| Ankle 2 views (73600) |
$247.80 |
$413 |
2.7× |
| Brain imaging, positron emission tomography (PET); metabolic evaluation Age Under 21 (78608) |
$1,776 |
$2,960 |
1.2× |
| Clavicle complete (73000) |
$303 |
$505 |
3.3× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$589.20 |
$982 |
1.6× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$1,309.80 |
$2,183 |
7.1× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,011 |
$1,685 |
5.5× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,938 |
$3,230 |
10.5× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$1,062.60 |
$1,771 |
5.7× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$1,135.20 |
$1,892 |
6.1× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$805.20 |
$1,342 |
4.4× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$1,396.80 |
$2,328 |
7.5× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$1,922.40 |
$3,204 |
17.4× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,408.80 |
$2,348 |
7.6× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,197.60 |
$1,996 |
6.5× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,392 |
$2,320 |
7.5× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$1,587.60 |
$2,646 |
14.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$1,286.40 |
$2,144 |
7.0× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$952.20 |
$1,587 |
8.6× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$1,287 |
$2,145 |
7.0× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,480.20 |
$2,467 |
8.0× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$1,118.40 |
$1,864 |
6.0× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$2,808 |
$4,680 |
15.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$3,034.20 |
$5,057 |
8.2× |
| CT abdomen and pelvis without contrast (74176) |
$2,098.20 |
$3,497 |
8.3× |
| CT abdomen w & w/o contrast (74170) |
$1,937.40 |
$3,229 |
10.5× |
| CT abdomen w/contrast (74160) |
$1,483.80 |
$2,473 |
8.0× |
| CT abdomen w/o contrast (74150) |
$906 |
$1,510 |
8.2× |
| CT cervical spine w/contrast (72126) |
$1,221 |
$2,035 |
3.3× |
| CT cervical spine w/o contrast (72125) |
$1,684.80 |
$2,808 |
15.3× |
| CT chest w/contrast (71260) |
$1,227 |
$2,045 |
6.6× |
| CT extremity upper w & w/o contrast (73202) |
$1,525.80 |
$2,543 |
8.2× |
| CT extremity upper w/o contrast (73200) |
$1,922.40 |
$3,204 |
17.4× |
| CT head/brain with contrast (70460) |
$1,271.40 |
$2,119 |
6.9× |
| CT head/brain without and with contrast (70470) |
$1,938.60 |
$3,231 |
10.5× |
| CT l-spine w/contrast (72132) |
$1,118.40 |
$1,864 |
3.0× |
| CT limited/localized follow up study (76380) |
$393 |
$655 |
4.3× |
| CT lower extremity w/dye (73701) |
$1,105.20 |
$1,842 |
6.0× |
| CT lumbar spine w/o contrast (72131) |
$1,311.60 |
$2,186 |
11.9× |
| CT maxillofacial w/wo contrast (70488) |
$1,338.60 |
$2,231 |
7.2× |
| CT neck w/contrast (70491) |
$1,338.60 |
$2,231 |
7.2× |
| CT neck w/o contrast (70490) |
$870.60 |
$1,451 |
7.9× |
| CT pelvis w & w/o contrast (72194) |
$1,558.20 |
$2,597 |
8.4× |
| CT pelvis w/o contrast (72192) |
$1,311.60 |
$2,186 |
11.9× |
| CT thoracic spine w/contrast (72129) |
$1,354.20 |
$2,257 |
7.3× |
| CT thoracic spine w/o contrast (72128) |
$1,309.80 |
$2,183 |
11.9× |
| CT thorax lung cancer scr c- (71271) |
$905.40 |
$1,509 |
8.2× |
| CT thorax w/o contrast (71250) |
$1,954.50 |
$3,257.50 |
17.7× |
| CT upper extremity w/dye (73201) |
$1,164 |
$1,940 |
3.2× |
| CTA head w contrast (70496) |
$1,732.20 |
$2,887 |
9.4× |
| Cystography, minimum of 3 views, radiological supervision and interpretation Age Under 21 (74430) |
$534 |
$890 |
1.5× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$297.60 |
$496 |
2.7× |
| Fetal biophys profile w/o nst (76819) |
$314.40 |
$524 |
2.9× |
| Fetal biophysical profile non-stress testing (76818) |
$342 |
$570 |
3.1× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$184.20 |
$307 |
0.7× |
| Hepatobil syst imag inc gb w/pharma intervenj (78227) |
$974.40 |
$1,624 |
1.7× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$813.60 |
$1,356 |
1.9× |
