| Ankle 2 views (73600) |
$268.02 |
$412.34 |
2.9× |
| Cephalogram, orthodontic Age Under 21 (70350) |
$13.88 |
$21.35 |
0.2× |
| Cisternography, positive contrast, radiological supervision and interpretation Age Under 21 (70015) |
$89.57 |
$137.80 |
0.1× |
| Clavicle complete (73000) |
$143.88 |
$221.36 |
1.6× |
| Complex dynamic pharyngeal and speech evaluation by cine or video recording Age Under 21 (70371) |
$66.84 |
$102.83 |
0.3× |
| Computed tomographic angiography, abdomen and pelvis, with contrast material(s), including noncontrast images, if… (74174) |
$2,199.79 |
$3,384.30 |
6.0× |
| Computed tomographic angiography, abdomen, with contrast material(s), including noncontrast images, if performed, and… (74175) |
$2,068.76 |
$3,182.70 |
11.2× |
| Computed tomographic angiography, abdominal aorta and bilateral iliofemoral lower extremity runoff, with contrast… (75635) |
$1,972.76 |
$3,035 |
10.7× |
| Computed tomographic angiography, chest (noncoronary), with contrast material(s), including noncontrast images, if… (71275) |
$1,405.14 |
$2,161.76 |
7.6× |
| Computed tomographic angiography, lower extremity, with contrast material(s), including noncontrast images, if… (73706) |
$2,752.24 |
$4,234.22 |
14.9× |
| Computed tomographic angiography, neck, with contrast material(s), including noncontrast images, if performed, and… (70498) |
$131.07 |
$201.65 |
0.7× |
| Computed tomographic angiography, pelvis, with contrast material(s), including noncontrast images, if performed, and… (72191) |
$2,210.88 |
$3,401.36 |
11.9× |
| Computed tomographic angiography, upper extremity, with contrast material(s), including noncontrast images, if… (73206) |
$1,700.48 |
$2,616.13 |
9.2× |
| Computed tomography, cervical spine; without contrast material, followed by contrast material(s) and further sections… (72127) |
$680.21 |
$1,046.48 |
3.7× |
| Computed tomography, lower extremity; without contrast material Age Under 21 (73700) |
$865.36 |
$1,331.32 |
7.8× |
| Computed tomography, lower extremity; without contrast material, followed by contrast material(s) and further sections… (73702) |
$1,967.67 |
$3,027.19 |
10.6× |
| Computed tomography, lumbar spine; without contrast material, followed by contrast material(s) and further sections Age… (72133) |
$1,155.80 |
$1,778.16 |
6.2× |
| Computed tomography, maxillofacial area; with contrast material(s) Age Under 21 (70487) |
$1,062.90 |
$1,635.24 |
5.7× |
| Computed tomography, maxillofacial area; without contrast material Age Under 21 (70486) |
$693.07 |
$1,066.26 |
6.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; with contrast material(s) Age… (70481) |
$972.74 |
$1,496.52 |
5.3× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material Age… (70480) |
$1,593.22 |
$2,451.10 |
14.4× |
| Computed tomography, orbit, sella, or posterior fossa or outer, middle, or inner ear; without contrast material,… (70482) |
$989.30 |
$1,522.01 |
5.3× |
| Computed tomography, soft tissue neck; without contrast material followed by contrast material(s) and further sections… (70492) |
$1,060.28 |
$1,631.21 |
5.7× |
