) |
$102 |
$541.07 |
1.2× |
| Heart Infarct Image (78466) |
$333 |
$1,756.50 |
0.8× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$534 |
$2,811.88 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$466 |
$2,457.40 |
1.2× |
| Ht muscle image spect sing (78451) |
$1,293 |
$6,806.20 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$95 |
$501.16 |
1.1× |
| Hysterosalpingogram (74740) |
$344 |
$1,815.25 |
1.4× |
| Kidney imaging morphology (78700) |
$292 |
$1,540 |
0.7× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$508 |
$2,674 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$527 |
$2,777 |
1.0× |
| Knee 3 views (73562) |
$112 |
$591.14 |
1.3× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$339 |
$1,787.20 |
0.8× |
| Liver imaging w/vascular flow (78202) |
$339 |
$1,787.20 |
0.6× |
| Lymphoscintigraphy (78195) |
$402 |
$2,119.58 |
0.7× |
| Meckels Diverticulum (78290) |
$282 |
$1,498 |
0.7× |
| MRA head w/o contrast (70544) |
$727 |
$3,831.25 |
3.0× |
| MRA head with contrast (70545) |
$579 |
$3,051.45 |
1.7× |
| MRA neck w contrast (70548) |
$784 |
$4,130.63 |
2.2× |
| MRA neck w/o contrast (70547) |
$723 |
$3,805.32 |
3.0× |
| MRI abdomen w contrast (74182) |
$876 |
$4,615 |
2.5× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,231 |
$6,480.38 |
3.5× |
| MRI abdomen w/o contrast (74181) |
$795 |
$3,610.02 |
3.3× |
| MRI any jnt lwr ext with con lt (73722) |
$822 |
$4,331.25 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$943 |
$4,966 |
1.2× |
| MRI c-spine with contrast (72142) |
$825 |
$4,344.76 |
2.4× |
| MRI cervical spine w/o contrast (72141) |
$617 |
$3,248.75 |
2.6× |
| MRI chest w/o & w/contrast material (71552) |
$977 |
$5,143 |
2.8× |
| MRI chest w/o contrast (71550) |
$720 |
$3,791.25 |
3.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$822 |
$4,331.25 |
3.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$576 |
$3,033 |
2.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$984 |
$5,181.95 |
2.8× |
| MRI pelvis w contrast (72196) |
$788 |
$4,151 |
2.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,077 |
$5,673.07 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$763 |
$4,020.50 |
3.2× |
| MRI scan of arm joint before and after contrast (73223) |
$943 |
$5,280.13 |
2.7× |
| MRI scan of leg joint before and after contrast (73723) |
$673 |
$3,543.75 |
1.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,060 |
$5,579.96 |
3.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$941 |
$4,952.75 |
2.7× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,160 |
$6,107.74 |
3.3× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$948 |
$4,990.63 |
2.7× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,046 |
$5,506.25 |
3.0× |
| MRI thoracic spine w/o contrast (72146) |
$854 |
$4,499 |
3.6× |
| MRI tmj (70336) |
$763 |
$4,018.15 |
3.2× |
| MRI upper ext joint w/o contrast (73221) |
$759 |
$3,998.75 |
3.2× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$719 |
$3,785 |
2.1× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$715 |
$3,955.48 |
3.0× |
| Myelogram Cervical (72240) |
$425 |
$2,241.50 |
0.5× |
| Myelogram Lumbar (72265) |
$590 |
$3,108.52 |
0.7× |
| Myelogram thoracic (72255) |
$376 |
$1,982 |
0.5× |
| Myelography 2 or more regions (72270) |
$514 |
$2,705.50 |
0.7× |
| Myocardial Spect Multiple Studies (78452) |
$734 |
$5,141 |
0.6× |
| Neck soft tissue (70360) |
$90 |
$476.44 |
1.0× |
| Nm gastric emptying study (78264) |
$457 |
$2,410.38 |
1.1× |
| Nuclear medicine study of heart muscle at rest with stress (78453) |
$734 |
$3,863.70 |
0.6× |
| Nuclear medicine study of kidney and blood flow (78701) |
$449 |
$2,365.56 |
1.1× |
| Nuclear medicine study to assess blood clot in vein of side (78457) |
$357 |
$1,881.45 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$128 |
$676 |
1.2× |
| Osseous survey infant (77076) |
$143 |
$756.25 |
1.4× |
| Osseous survey limited (77074) |
$129 |
$680 |
1.2× |
| Parathyroid imaging (78070) |
$340 |
$1,790 |
0.8× |
| Pelvis 1 or 2 views (72170) |
$66 |
$485.40 |
0.6× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$1,072 |
$5,647.13 |
3.1× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$349 |
$1,840.65 |
0.9× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$389 |
$2,050.81 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$275 |
$1,452.20 |
0.5× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$72 |
$380 |
0.8× |
| Radex hips bilateral with pelvis 2 views (73521) |
$156 |
$825.69 |
1.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$82 |
$435.54 |
0.8× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$123 |
$647.50 |
1.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$98 |
$517 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$155 |
$816.31 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$97 |
$514.25 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$225 |
$1,188.75 |
1.3× |
| Radiologic exam upr gi trc double contrast study (74246) |
$200 |
$1,053.75 |
1.1× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$101 |
$535.26 |
1.2× |
| Radiological examination surgical specimen (76098) |
$347 |
$1,830.65 |
0.6× |
| Ribs bilateral 3 views (71110) |
$137 |
$724.17 |
1.3× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$542 |
$2,856.75 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$368 |