| Intestine imaging (eg, ectopic gastric mucosa, Meckel's localization, volvulus) Age Under 21 (78290) |
$728.40 |
$1,214 |
1.7× |
| Kidney imaging morphology; with vascular flow Age Under 21 (78701) |
$694.20 |
$1,157 |
1.6× |
| Kidney imaging morphology; with vascular flow and function, single study without pharmacological intervention Age Under… (78707) |
$431.40 |
$719 |
0.8× |
| Kidney imaging morphology; with vascular flow and function, single study, with pharmacological intervention (eg,… (78708) |
$516 |
$860 |
0.9× |
| Liver and spleen imaging (78215) |
$575.40 |
$959 |
1.4× |
| Lung perfusion imaging (78580) |
$417.60 |
$696 |
1.0× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$1,470 |
$2,450 |
4.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,174.20 |
$1,957 |
3.2× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$869.40 |
$1,449 |
3.5× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,767 |
$2,945 |
4.8× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$780 |
$1,300 |
2.1× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$1,159.20 |
$1,932 |
4.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,256.40 |
$2,094 |
3.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,486.20 |
$2,477 |
4.0× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$2,400 |
$4,000 |
6.5× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,488 |
$2,480 |
4.0× |
| Mandible min 4v (70110) |
$149.40 |
$249 |
1.4× |
| MRA head w/o contrast (70544) |
$1,700.40 |
$2,834 |
6.8× |
| MRA neck w/ contrast (70548) |
$1,361.40 |
$2,269 |
3.7× |
| MRA neck w/o contrast (70547) |
$1,220.40 |
$2,034 |
4.8× |
| MRI abdomen w/contrast (74182) |
$1,059.60 |
$1,766 |
2.9× |
| MRI abdomen w/o contrast (74181) |
$867 |
$1,445 |
3.4× |
| MRI abdomen w/wo contrast (74183) |
$2,913 |
$4,855 |
7.9× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,585.80 |
$2,643 |
1.9× |
| MRI c-spine w&w/o cont (72156) |
$1,788.60 |
$2,981 |
4.9× |
| MRI cervical spine w/contrast (72142) |
$1,648.80 |
$2,748 |
4.5× |
| MRI chest w/o contrast (71550) |
$1,614 |
$2,690 |
6.4× |
| MRI chest w/wo contrast (71552) |
$1,101.60 |
$1,836 |
3.0× |
| MRI fetal sngl/1st gestation (74712) |
$701.40 |
$1,169 |
2.8× |
| MRI joint upr extr w/o&w/dye (73223) |
$1,994.40 |
$3,324 |
5.4× |
| MRI joint upr extrem w/dye (73222) |
$2,034 |
$3,390 |
2.5× |
| MRI joint upr extrem w/o dye (73221) |
$1,886.40 |
$3,144 |
7.5× |
| MRI lumbar spine w/contrast (72149) |
$1,316.40 |
$2,194 |
3.6× |
| MRI lumbar spine w/wo contrast (72158) |
$2,612.40 |
$4,354 |
7.1× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,533.60 |
$2,556 |
4.2× |
| MRI pelvis w & w/o contrast (72197) |
$1,990.80 |
$3,318 |
5.4× |
| MRI pelvis w/contrast (72196) |
$1,525.80 |
$2,543 |
4.1× |
| MRI pelvis w/o contrast (72195) |
$1,500 |
$2,500 |
6.0× |
| MRI spine cervical w/o contrast (72141) |
$1,459.80 |
$2,433 |
5.8× |
| MRI t-spine w&w/o cont (72157) |
$2,158.20 |
$3,597 |
5.9× |
| MRI thoracic spine w/contrast (72147) |
$1,561.20 |
$2,602 |
4.2× |
| MRI thoracic spine w/o contrst (72146) |
$1,705.20 |
$2,842 |
6.8× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$1,663.20 |
$2,772 |
6.6× |
| Nm bone 3 phase (78315) |
$780 |
$1,300 |
1.8× |
| Nm bone imaging whole body (78306) |
$709.20 |
$1,182 |
1.7× |
| Nm gastric emptying (78264) |
$582.60 |
$971 |
1.4× |
| Nm lung ventilation imaging (78579) |
$525.60 |
$876 |
1.2× |
| Nuclear medicine study of bone and/or joint limited area (78300) |
$370.20 |
$617 |
0.9× |
| Ob us limited fetus(s) (76815) |
$544.20 |
$907 |
4.9× |
| Ob us nuchal meas 1 gest (76813) |
$232.20 |
$387 |
2.1× |
| Parathyrd planar w/spect&CT (78072) |
$819 |
$1,365 |
1.4× |
| Parathyroid planar imaging (78070) |
$615 |
$1,025 |
1.5× |
| PET imaging CT attenuation skull base mid-thigh (78815) |
$2,330.40 |
$3,884 |
1.5× |
| PET imaging CT for attenuation limited area (78814) |
$2,239.20 |
$3,732 |
1.5× |
| PET imaging for CT attenuation whole body (78816) |
$2,820.60 |
$4,701 |
1.9× |
| PET imaging whole body (78813) |
$1,776 |
$2,960 |
1.2× |
| Pulmonary ventilation & perfusion imaging (78582) |
$669 |
$1,115 |