| Computed tomography, thoracic spine; without contrast material, followed by contrast material(s) and further sections… (72130) |
$680.49 |
$1,046.90 |
3.7× |
| Computed tomography, thorax, diagnostic; without contrast material, followed by contrast material(s) and further… (71270) |
$822.70 |
$1,265.68 |
4.4× |
| CT abdomen and pelvis without and with contrast (74178) |
$2,000.36 |
$3,077.48 |
5.4× |
| CT abdomen and pelvis without contrast (74176) |
$1,550.15 |
$2,384.84 |
6.2× |
| CT abdomen w & w/o contrast (74170) |
$1,384.86 |
$2,130.56 |
7.5× |
| CT abdomen w/contrast (74160) |
$1,308.44 |
$2,012.97 |
7.1× |
| CT abdomen w/o contrast (74150) |
$1,737.17 |
$2,672.57 |
15.8× |
| CT cervical spine w/contrast (72126) |
$1,283.28 |
$1,974.29 |
3.5× |
| CT cervical spine w/o contrast (72125) |
$1,007.42 |
$1,549.88 |
9.1× |
| CT chest w/contrast (71260) |
$1,094.88 |
$1,684.43 |
5.9× |
| CT extremity upper w & w/o contrast (73202) |
$1,549.77 |
$2,384.26 |
8.4× |
| CT extremity upper w/o contrast (73200) |
$883.17 |
$1,358.72 |
8.0× |
| CT head/brain with contrast (70460) |
$1,085.80 |
$1,670.47 |
5.9× |
| CT head/brain without and with contrast (70470) |
$1,891.18 |
$2,909.50 |
10.2× |
| CT l-spine w/contrast (72132) |
$1,003.30 |
$1,543.54 |
2.7× |
| CT lower extremity w/dye (73701) |
$1,005.30 |
$1,546.62 |
5.4× |
| CT lumbar spine w/o contrast (72131) |
$907.58 |
$1,396.28 |
8.2× |
| CT maxillofacial w/wo contrast (70488) |
$989.30 |
$1,522.01 |
5.3× |
| CT neck w/contrast (70491) |
$1,059.42 |
$1,629.88 |
5.7× |
| CT neck w/o contrast (70490) |
$979.64 |
$1,507.12 |
8.9× |
| CT pelvis w & w/o contrast (72194) |
$1,189.51 |
$1,830.01 |
6.4× |
| CT pelvis w/o contrast (72192) |
$925.82 |
$1,424.34 |
8.4× |
| CT thoracic spine w/contrast (72129) |
$875.63 |
$1,347.12 |
4.7× |
| CT thoracic spine w/o contrast (72128) |
$990.76 |
$1,524.24 |
9.0× |
| CT thorax lung cancer scr c- (71271) |
$125.72 |
$193.41 |
1.1× |
| CT thorax w/o contrast (71250) |
$812.74 |
$1,250.37 |
7.4× |
| CT upper extremity w/dye (73201) |
$1,107.01 |
$1,703.09 |
3.0× |
| CTA head w contrast (70496) |
$1,495.06 |
$2,300.08 |
8.1× |
| Dacryocystography, nasolacrimal duct, radiological supervision and interpretation Age Under 21 (70170) |
$22.85 |
$35.15 |
0.1× |
| Dual-energy X-ray absorptiometry (DXA), bone density study, 1 or more sites; axial skeleton (eg, hips, pelvis, spine)… (77080) |
$214.14 |
$329.45 |
1.9× |
| Fluoroscopy up to 1 hour physician/qhp time (76000) |
$490.24 |
$754.22 |
1.9× |
| Full mouth X-ray of teeth (70320) |
$17.63 |
$27.13 |
0.1× |
| Magnetic resonance (eg, proton) imaging, any joint of lower extremity; without contrast material(s), followed by… (73723) |
$3,698.45 |
$5,689.93 |
10.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; with contrast material(s) Age Under 21 (73719) |
$1,960.34 |
$3,015.90 |
5.3× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s) Age Under 21 (73718) |
$1,265.82 |
$1,947.41 |
5.0× |
| Magnetic resonance (eg, proton) imaging, lower extremity other than joint; without contrast material(s), followed by… (73720) |
$1,840.38 |
$2,831.34 |
5.0× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s) Age Under 21 (70542) |
