| Abdomen 2 views (74019) |
$104 |
$765.29 |
1.0× |
| Acute gastrointestinal blood loss imaging (78278) |
$398 |
$2,069.62 |
1.0× |
| Angiography extremity bilateral rs&i (75716) |
$3,147 |
$9,095.15 |
1.0× |
| Angiography extremity unilateral rs&i (75710) |
$3,147 |
$12,448.58 |
1.0× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$5,546 |
$15,969 |
1.0× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,147 |
$9,639 |
1.0× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,147 |
$9,639 |
1.0× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$5,546 |
$15,561.70 |
1.0× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$3,147 |
$3,990.53 |
1.0× |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
$3,147 |
$15,802 |
1.0× |
| Ankle 2 views (73600) |
$86 |
$865.11 |
1.0× |
| Antegrade urography radiological supvj & interpj (74425) |
$347 |
$1,954.33 |
1.0× |
| Aortogram thoracic (75605) |
$5,546 |
$26,609.30 |
1.0× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,147 |
$9,095.15 |
1.0× |
| Aortography abdominal serialography rs&i (75625) |
$3,147 |
$9,095.15 |
1.0× |
| Arthrogram elbow (73085) |
$347 |
$1,887.06 |
1.0× |
| Arthrogram hip (73525) |
$347 |
$1,365.37 |
1.0× |
| Arthrogram shoulder (73040) |
$347 |
$1,274.73 |
1.0× |
| Arthrogram wrist (73115) |
$347 |
$1,009.68 |
1.0× |
| Arthrography knee lt (73580) |
$347 |
$2,054.82 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$398 |
$3,325.17 |
1.0× |
| Bone Imaging 3 Phase (78315) |
$398 |
$3,424.61 |
1.0× |
| Bone survey complete (77075) |
$104 |
$1,387.16 |
1.0× |
| Brain image w/flow 4 + views (78606) |
$541 |
$2,676.13 |
1.0× |
| Brain imaging < 4 static views w vascular flow (78601) |
$398 |
$1,929.76 |
1.0× |
| Brain Imaging Minimum 4 Static Views (78605) |
$541 |
$2,652.20 |
1.0× |
| Cervical spine 2 or 3 views (72040) |
$86 |
$984.44 |
1.0× |
| Chest 1 view (71045) |
$86 |
$416.49 |
1.0× |
| Chest 3 views (71047) |
$86 |
$654 |
1.0× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$174 |
$1,172.60 |
1.0× |
| Clavicle complete (73000) |
$86 |
$1,065.90 |
1.0× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$104 |
$464.11 |
1.0× |
| CT abdomen and pelvis without and with contrast (74178) |
$347 |
$9,899.45 |
1.0× |
| CT abdomen and pelvis without contrast (74176) |
$237 |
$7,974.73 |
1.0× |
| CT abdomen w contrast (74160) |
$174 |
$5,143.62 |
1.0× |
| CT abdomen w wo contrast (74170) |
$174 |
$5,840.09 |
1.0× |
| CT abdomen w/o contrast (74150) |
$104 |
$4,301.47 |
1.0× |
| CT angio hrt w/3d image (75574) |
$347 |
$3,476.52 |
1.0× |
| CT angiography upper extremity lt (73206) |
$174 |
$6,669.62 |
1.0× |
| CT c-spine w/o contrast (72125) |
$104 |
$4,880.88 |
1.0× |
| CT cervical spine with contrast (72126) |
$347 |
$5,243.45 |
1.0× |
| CT chest w/wo contrast (71270) |
$174 |
$5,480.96 |
1.0× |
| CT chest with contrast (71260) |
$174 |
$4,560.77 |
1.0× |
| CT head/brain with contrast (70460) |
$174 |
$4,735.17 |
1.0× |
| CT head/brain without and with contrast (70470) |
$174 |
$5,015.13 |
1.0× |
| CT heart no contrast quant eval coronry calcium (75571) |
$86 |
$451.35 |
1.0× |
| CT iac w contrast (70481) |
$174 |
$3,517.82 |
1.0× |
| CT limited/localized follow up study (76380) |
$86 |
$451.35 |
1.0× |
| CT lower ext w/o (73700) |
$104 |
$4,143.13 |
1.0× |
| CT lower extremity w wo contrast (73702) |
$174 |
$2,428.90 |
1.0× |
| CT lower extremity with contrast (73701) |
$174 |
$3,461.60 |
1.0× |
| CT lumbar spine w & w/o contrast (72133) |
$174 |
$956.61 |
1.0× |
| CT lumbar spine w/o contrast (72131) |
$104 |
$5,015.13 |
1.0× |
| CT lumbar spine with contrast (72132) |
$347 |
$5,532.58 |
1.0× |
| CT maxillofacial w contrast (70487) |
$174 |
$4,575.68 |
1.0× |
| CT maxillofacial w/o contrast (70486) |
$104 |
$4,512.58 |
1.0× |
| CT maxillofacial w/wo contrast (70488) |
$174 |
$996.73 |
1.0× |
| CT neck soft tissue w contrast (70491) |
$174 |
$5,025.45 |
1.0× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$174 |