1.2× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$162 |
$270 |
0.3× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$117 |
$195 |
1.3× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$350.40 |
$584 |
3.2× |
| Radex hip unilateral with pelvis 1 view (73501) |
$169.80 |
$283 |
1.8× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$143.40 |
$239 |
1.6× |
| Radex hips bilateral with pelvis 2 views (73521) |
$183.60 |
$306 |
1.7× |
| Radex spine cervical 2 or 3 views (72040) |
$240 |
$400 |
2.6× |
| Radex spine cervical 4 or 5 views (72050) |
$360 |
$600 |
3.3× |
| Radex spine cervical 6 or more views (72052) |
$348.60 |
$581 |
3.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$117.60 |
$196 |
1.3× |
| Radiologic exam abdomen 3+ views (74021) |
$333.60 |
$556 |
3.0× |
| Radiologic exam chest 3 views (71047) |
$108 |
$180 |
1.2× |
| Radiologic exam chest 4+ views (71048) |
$235.20 |
$392 |
2.1× |
| Radiologic exam colon double contrast study (74280) |
$384.60 |
$641 |
2.1× |
| Radiologic exam colon single contrast study (74270) |
$288 |
$480 |
1.6× |
| Radiologic exam esophagus single contrast study (74220) |
$184.20 |
$307 |
1.0× |
| Radiologic exam small int single contrast study (74250) |
$227.40 |
$379 |
1.2× |
| Radiologic exam swallow function contrast study (74230) |
$144 |
$240 |
0.8× |
| Radiologic exam upr gi trc double contrast study (74246) |
$174.60 |
$291 |
0.9× |
| Radiologic exam upr gi trc single contrast study (74240) |
$193.80 |
$323 |
1.0× |
| Radiologic examination femur 1 view (73551) |
$103.20 |
$172 |
1.1× |
| Radiologic examination femur minimum 2 views (73552) |
$96.60 |
$161 |
1.1× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$107.40 |
$179 |
1.2× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$345 |
$575 |
3.8× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$452.40 |
$754 |
4.1× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$263.40 |
$439 |
2.9× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$219.60 |
$366 |
2.4× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$324.60 |
$541 |
3.5× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$222 |
$370 |
2.4× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$225 |
$375 |
2.5× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$452.40 |
$754 |
4.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$267 |
$445 |
2.4× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$205.80 |
$343 |
2.2× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$552 |
$920 |
5.0× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$330.60 |
$551 |
3.0× |
| Radiologic examination, salivary gland for calculus Age Under 21 (70380) |
$136.80 |
$228 |
1.5× |
| Radiologic examination, shoulder, arthrography, radiological supervision and interpretation Age Under 21 (73040) |
$320.40 |
$534 |
0.9× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$316.80 |
$528 |
3.5× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$123.60 |
$206 |
1.3× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$140.40 |
$234 |
1.3× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$369 |
$615 |
3.3× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$391.20 |
$652 |
3.5× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$273.60 |
$456 |
3.0× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$159 |
$265 |
1.7× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$250.20 |
$417 |
2.7× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$91.20 |
$152 |
1.0× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$130.80 |
$218 |
1.2× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Age Under 21 (70370) |
$70.80 |
$118 |
0.8× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$129.60 |
$216 |
1.4× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$205.20 |
$342 |
2.2× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$149.40 |
$249 |
1.4× |
| Saline infusion sonohysterography (SIS), including color flow Doppler, when performed Age Under 21 (76831) |
$319.80 |
$533 |
1.3× |
| Scapula complete (73010) |
$233.40 |
$389 |
2.1× |
| Screening digital breast tomosynthesis bi (77063) |
