| 3-D radiotherapy plan dose-volume histograms (77295) |
$2,085 |
$3,475 |
1.7× |
| Abdomen 2 views (74019) |
$154.80 |
$258 |
1.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$441.60 |
$736 |
1.3× |
| Angiography extremity bilateral rs&i (75716) |
$2,212.20 |
$3,687 |
0.8× |
| Angiography extremity unilateral rs&i (75710) |
$2,520 |
$4,200 |
0.9× |
| Ankle 2 views (73600) |
$111 |
$185 |
1.5× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$1,890.30 |
$3,150.50 |
0.7× |
| Aortography abdominal serialography rs&i (75625) |
$2,520 |
$4,200 |
0.9× |
| Arthrogram hip (73525) |
$470.40 |
$784 |
1.6× |
| Arthrogram shoulder (73040) |
$360 |
$600 |
1.2× |
| Basic radiation dosimetry calculation (77300) |
$270 |
$450 |
2.3× |
| Bone &/Joint Imaging Limited Area (78300) |
$218.70 |
$364.50 |
0.6× |
| Bone &/joint imaging whole body (78306) |
$370.20 |
$617 |
1.1× |
| Bone age studies (77072) |
$158.40 |
$264 |
1.8× |
| Bone Imaging 3 Phase (78315) |
$471.30 |
$785.50 |
1.4× |
| Bone Marrow Imaging Limited Area (78102) |
$306 |
$510 |
0.9× |
| Bone survey complete (77075) |
$340.80 |
$568 |
3.8× |
| Brain Imaging Pet Metabolic Evaluation (78608) |
$2,172 |
$3,620 |
1.8× |
| Cervical spine 2 or 3 views (72040) |
$169.50 |
$282.50 |
2.3× |
| Chest 1 view (71045) |
$68.40 |
$114 |
0.9× |
| Chest 3 views (71047) |
$108.30 |
$180.50 |
1.4× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$360.60 |
$601 |
2.4× |
| Clavicle complete (73000) |
$108.90 |
$181.50 |
1.5× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$133.80 |
$223 |
1.5× |
| Continuing medical physics consltj pr wk (77336) |
$298.65 |
$497.75 |
2.6× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,460.10 |
$2,433.50 |
4.9× |
| CT abdomen and pelvis without contrast (74176) |
$1,243.50 |
$2,072.50 |
6.0× |
| CT abdomen w contrast (74160) |
$757.20 |
$1,262 |
5.0× |
| CT abdomen w wo contrast (74170) |
$793.20 |
$1,322 |
5.2× |
| CT abdomen w/o contrast (74150) |
$666.90 |
$1,111.50 |
7.4× |
| CT angio hrt w/3d image (75574) |
$561 |
$935 |
1.9× |
| CT angiography upper extremity lt (73206) |
$1,001.10 |
$1,668.50 |
6.6× |
| CT c-spine w/o contrast (72125) |
$630.90 |
$1,051.50 |
7.0× |
| CT cervical spine w&w/o contrast (72127) |
$793.20 |
$1,322 |
5.2× |
| CT cervical spine with contrast (72126) |
$660 |
$1,100 |
2.2× |
| CT chest w/wo contrast (71270) |
$885.30 |
$1,475.50 |
5.9× |
| CT chest with contrast (71260) |
$666.90 |
$1,111.50 |
4.4× |
| CT head/brain with contrast (70460) |
$685.20 |
$1,142 |
4.5× |
| CT head/brain without and with contrast (70470) |
$858 |
$1,430 |
5.7× |
| CT heart no contrast quant eval coronry calcium (75571) |
$59.40 |
$99 |
0.8× |
| CT iac w contrast (70481) |
$685.20 |
$1,142 |
4.5× |
| CT lower ext w/o (73700) |
$353.40 |
$589 |
3.9× |
| CT lower extremity w wo contrast (73702) |
$396 |
$660 |
2.6× |
| CT lower extremity with contrast (73701) |
$334.80 |
$558 |
2.2× |
| CT lumbar spine w & w/o contrast (72133) |
$924 |
$1,540 |
6.1× |
| CT lumbar spine w/o contrast (72131) |
$594.90 |
$991.50 |
6.6× |
| CT lumbar spine with contrast (72132) |
$369 |
$615 |
1.2× |
| CT maxillofacial w contrast (70487) |
$685.20 |
$1,142 |
4.5× |
| CT maxillofacial w/o contrast (70486) |
$492 |
$820 |
5.5× |
| CT neck soft tissue w contrast (70491) |
$666.90 |
$1,111.50 |
4.4× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$726 |
$1,210 |
4.8× |
| CT orbits w/o contrast (70480) |
$492 |
$820 |
5.5× |
| CT pelvis w & w/o contrast (72194) |
$900 |
$1,500 |
6.0× |
| CT pelvis w/o contrast (72192) |
$576.60 |
$961 |
6.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$726 |
$1,210 |
4.8× |
| CT soft tissue neck w/o contrast (70490) |
$639.60 |
$1,066 |
7.1× |
| CT thoracic spine w/contrast (72129) |
$230.40 |
$384 |
1.5× |
| CT thoracic spine w/o contrast (72128) |
$594.90 |
$991.50 |
6.6× |
| CT thoracic spine w/wo contrast (72130) |
$223.80 |
$373 |
1.5× |
| CT thorax w/o contrast (71250) |
$612.90 |
$1,021.50 |
6.8× |
| CT upper extremity w/o contrast rt (73200) |
$342.60 |
$571 |
3.8× |
| CT upper extremity with contrast (73201) |
$470.40 |
$784 |