$1,212.46 |
$1,865.32 |
3.3× |
| Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) Age Under 21 (70540) |
$2,153.28 |
$3,312.74 |
8.6× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Age Under 21 (73219) |
$1,903.60 |
$2,928.62 |
5.2× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$3,508.77 |
$5,398.11 |
9.5× |
| Magnetic resonance angiography, head; with contrast material(s) Age Under 21 (70545) |
$1,196.47 |
$1,840.72 |
3.3× |
| Magnetic resonance angiography, head; without contrast material(s), followed by contrast material(s) and further… (70546) |
$1,868.60 |
$2,874.78 |
5.1× |
| Magnetic resonance angiography, neck; without contrast material(s), followed by contrast material(s) and further… (70549) |
$1,852.70 |
$2,850.32 |
5.0× |
| Magnetic resonance imaging, brain, functional MRI; including test selection and administration of repetitive body part… (70554) |
$1,071.53 |
$1,648.50 |
4.3× |
| Magnetic resonance imaging, brain, functional MRI; requiring physician or psychologist administration of entire… (70555) |
$187.84 |
$288.98 |
0.7× |
| Mandible min 4v (70110) |
$353.08 |
$543.20 |
3.2× |
| MRA head w/o contrast (70544) |
$1,306.49 |
$2,009.98 |
5.2× |
| MRA neck w/ contrast (70548) |
$2,005.86 |
$3,085.94 |
5.5× |
| MRA neck w/o contrast (70547) |
$1,732.09 |
$2,664.76 |
6.9× |
| MRI abdomen w/contrast (74182) |
$3,110.45 |
$4,785.30 |
8.5× |
| MRI abdomen w/o contrast (74181) |
$2,812.56 |
$4,327.02 |
11.2× |
| MRI abdomen w/wo contrast (74183) |
$3,140.36 |
$4,831.32 |
8.5× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,960.34 |
$3,015.90 |
2.4× |
| MRI brain w/dye (70558) |
$266.29 |
$409.68 |
1.4× |
| MRI brain w/o & w/dye (70559) |
$250.35 |
$385.15 |
1.4× |
| MRI brain w/o dye (70557) |
$240.66 |
$370.25 |
0.4× |
| MRI c-spine w&w/o cont (72156) |
$1,688.90 |
$2,598.30 |
4.6× |
| MRI cervical spine w/contrast (72142) |
$1,219.28 |
$1,875.82 |
3.3× |
| MRI chest w/contrast (71551) |
$1,475.60 |
$2,270.15 |
1.8× |
| MRI chest w/o contrast (71550) |
$1,124.35 |
$1,729.76 |
4.5× |
| MRI chest w/wo contrast (71552) |
$1,537.40 |
$2,365.24 |
4.2× |
| MRI joint upr extr w/o&w/dye (73223) |
$2,204.20 |
$3,391.08 |
6.0× |
| MRI joint upr extrem w/dye (73222) |
$2,370.51 |
$3,646.94 |
2.9× |
| MRI joint upr extrem w/o dye (73221) |
$1,067.56 |
$1,642.39 |
4.2× |
| MRI lumbar spine w/contrast (72149) |
$1,219 |
$1,875.40 |
3.3× |
| MRI lumbar spine w/wo contrast (72158) |
$1,824.47 |
$2,806.88 |
5.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,785.60 |
$2,747.08 |
4.9× |
| MRI pelvis w & w/o contrast (72197) |
$3,979.57 |
$6,122.41 |
10.8× |
| MRI pelvis w/contrast (72196) |
$2,920.22 |
$4,492.64 |
7.9× |
| MRI pelvis w/o contrast (72195) |
$3,451 |
$5,309.23 |
13.7× |
| MRI spine cervical w/o contrast (72141) |
$1,200.50 |
$1,846.92 |
4.8× |
| MRI t-spine w&w/o cont (72157) |
$1,773.85 |
$2,729 |
4.8× |
| MRI thoracic spine w/contrast (72147) |
$1,218.58 |
$1,874.73 |
3.3× |
| MRI thoracic spine w/o contrst (72146) |
$1,306.86 |
$2,010.56 |
5.2× |
| MRI tmj (70336) |
$1,081.44 |
$1,663.76 |
4.3× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$2,572.40 |