$44.40 |
$74 |
— |
| Thyroid uptake w/blood flow sngle/mult quan meas (78014) |
$746.40 |
$1,244 |
1.8× |
| Ultrasound breast limited (76642) |
$658.20 |
$1,097 |
7.2× |
| Ultrasound, abdomen limited (76705) |
$631.20 |
$1,052 |
5.7× |
| Ultrasound, limited, joint or focal evaluation of other nonvascular extremity structure(s) (eg, joint space,… (76882) |
$228.60 |
$381 |
2.1× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$1,114.20 |
$1,857 |
10.1× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation plus detailed fetal… (76811) |
$731.40 |
$1,219 |
2.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$595.50 |
$992.50 |
5.4× |
| Ultrasound, transplanted kidney, real time and duplex Doppler with image documentation Age Under 21 (76776) |
$255 |
$425 |
2.3× |
| Umbilical-artery Doppler (OB) (76820) |
$172.80 |
$288 |
1.6× |
| Ureteral reflux study (78740) |
$612.60 |
$1,021 |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$346.80 |
$578 |
1.4× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$312.60 |
$521 |
1.7× |
| Us abdominal aorta real time screen study aaa (76706) |
$184.20 |
$307 |
1.7× |
| Us breast uni real time with image complete (76641) |
$409.80 |
$683 |
3.7× |
| Us chest (76604) |
$285.60 |
$476 |
2.6× |
| Us compl joint r-t w/image documentation (76881) |
$589.80 |
$983 |
5.3× |
| Us exam, pelvic, limited (76857) |
$556.80 |
$928 |
5.0× |
| US OB Follow-Up/Repeat (76816) |
$925.20 |
$1,542 |
8.4× |
| Us ob transvaginal (76817) |
$270.60 |
$451 |
2.5× |
| Us retroperitoneal complete (76770) |
$396 |
$660 |
3.6× |
| Us retroperitoneal ltd (76775) |
$515.40 |
$859 |
4.7× |
| Us scrotum (76870) |
$693 |
$1,155 |
6.3× |
| Us soft tissue head/neck (76536) |
$852.60 |
$1,421 |
7.7× |
| X-ray exam hips bi 3-4 views (73522) |
$228.60 |
$381 |
2.1× |
| X-ray exam of finger(s) (73140) |
$172.20 |
$287 |
1.9× |
| X-ray exam of knee 1 or 2 (73560) |
$204 |
$340 |
2.2× |
| X-ray exam ribs bil 3 views (71110) |
$474.60 |
$791 |
4.3× |
| X-ray exam ribs uni 2 views (71100) |
$352.80 |
$588 |
3.8× |
| X-ray heel (73650) |
$267 |
$445 |
2.9× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$168.60 |
$281 |
1.5× |
| X-ray retrograde pyelogram (74420) |
$416.40 |
$694 |
1.1× |
| Xr abdomen 1 view (74018) |
$172.80 |
$288 |
1.9× |
| Xr arthrogram ankle (73615) |
$175.20 |
$292 |
0.5× |
| Xr arthrogram elbow (73085) |
$323.40 |
$539 |
0.9× |
| Xr arthrogram hip (73525) |
$678 |
$1,130 |
1.8× |
| Xr arthrogram knee (73580) |
$385.20 |
$642 |
1.0× |
| Xr arthrogram wrist (73115) |
$178.20 |
$297 |
0.5× |
| Xr bone age studies (77072) |
$121.20 |
$202 |
1.1× |
| Xr bone length study (77073) |
$131.40 |
$219 |
1.2× |
| Xr bone survey ltd (77074) |
$122.40 |
$204 |
1.1× |
| Xr chest 1 view (71045) |
$97.20 |
$162 |
1.1× |
| Xr chest 2 views (71046) |
$320.40 |
$534 |
3.5× |
| Xr eye foreign body (70030) |
$78 |
$130 |
0.8× |
| Xr facial bones 3+ views (70150) |
$340.20 |
$567 |
3.1× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$195 |
$325 |
2.1× |
| Xr forearm 2 views (73090) |
$300.60 |
$501 |
3.3× |
| Xr hand 2v (73120) |
$168.60 |
$281 |
1.5× |
| Xr hysterosalpingogram (74740) |
$249.60 |
$416 |
1.0× |
| Xr neck soft tissue (70360) |
$206.40 |
$344 |
2.2× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$211.20 |
$352 |
2.3× |
| Xr osseous survey complete (77075) |
$397.80 |
$663 |
3.6× |
| Xr pelvis 1-2 views (72170) |
$123 |
$205 |
1.1× |
| Xr sacrum/coccyx 2+ views (72220) |
$141 |
$235 |
1.5× |
| Xr sella turcica (70240) |
$111.60 |
$186 |
1.2× |
| Xr shoulder 1 view (73020) |
$130.20 |
$217 |
1.4× |
| Xr sinuses 3+ views (70220) |
$393.60 |
$656 |
4.3× |
| Xr skull min 4 view (70260) |
$219 |
$365 |
2.0× |
| Xr spine 1 view (72020) |
$97.80 |
$163 |
1.1× |
| Xr spine thoracic 3v (72072) |
$258.60 |
$431 |
2.3× |
| Xr sternum 2+ views (71120) |
$263.40 |
$439 |
2.9× |
| Xr t-spine 2 views (72070) |
$187.80 |
$313 |
1.7× |
| Xr tibia/fibula 2 views (73590) |
$386.40 |
$644 |
4.2× |
| Xr tmj bilateral (70330) |
$274.80 |
$458 |
3.0× |
| Xr wrist 2 views (73100) |
$145.20 |
$242 |
1.6× |