1.6× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$1,050 |
$1,750 |
6.9× |
| Cta Abdomen (74175) |
$1,126.80 |
$1,878 |
7.5× |
| CTA abdomen pelvis (74174) |
$1,126.80 |
$1,878 |
3.7× |
| CTA chest (71275) |
$612.90 |
$1,021.50 |
4.1× |
| Cta Head (70496) |
$1,047.60 |
$1,746 |
6.9× |
| CTA lwr ext w&w/o contrast (73706) |
$1,045.50 |
$1,742.50 |
6.9× |
| Cta Neck (70498) |
$1,118.10 |
$1,863.50 |
7.4× |
| Cystography minimum 3 views rs&i (74430) |
$579 |
$965 |
1.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$218.70 |
$364.50 |
2.4× |
| Echoencephalography real time imaging (76506) |
$149.70 |
$249.50 |
1.7× |
| Esophagus (74220) |
$188.70 |
$314.50 |
1.2× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$325.20 |
$542 |
3.6× |
| Fluoroscopy up to 1 hr (76000) |
$168.30 |
$280.50 |
0.8× |
| Foot 2 views (73620) |
$111 |
$185 |
1.5× |
| Forearm 2 views (73090) |
$73.50 |
$122.50 |
1.0× |
| Gated Heart Planar Single (78472) |
$560.10 |
$933.50 |
1.6× |
| Hand 2 views (73120) |
$136.80 |
$228 |
1.5× |
| Hand 3 views (73130) |
$81.90 |
$136.50 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$476.40 |
$794 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$389.40 |
$649 |
1.1× |
| Ht muscle image spect sing (78451) |
$1,020 |
$1,700 |
0.9× |
| Humerus Min 2 Views Left (73060) |
$81.90 |
$136.50 |
1.1× |
| Hysterosalpingogram (74740) |
$298.20 |
$497 |
1.4× |
| Image fusion (77399) |
$113.10 |
$188.50 |
1.0× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$312.30 |
$520.50 |
0.7× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$370.20 |
$617 |
0.8× |
| Knee 3 views (73562) |
$111 |
$185 |
1.5× |
| Liver & spleen imaging static only (78215) |
$496.20 |
$827 |
1.4× |
| Lung perfusion differential (78597) |
$437.70 |
$729.50 |
1.3× |
| Lymphoscintigraphy (78195) |
$370.20 |
$617 |
0.8× |
| Meckels Diverticulum (78290) |
$370.50 |
$617.50 |
1.1× |
| Mlc imrt design & construction per imrt plan (77338) |
$1,266.38 |
$2,110.64 |
3.9× |
| MRA head w/o contrast (70544) |
$716.40 |
$1,194 |
3.5× |
| MRA neck w/o contrast (70547) |
$297.60 |
$496 |
1.4× |
| MRI abdomen w contrast (74182) |
$891 |
$1,485 |
3.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$990 |
$1,650 |
3.3× |
| MRI abdomen w/o contrast (74181) |
$807.90 |
$1,346.50 |
3.9× |
| MRI any jnt lwr ext with con lt (73722) |
$792 |
$1,320 |
1.2× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$759 |
$1,265 |
1.1× |
| MRI c-spine with contrast (72142) |
$976.80 |
$1,628 |
3.2× |
| MRI cervical spine w/o contrast (72141) |
$740.40 |
$1,234 |
3.6× |
| MRI chest w/o & w/contrast material (71552) |
$792 |
$1,320 |
2.6× |
| MRI chest w/o contrast (71550) |
$695.40 |
$1,159 |
3.4× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$693 |
$1,155 |
2.3× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$726 |
$1,210 |
2.4× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$693 |
$1,155 |
3.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$493.20 |
$822 |
1.6× |
| MRI orbit/face/neck w/contrast (70542) |
$792 |
$1,320 |
2.6× |
| MRI pelvis w contrast (72196) |
$757.50 |
$1,262.50 |
2.5× |
| MRI pelvis w/o & w/contrast material (72197) |
$858 |
$1,430 |
2.9× |
| MRI pelvis w/o contrast (72195) |
$757.50 |
$1,262.50 |
3.7× |
| MRI scan of arm joint before and after contrast (73223) |
$858 |
$1,430 |
2.9× |
| MRI scan of leg joint before and after contrast (73723) |
$858 |
$1,430 |
2.9× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,287.90 |
$2,146.50 |
4.3× |
| MRI spinal canal lumbar w/contrast material (72149) |
$976.80 |
$1,628 |
3.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,235.70 |
$2,059.50 |
4.1× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$976.80 |
$1,628 |
3.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,296 |
$2,160 |
4.3× |
| MRI thoracic spine w/o contrast (72146) |
$774.30 |
$1,290.50 |
3.8× |
| MRI upper ext joint w/o contrast (73221) |
$740.40 |
$1,234 |
3.6× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$716.40 |
$1,194 |
2.4× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$693 |
$1,155 |
3.4× |