$3,957.53 |
10.2× |
| Ob us limited fetus(s) (76815) |
$300.14 |
$461.75 |
2.7× |
| Optic foramina (70190) |
$17.10 |
$26.30 |
0.2× |
| Panoramic X-ray of jaws (70355) |
$16.01 |
$24.63 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 1 vw (72081) |
$196.06 |
$301.62 |
2.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$23.94 |
$36.83 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 4/5 vw (72083) |
$27.29 |
$41.98 |
0.2× |
| Radex entir thrc lmbr crv sac spi w/skull 6/> vw (72084) |
$32 |
$49.23 |
0.3× |
| Radex hip unilateral with pelvis 1 view (73501) |
$14.40 |
$22.15 |
0.2× |
| Radex hip unilateral with pelvis 2-3 views (73502) |
$346.54 |
$533.14 |
3.8× |
| Radex spine cervical 2 or 3 views (72040) |
$204.48 |
$314.59 |
2.2× |
| Radex spine cervical 4 or 5 views (72050) |
$267.80 |
$412 |
2.4× |
| Radex spine cervical 6 or more views (72052) |
$22.85 |
$35.15 |
0.2× |
| Radex spine thoracolumbar junction min 2 views (72080) |
$168.70 |
$259.54 |
1.8× |
| Radiologic exam chest 3 views (71047) |
$227.42 |
$349.88 |
2.5× |
| Radiologic exam chest 4+ views (71048) |
$23.50 |
$36.15 |
0.2× |
| Radiologic exam esophagus single contrast study (74220) |
$499.19 |
$767.98 |
2.7× |
| Radiologic exam small int single contrast study (74250) |
$786.17 |
$1,209.49 |
4.2× |
| Radiologic exam upr gi trc double contrast study (74246) |
$672.46 |
$1,034.56 |
3.6× |
| Radiologic examination femur 1 view (73551) |
$217.36 |
$334.40 |
2.4× |
| Radiologic examination femur minimum 2 views (73552) |
$177.42 |
$272.94 |
1.9× |
| Radiologic examination from nose to rectum for foreign body, single view, child Age Under 21 (76010) |
$375.29 |
$577.37 |
4.1× |
| Radiologic examination, ankle; complete, minimum of 3 views Age Under 21 (73610) |
$172.54 |
$265.46 |
1.9× |
| Radiologic examination, complete acute abdomen series, including 2 or more views of the abdomen (eg, supine, erect,… (74022) |
$256 |
$393.85 |
2.3× |
| Radiologic examination, elbow; 2 views Age Under 21 (73070) |
$246 |
$378.46 |
2.7× |
| Radiologic examination, elbow; complete, minimum of 3 views Age Under 21 (73080) |
$176.33 |
$271.28 |
1.9× |
| Radiologic examination, facial bones; less than 3 views Age Under 21 (70140) |
$158.45 |
$243.77 |
1.7× |
| Radiologic examination, foot; complete, minimum of 3 views Age Under 21 (73630) |
$165.52 |
$254.65 |
1.8× |
| Radiologic examination, hand; minimum of 3 views Age Under 21 (73130) |
$167.44 |
$257.61 |
1.8× |
| Radiologic examination, internal auditory meati, complete Age Under 21 (70134) |
$139.38 |
$214.44 |
0.2× |
| Radiologic examination, knee; both knees, standing, anteroposterior Age Under 21 (73565) |
$147.55 |
$227 |
1.6× |
| Radiologic examination, knee; complete, 4 or more views Age Under 21 (73564) |
$396.36 |
$609.79 |
3.6× |
| Radiologic examination, mandible; partial, less than 4 views Age Under 21 (70100) |
$214.46 |
$329.94 |
2.3× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Age Under 21 (70130) |
$88.72 |
$136.50 |
0.8× |
| Radiologic examination, mastoids; less than 3 views per side Age Under 21 (70120) |
$82.61 |
$127.09 |
0.7× |