$3,193.10 |
1.0× |
| CT orbits w/o contrast (70480) |
$104 |
$4,412.76 |
1.0× |
| CT pelvis w & w/o contrast (72194) |
$174 |
$996.73 |
1.0× |
| CT pelvis w/o contrast (72192) |
$104 |
$3,781.71 |
1.0× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$174 |
$3,253.91 |
1.0× |
| CT soft tissue neck w/o contrast (70490) |
$104 |
$3,672.71 |
1.0× |
| CT thoracic spine w/contrast (72129) |
$174 |
$2,672.20 |
1.0× |
| CT thoracic spine w/o contrast (72128) |
$104 |
$4,894.65 |
1.0× |
| CT thorax w/o contrast (71250) |
$104 |
$4,067.41 |
1.0× |
| CT upper extremity w/o & w/contrast material (73202) |
$174 |
$956.61 |
1.0× |
| CT upper extremity w/o contrast rt (73200) |
$104 |
$4,220 |
1.0× |
| CT upper extremity with contrast (73201) |
$347 |
$3,461.60 |
1.0× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$174 |
$5,385.73 |
1.0× |
| Cta Abdomen (74175) |
$174 |
$4,292.29 |
1.0× |
| CTA abdomen pelvis (74174) |
$347 |
$9,457.71 |
1.0× |
| CTA chest (71275) |
$174 |
$5,503.91 |
1.0× |
| Cta Head (70496) |
$174 |
$4,867.11 |
1.0× |
| CTA lwr ext w&w/o contrast (73706) |
$174 |
$4,762.71 |
1.0× |
| Cta Neck (70498) |
$174 |
$5,631.26 |
1.0× |
| Cta Pelvis (72191) |
$174 |
$890.10 |
1.0× |
| Cystography minimum 3 views rs&i (74430) |
$347 |
$1,813.98 |
1.0× |
| Dxa bone density study 1/> sites axial skel (77080) |
$104 |
$977.55 |
1.0× |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
$86 |
$391.25 |
1.0× |
| Esophagus (74220) |
$174 |
$984.44 |
1.0× |
| Fluoroscopy up to 1 hr (76000) |
$237 |
$1,122.12 |
1.0× |
| Foot 2 views (73620) |
$86 |
$865.11 |
1.0× |
| Forearm 2 views (73090) |
$86 |
$920.18 |
1.0× |
| Gated Heart Planar Single (78472) |
$398 |
$2,103.45 |
1.0× |
| Hand 2 views (73120) |
$104 |
$814.64 |
1.0× |
| Hand 3 views (73130) |
$86 |
$1,011.98 |
1.0× |
| Heart Infarct Image (78466) |
$398 |
$1,929.76 |
1.0× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$541 |
$2,730.62 |
1.0× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$398 |
$3,091.33 |
1.0× |
| Ht muscle image spect sing (78451) |
$1,290 |
$6,596.79 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$86 |
$983.30 |
1.0× |
| Hysterosalpingogram (74740) |
$237 |
$1,025.75 |
1.0× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$541 |
$2,731.77 |
1.0× |
| Knee 3 views (73562) |
$86 |
$1,041.80 |
1.0× |
| Liver imaging w/vascular flow (78202) |
$541 |
$1,240.24 |
1.0× |
| Lymphoscintigraphy (78195) |
$541 |
$2,485.96 |
1.0× |
| MRA head w/o contrast (70544) |
$237 |
$4,810.89 |
1.0× |
| MRA head with contrast (70545) |
$347 |
$3,253.91 |
1.0× |
| MRA neck w contrast (70548) |
$347 |
$3,253.91 |
1.0× |
| Mra Neck W/O &W/Contrast Material (70549) |
$347 |
$1,954.33 |
1.0× |
| MRA neck w/o contrast (70547) |
$237 |
$4,541.27 |
1.0× |
| MRI abdomen w/o & w/contrast material (74183) |
$347 |
$7,197.41 |
1.0× |
| MRI abdomen w/o contrast (74181) |
$237 |
$5,320.33 |
1.0× |
| MRI any jnt lwr ext with con lt (73722) |
$781 |
$8,061.38 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$781 |
$8,639.65 |
1.0× |
| MRI breast w/o contrast bilateral (77047) |
$237 |
$1,238.44 |
1.0× |
| MRI c-spine with contrast (72142) |
$347 |
$5,267.55 |
1.0× |
| MRI cervical spine w/o contrast (72141) |
$237 |
$5,479.81 |
1.0× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$347 |
$5,262.96 |
1.0× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$237 |
$6,806.16 |
1.0× |
| MRI orbit face &/neck w/o contrast (70540) |
$237 |
$2,472.57 |
1.0× |
| MRI orbit/face/neck w&w/o cont (70543) |
$347 |
$5,765.51 |
1.0× |
| MRI pelvis w/o & w/contrast material (72197) |
$347 |
$6,849.77 |
1.0× |
| MRI pelvis w/o contrast (72195) |
$237 |
$5,241.16 |
1.0× |
| MRI scan of arm joint before and after contrast (73223) |
$347 |
$8,705.05 |
1.0× |
| MRI scan of leg joint before and after contrast (73723) |
$347 |
$8,866.82 |
1.0× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$347 |
$9,482.96 |