| Myocardial Spect Multiple Studies (78452) |
$1,920 |
$3,200 |
1.7× |
| Neck soft tissue (70360) |
$116.10 |
$193.50 |
1.5× |
| Nm gastric emptying study (78264) |
$381.30 |
$635.50 |
1.1× |
| Ntsty modul radthx pln dose-vol histos (77301) |
$2,380.50 |
$3,967.50 |
2.0× |
| Nuclear Rx Oral Admin (79005) |
$147 |
$245 |
0.7× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$102.30 |
$170.50 |
1.1× |
| Osseous survey infant (77076) |
$135 |
$225 |
1.5× |
| Osseous survey limited (77074) |
$231.60 |
$386 |
2.6× |
| Parathyrd planar w/wo subtrj (78071) |
$451.80 |
$753 |
1.3× |
| Pelvis 1 or 2 views (72170) |
$118.80 |
$198 |
1.3× |
| PET image w/CT, skull-thigh (78815) |
$2,172 |
$3,620 |
1.8× |
| PET imaging CT for attenuation limited area (78814) |
$2,172 |
$3,620 |
1.8× |
| PET imaging for CT attenuation whole body (78816) |
$2,172 |
$3,620 |
1.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$740.40 |
$1,234 |
2.5× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$350.40 |
$584 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$155.10 |
$258.50 |
1.7× |
| Radex hips bilateral with pelvis 2 views (73521) |
$136.80 |
$228 |
1.5× |
| Radiation treatment delivery 1 mev >= complex (77412) |
$255 |
$425 |
0.5× |
| Radiation treatment delivery 1 mev >= simple (77402) |
$156.60 |
$261 |
1.8× |
| Radiation tx delivery 1 mev >= intermediate (77407) |
$135 |
$225 |
0.4× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$139.20 |
$232 |
1.5× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$114.30 |
$190.50 |
1.5× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$86.40 |
$144 |
1.2× |
| Radiologic exam colon single contrast study (74270) |
$251.70 |
$419.50 |
1.7× |
| Radiologic exam upr gi trc single contrast study (74240) |
$251.70 |
$419.50 |
1.7× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$111 |
$185 |
1.5× |
| Radiological examination surgical specimen (76098) |
$324 |
$540 |
0.7× |
| Ribs bilateral 3 views (71110) |
$174.30 |
$290.50 |
1.9× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$1,843.80 |
$3,073 |
3.9× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$432.30 |
$720.50 |
0.9× |
| Rp Therapy Intravenous Administration (79101) |
$319.20 |
$532 |
1.6× |
| Scanogram (77073) |
$199.50 |
$332.50 |
2.2× |
| Scapula complete (73010) |
$108.90 |
$181.50 |
1.2× |
| Screening digital breast tomosynthesis (77063) |
$30 |
$50 |
1.3× |
| Simulation intermediate (77285) |
$458.40 |
$764 |
1.4× |
| Small bowel series (74250) |
$251.70 |
$419.50 |
1.7× |
| Spec telethx port pln parts hemibdy tot bdy (77321) |
$566.10 |
$943.50 |
1.8× |
| Special dosimetry (77331) |
$236.16 |
$393.60 |
2.0× |
| Special treatment procedure (77470) |
$1,160.55 |
$1,934.25 |
2.4× |
| Spine thoracic 3 views (72072) |
$145.20 |
$242 |
1.6× |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
$483 |
$805 |
1.5× |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
$483 |
$805 |
1.5× |
| Ther rad simulaj-aided field setting complex (77290) |
$687.91 |
$1,146.52 |
2.1× |
| Ther rad simulaj-aided field setting simple (77280) |
$330.90 |
$551.50 |
2.9× |
| Thyroid Imaging With Vascular Flow (78013) |
$222.60 |
$371 |
0.6× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$308.10 |
$513.50 |
0.9× |
| Treatment devices simple (77332) |
$268.50 |
$447.50 |
2.3× |
| Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) |
$492 |
$820 |
1.4× |
| Tx devices design & construction complex (77334) |
$556.80 |
$928 |
1.7× |
| Ultrasound, abdomen limited (76705) |
$177.60 |
$296 |
2.0× |
| Umbilical-artery Doppler (OB) (76820) |
$139.20 |
$232 |
1.5× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$111 |
$185 |
1.5× |
| Unlisted fluoroscopic procedure (76496) |
$361.20 |
$602 |
4.8× |
| Upper Extremity Infant (73092) |
$91.50 |
$152.50 |
1.0× |
| Urethrocystography voiding (74455) |
$233.10 |
$388.50 |
1.1× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$184.50 |
$307.50 |
1.2× |
| Us abdl aorta screen aaa (76706) |
$136.80 |
$228 |
1.5× |
| Us breast unilateral complete (76641) |
$132 |
$220 |
1.5× |
| Us breast unilateral limited (76642) |