| Radiologic examination, nasal bones, complete, minimum of 3 views Age Under 21 (70160) |
$157.96 |
$243.02 |
1.7× |
| Radiologic examination, pharynx and/or cervical esophagus, including scout neck radiograph(s) and delayed image(s),… (74210) |
$406.98 |
$626.13 |
2.2× |
| Radiologic examination, ribs, bilateral; including posteroanterior chest, minimum of 4 views Age Under 21 (71111) |
$282.10 |
$434 |
2.6× |
| Radiologic examination, ribs, unilateral; including posteroanterior chest, minimum of 3 views Age Under 21 (71101) |
$460.71 |
$708.78 |
4.2× |
| Radiologic examination, sacroiliac joints; less than 3 views Age Under 21 (72200) |
$336.10 |
$517.07 |
3.0× |
| Radiologic examination, salivary gland for calculus Age Under 21 (70380) |
$12.76 |
$19.63 |
0.1× |
| Radiologic examination, shoulder; complete, minimum of 2 views Age Under 21 (73030) |
$169.75 |
$261.15 |
1.8× |
| Radiologic examination, sinuses, paranasal, less than 3 views Age Under 21 (70210) |
$116.34 |
$178.98 |
1.3× |
| Radiologic examination, skull; less than 4 views Age Under 21 (70250) |
$192.80 |
$296.60 |
1.7× |
| Radiologic examination, spine, lumbosacral; 2 or 3 views Age Under 21 (72100) |
$370.50 |
$570 |
3.4× |
| Radiologic examination, spine, lumbosacral; bending views only, 2 or 3 views Age Under 21 (72120) |
$145.30 |
$223.54 |
1.3× |
| Radiologic examination, spine, lumbosacral; complete, including bending views, minimum of 6 views Age Under 21 (72114) |
$23.40 |
$36 |
0.2× |
| Radiologic examination, spine; thoracic, minimum of 4 views Age Under 21 (72074) |
$206.22 |
$317.26 |
1.9× |
| Radiologic examination, teeth; partial examination, less than full mouth Age Under 21 (70310) |
$12.79 |
$19.68 |
0.1× |
| Radiologic examination, teeth; single view Age Under 21 (70300) |
$7.95 |
$12.23 |
0.1× |
| Radiologic examination, wrist; complete, minimum of 3 views Age Under 21 (73110) |
$165.17 |
$254.11 |
1.8× |
| Radiologic examination; acromioclavicular joints, bilateral, with or without weighted distraction Age Under 21 (73050) |
$132.26 |
$203.48 |
1.4× |
| Radiologic examination; humerus, minimum of 2 views Age Under 21 (73060) |
$177.02 |
$272.34 |
1.9× |
| Radiologic examination; lower extremity, infant, minimum of 2 views Age Under 21 (73592) |
$151.37 |
$232.88 |
1.6× |
| Radiologic examination; orbits, complete, minimum of 4 views Age Under 21 (70200) |
$101.42 |
$156.04 |
0.9× |
| Radiologic examination; pharynx or larynx, including fluoroscopy and/or magnification technique Age Under 21 (70370) |
$23.92 |
$36.80 |
0.3× |
| Radiologic examination; sternoclavicular joint or joints, minimum of 3 views Age Under 21 (71130) |
$116.84 |
$179.76 |
1.3× |
| Radiologic examination; toe(s), minimum of 2 views Age Under 21 (73660) |
$144 |
$221.54 |
1.6× |
| Radiologic examination; upper extremity, infant, minimum of 2 views Age Under 21 (73092) |
$167.72 |
$258.03 |
1.5× |
| Scapula complete (73010) |
$339.72 |
$522.64 |
3.1× |
| Screening digital breast tomosynthesis bi (77063) |
$45.27 |
$69.65 |
— |
| Temporomandibular joint arthrography, radiological supervision and interpretation Age Under 21 (70332) |
$40.98 |
$63.05 |
0.2× |