1.0× |
| MRI spinal canal lumbar w/contrast material (72149) |
$347 |
$3,644.03 |
1.0× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$347 |
$7,501.47 |
1.0× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$347 |
$3,644.03 |
1.0× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$347 |
$7,792.90 |
1.0× |
| MRI thoracic spine w/o contrast (72146) |
$237 |
$5,388.01 |
1.0× |
| MRI tmj (70336) |
$237 |
$5,078.23 |
1.0× |
| MRI upper ext joint w/o contrast (73221) |
$237 |
$7,132.01 |
1.0× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$347 |
$3,904.47 |
1.0× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$237 |
$6,302.47 |
1.0× |
| Myocardial Spect Multiple Studies (78452) |
$1,290 |
$7,670.95 |
1.0× |
| N-Invas Est C Ffr Augmnt Sw Alys Cta I&R Phy/Qhp (75580) |
$855 |
$4,980.90 |
1.0× |
| Neck soft tissue (70360) |
$86 |
$713.66 |
1.0× |
| Nm gastric emptying study (78264) |
$398 |
$3,050.89 |
1.0× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$104 |
$1,023.45 |
1.0× |
| Parathyroid imaging (78070) |
$398 |
$2,447.71 |
1.0× |
| Pelvis 1 or 2 views (72170) |
$104 |
$735.46 |
1.0× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$347 |
$9,445.10 |
1.0× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,147 |
$9,639 |
1.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$398 |
$2,153.76 |
1.0× |
| Pulmonary Ventilation & Perfusion Imaging (78582) |
$541 |
$3,742.59 |
1.0× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$544 |
$1,815.13 |
1.0× |
| Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) |
$86 |
$460.85 |
1.0× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$104 |
$985.59 |
1.0× |
| Radex hips bilateral with pelvis 2 views (73521) |
$104 |
$607.50 |
1.0× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$104 |
$944.27 |
1.0× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$86 |
$415.35 |
1.0× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$86 |
$533.53 |
1.0× |
| Radiologic exam colon single contrast study (74270) |
$174 |
$996.73 |
1.0× |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
$174 |
$901.56 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$174 |
$1,024.31 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$174 |
$1,682.03 |
1.0× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$86 |
$741.20 |
1.0× |
| Radiological examination surgical specimen (76098) |
$544 |
$2,735.32 |
1.0× |
| Review by radiologist of liver vein image with assessment of blood flow (75889) |
$3,147 |
$9,639 |
1.0× |
| Ribs bilateral 3 views (71110) |
$104 |
$682.67 |
1.0× |
| Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) |
$398 |
$2,103.45 |
1.0× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$541 |
$6,764.65 |
1.0× |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
$1,425 |
$8,258.61 |
1.0× |
| Scanogram (77073) |
$104 |
$458.95 |
1.0× |
| Scapula complete (73010) |
$104 |
$1,332.09 |
1.0× |
| Screening digital breast tomosynthesis (77063) |
$21 |
$91.79 |
0.9× |
| Small bowel series (74250) |
$174 |
$1,400.93 |
1.0× |
| Spine thoracic 3 views (72072) |
$104 |
$909.86 |
1.0× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$398 |
$2,550.42 |
1.0× |
| Ultrasound, abdomen limited (76705) |
$104 |
$1,717.61 |
1.0× |
| Unlisted Ultrasound Procedure (76999) |
$86 |
$451.35 |
1.0× |
| Upper Extremity Infant (73092) |
$104 |
$686.12 |
1.0× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$174 |
$1,171.46 |
1.0× |
| Us abdl aorta screen aaa (76706) |
$104 |
$555.64 |
1.0× |
| Us breast unilateral complete (76641) |
$104 |
$1,238.01 |
1.0× |
| Us breast unilateral limited (76642) |
$86 |
$464.11 |
1.0× |
| Us chest (76604) |
$104 |
$874.28 |
1.0× |
| Us guided compression repair (76936) |
$215 |
$1,520.26 |
1.0× |
| Us kidney transplant (76776) |
$104 |
$1,155.39 |
1.0× |
| Us ob transvaginal (76817) |
$104 |
$1,112.95 |
1.0× |
| Us pelvic non ob complete (76856) |
$104 |
$1,559.27 |