$177.60 |
$296 |
2.4× |
| Us chest (76604) |
$139.20 |
$232 |
1.5× |
| Us compl joint r-t w/image documentation (76881) |
$112.50 |
$187.50 |
1.2× |
| Us elastography parenchyma (76981) |
$106.80 |
$178 |
1.2× |
| Us guided compression repair (76936) |
$357 |
$595 |
1.9× |
| Us infant hips dynamic (76885) |
$111 |
$185 |
1.5× |
| Us kidney transplant (76776) |
$136.80 |
$228 |
1.5× |
| Us ob transvaginal (76817) |
$223.50 |
$372.50 |
2.5× |
| Us pelvic non ob complete (76856) |
$223.50 |
$372.50 |
2.5× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$147 |
$245 |
1.6× |
| Us pregnancy ltd (76815) |
$139.20 |
$232 |
1.5× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$203.40 |
$339 |
2.3× |
| Us retroperitoneal complete (76770) |
$315.60 |
$526 |
3.5× |
| Us retroperitoneal limited (76775) |
$264 |
$440 |
2.9× |
| Us scrotum and contents (76870) |
$151.50 |
$252.50 |
1.7× |
| Us soft tissue head/neck (76536) |
$183 |
$305 |
2.0× |
| Us spinal canal and contents (76800) |
$108 |
$180 |
1.2× |
| Us transrectal (76872) |
$336.60 |
$561 |
3.7× |
| Us xtr non-vasc lmtd (76882) |
$150 |
$250 |
1.7× |
| Venography caval inferior serialography rs&i (75825) |
$2,520 |
$4,200 |
0.9× |
| Venography extremity unilateral rs&i (75820) |
$1,611.60 |
$2,686 |
1.2× |
| Wrist 2 views (73100) |
$111 |
$185 |
1.5× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$136.80 |
$228 |
1.5× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$111 |
$185 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$285.60 |
$476 |
1.9× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$73.50 |
$122.50 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$111 |
$185 |
1.5× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$111 |
$185 |
1.5× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$136.80 |
$228 |
1.5× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$159.60 |
$266 |
1.8× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$137.10 |
$228.50 |
1.8× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$111 |
$185 |
1.5× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$111 |
$185 |
1.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$136.80 |
$228 |
1.5× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$111 |
$185 |
1.5× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$111 |
$185 |
1.5× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$133.80 |
$223 |
1.5× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$133.80 |
$223 |
1.5× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$116.10 |
$193.50 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$133.80 |
$223 |
1.5× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$579 |
$965 |
1.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$139.20 |
$232 |
1.9× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$136.80 |
$228 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$136.80 |
$228 |
1.5× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$112.50 |
$187.50 |
1.5× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$108.90 |
$181.50 |
1.5× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$162.30 |
$270.50 |
2.2× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$159.60 |
$266 |
1.8× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$168.60 |
$281 |
1.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$111 |
$185 |
1.5× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$118.80 |
$198 |
1.6× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$136.80 |
$228 |
1.5× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$111 |
$185 |
1.5× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$81.90 |
$136.50 |
1.1× |
| Xr c-spine 6 or more views (72052) |
$120 |
$200 |
1.3× |
| Xr chest 4+ views (71048) |
$104.70 |
$174.50 |
1.2× |
| Xr finger(s) 2+ views (73140) |
$73.50 |
$122.50 |
1.0× |
| Xr shoulder 1 view (73020) |
$61.20 |
$102 |
0.8× |
| Xr spine cervical 4 or 5 views (72050) |
$198.30 |
$330.50 |
2.2× |
| Xr tibia/fibula 2 views (73590) |
$111 |
$185 |
1.5× |
| Xr tmj bilateral (70330) |
$121.80 |
$203 |
1.6× |
| Xray knee 1 or 2 views rt (73560) |
$111 |
$185 |
1.5× |