| Ultrasound breast limited (76642) |
$110.58 |
$170.13 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$301.76 |
$464.26 |
2.7× |
| Ultrasound, pelvic (nonobstetric), real time with image documentation; complete Age Under 21 (76856) |
$646.33 |
$994.35 |
5.9× |
| Ultrasound, pregnant uterus, real time with image documentation, fetal and maternal evaluation, first trimester (< 14… (76801) |
$501.44 |
$771.44 |
4.5× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography Age Under 21 (74400) |
$574 |
$883.08 |
3.1× |
| Us compl joint r-t w/image documentation (76881) |
$505.89 |
$778.29 |
4.6× |
| Us encephalogram (76506) |
$574 |
$883.08 |
5.2× |
| Us exam, pelvic, limited (76857) |
$355.42 |
$546.80 |
3.2× |
| Us retroperitoneal complete (76770) |
$657.07 |
$1,010.87 |
6.0× |
| Us scrotum (76870) |
$597.12 |
$918.64 |
5.4× |
| Us soft tissue head/neck (76536) |
$558.05 |
$858.54 |
5.1× |
| X-ray exam hips bi 3-4 views (73522) |
$369.65 |
$568.70 |
3.4× |
| X-ray exam of finger(s) (73140) |
$141.68 |
$217.98 |
1.5× |
| X-ray exam of knee 1 or 2 (73560) |
$164.39 |
$252.91 |
1.8× |
| X-ray exam ribs bil 3 views (71110) |
$185.58 |
$285.50 |
1.7× |
| X-ray exam ribs uni 2 views (71100) |
$17.08 |
$26.28 |
0.2× |
| X-ray heel (73650) |
$144.92 |
$222.94 |
1.6× |
| X-ray of joint between lower spine and hip bone 3 or more views|PROFESSIONAL COMPONENT (72202) |
$195.40 |
$300.62 |
1.8× |
| Xr abdomen 1 view (74018) |
$143.73 |
$221.12 |
1.6× |
| Xr abdomen 2 views (74019) |
$196.71 |
$302.64 |
1.8× |
| Xr bone age studies (77072) |
$150.74 |
$231.90 |
1.4× |
| Xr bone length study (77073) |
$320.62 |
$493.27 |
2.9× |
| Xr chest 1 view (71045) |
$200.85 |
$309 |
2.2× |
| Xr chest 2 views (71046) |
$169.20 |
$260.30 |
1.8× |
| Xr eye foreign body (70030) |
$13.85 |
$21.30 |
0.2× |
| Xr facial bones 3+ views (70150) |
$163.79 |
$251.98 |
1.5× |
| Xr foot arthritis pa only bilateral - report(ortho pro) (73620) |
$118.48 |
$182.26 |
1.3× |
| Xr forearm 2 views (73090) |
$171.42 |
$263.72 |
1.9× |
| Xr hand 2v (73120) |
$294.97 |
$453.80 |
2.7× |
| Xr neck soft tissue (70360) |
$206.94 |
$318.36 |
2.3× |
| Xr o knee w/ merchant view bilat - report(ortho pro) (73562) |
$182.32 |
$280.50 |
2.0× |
| Xr pelvis 1-2 views (72170) |
$153.08 |
$235.51 |
1.4× |
| Xr pelvis min 3 view (72190) |
$311.02 |
$478.48 |
2.8× |
| Xr sacrum/coccyx 2+ views (72220) |
$201.93 |
$310.66 |
2.2× |
| Xr sella turcica (70240) |
$82.88 |
$127.50 |
0.9× |
| Xr shoulder 1 view (73020) |
$231.47 |
$356.10 |
2.5× |
| Xr sialogram (70390) |
$28.75 |
$44.23 |
0.1× |
| Xr sinuses 3+ views (70220) |
$207.90 |
$319.84 |
2.3× |
| Xr skull min 4 view (70260) |
$156.99 |
$241.52 |
1.4× |
| Xr spine 1 view (72020) |
$189.20 |
$291.08 |
2.1× |
| Xr spine thoracic 3v (72072) |
$213.86 |
$329.01 |
1.9× |
| Xr sternum 2+ views (71120) |
$116 |
$178.47 |
1.3× |
| Xr t-spine 2 views (72070) |
$206.24 |
$317.28 |
1.9× |
| Xr tibia/fibula 2 views (73590) |
$179.88 |
$276.74 |
2.0× |
| Xr tmj bilateral (70330) |
$141.14 |
$217.14 |
1.5× |
| Xr tmj unilateral (70328) |
$139 |
$213.84 |
1.5× |
| Xr wrist 2 views (73100) |
$133.74 |
$205.76 |
1.5× |