$2,247.94 |
0.7× |
| Scanogram (77073) |
$79 |
$554.37 |
0.8× |
| Scapula complete (73010) |
$91 |
$521.90 |
0.9× |
| Screening digital breast tomosynthesis (77063) |
$47 |
$176 |
2.0× |
| Sella turcica (70240) |
$51 |
$269 |
0.6× |
| Shuntogram indwelling nonvascular shunt rs&i (75809) |
$131 |
$690 |
1.2× |
| Small bowel series (74250) |
$181 |
$955.69 |
1.0× |
| Speech evaluation complex (70371) |
$141 |
$745.20 |
0.6× |
| Spine thoracic 3 views (72072) |
$117 |
$618.81 |
1.1× |
| Testicular Imaging With Vascular Flow (78761) |
$359 |
$1,892.50 |
0.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$119 |
$629 |
0.3× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$398 |
$2,094.96 |
1.0× |
| Tomogram (76100) |
$161 |
$851 |
1.5× |
| Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) |
$817 |
$4,300 |
1.5× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$363 |
$1,915 |
0.9× |
| Ultrasound, abdomen limited (76705) |
$186 |
$1,082.28 |
1.8× |
| Umbilical-artery Doppler (OB) (76820) |
$85 |
$448 |
0.8× |
| Unlisted fluoroscopic procedure (76496) |
$62 |
$330 |
0.7× |
| Urethrocystography retrograde rs&i (74450) |
$282 |
$1,489 |
1.2× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$282 |
$1,489 |
1.6× |
| Us abdl aorta screen aaa (76706) |
$47 |
$283.50 |
0.4× |
| Us breast unilateral complete (76641) |
$147 |
$778.75 |
1.4× |
| Us breast unilateral limited (76642) |
$127 |
$672.19 |
1.5× |
| Us chest (76604) |
$158 |
$835.32 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$162 |
$856.25 |
1.5× |
| Us ob detailed single fetus (76811) |
$230 |
$1,214.25 |
1.0× |
| Us ob transvaginal (76817) |
$156 |
$823.75 |
1.5× |
| Us pelvic non ob complete (76856) |
$227 |
$1,199.95 |
2.2× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$196 |
$1,033.75 |
1.9× |
| Us pregnancy ltd (76815) |
$130 |
$270 |
1.2× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$179 |
$946.86 |
1.7× |
| Us retroperitoneal complete (76770) |
$231 |
$1,208.58 |
2.2× |
| Us scrotum and contents (76870) |
$208 |
$1,096.79 |
2.0× |
| Us soft tissue head/neck (76536) |
$192 |
$1,014.73 |
1.8× |
| Us spinal canal and contents (76800) |
$95 |
$500 |
0.9× |
| Us transrectal (76872) |
$159 |
$839 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$141 |
$742.50 |
1.3× |
| Venogram extremity bilateral (75822) |
$773 |
$4,070.25 |
0.5× |
| Venography caval inferior serialography rs&i (75825) |
$1,039 |
$5,468.75 |
0.3× |
| Venography extremity unilateral rs&i (75820) |
$773 |
$4,070.25 |
0.5× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$91 |
$480.94 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$104 |
$549.29 |
1.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$298 |
$1,572.50 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$95 |
$501.88 |
1.1× |
| X-ray exam hip uni 1 view (73501) |
$94 |
$477.05 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$101 |
$532.95 |
1.2× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$141 |
$742.50 |
1.3× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$226 |
$539.99 |
2.6× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$93 |
$491.65 |
1.1× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$131 |
$690.68 |
1.2× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$120 |
$631.98 |
1.1× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$221 |
$1,166.25 |
2.1× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$93 |
$492.43 |
1.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$118 |
$622.50 |
1.1× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$396 |
$2,088.49 |
1.1× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$103 |
$545.92 |
1.2× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$132 |
$695.29 |
1.3× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$157 |
$826.49 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$106 |
$562.38 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$103 |
$547.25 |
1.2× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$112 |
$592.63 |
1.3× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$136 |
$720.50 |
1.6× |
| X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) |
$66 |
$352 |
0.8× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$115 |
$607.65 |
1.1× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$106 |
$559.63 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$78 |
$413.05 |
0.9× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$82 |
$435.89 |
0.9× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$102 |
$542.09 |
1.2× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$109 |
$575.48 |
1.0× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$129 |
$679.69 |
1.2× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$90 |
$474.38 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$105 |
$556.88 |
1.2× |
| Xr chest 4+ views (71048) |
$126 |
$665 |
1.2× |
| Xr Cholecystography Oral Contrast (74290) |
$103 |
$547 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$87 |
$459.05 |
1.0× |
| Xr shoulder 1 view (73020) |
$92 |
$485.38 |
1.1× |
| Xr spine cervical 4 or 5 views (72050) |
$163 |
$859.38 |
1.6× |
| Xr tibia/fibula 2 views (73590) |
$98 |
$517.72 |
1.1× |
| Xr tmj bilateral (70330) |
$91 |
$483.75 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$93 |
$491.65 |
1.1× |