1.0× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$104 |
$1,006.24 |
1.0× |
| Us pregnancy ltd (76815) |
$104 |
$1,137.04 |
1.0× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$104 |
$1,688.92 |
1.0× |
| Us retroperitoneal complete (76770) |
$104 |
$1,680.89 |
1.0× |
| Us retroperitoneal limited (76775) |
$104 |
$1,251.78 |
1.0× |
| Us scrotum and contents (76870) |
$104 |
$1,481.25 |
1.0× |
| Us soft tissue head/neck (76536) |
$104 |
$1,717.61 |
1.0× |
| Us xtr non-vasc lmtd (76882) |
$104 |
$1,014.27 |
1.0× |
| Venogram extremity bilateral (75822) |
$1,568 |
$3,990.53 |
1.0× |
| Venography caval inferior serialography rs&i (75825) |
$3,147 |
$9,095.15 |
1.0× |
| Venography caval superior serialography rs&i (75827) |
$1,568 |
$2,262.60 |
1.0× |
| Venography extremity unilateral rs&i (75820) |
$1,568 |
$2,262.60 |
1.0× |
| Wrist 2 views (73100) |
$86 |
$865.11 |
1.0× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$104 |
$962.64 |
1.0× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$86 |
$712.51 |
1.0× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$86 |
$994.76 |
1.0× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$86 |
$906.42 |
1.0× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$86 |
$1,092.29 |
1.0× |
| X-ray exam hip uni 1 view (73501) |
$86 |
$1,194.41 |
1.0× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$86 |
$699.90 |
1.0× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$104 |
$607.50 |
1.0× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$104 |
$1,374.55 |
1.0× |
| X-ray exam of femur 1 (73551) |
$86 |
$1,354.05 |
1.0× |
| X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) |
$174 |
$956.61 |
1.0× |
| X-ray eye for foreign body (70030) |
$86 |
$813.47 |
1.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$104 |
$980.99 |
1.0× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$86 |
$451.35 |
1.0× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$86 |
$994.76 |
1.0× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$86 |
$865.11 |
1.0× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$104 |
$1,217.35 |
1.0× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$86 |
$851.34 |
1.0× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$86 |
$774.47 |
1.0× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$104 |
$1,225.38 |
1.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$104 |
$1,677.44 |
1.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$104 |
$753.83 |
1.0× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$86 |
$721.69 |
1.0× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$104 |
$876.59 |
1.0× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$347 |
$2,735.32 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$86 |
$485.33 |
1.0× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$104 |
$1,165.71 |
1.0× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$104 |
$1,181.79 |
1.0× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$104 |
$686.12 |
1.0× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$86 |
$1,001.64 |
1.0× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$86 |
$980.99 |
1.0× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$86 |
$1,202.43 |
1.0× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$104 |
$894.95 |
1.0× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$104 |
$837.59 |
1.0× |
| X-Ray Spine One View - Xr Spine (72020) |
$86 |
$658.58 |
1.0× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$86 |
$658.58 |
1.0× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$104 |
$423.37 |
1.0× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$86 |
$618.43 |
1.0× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$86 |
$1,011.98 |
1.0× |
| Xr c-spine 6 or more views (72052) |
$104 |
$1,295.37 |
1.0× |
| Xr chest 4+ views (71048) |
$104 |
$766.43 |
1.0× |
| Xr finger(s) 2+ views (73140) |
$86 |
$761.85 |
1.0× |
| Xr shoulder 1 view (73020) |
$86 |
$993.62 |
1.0× |
| Xr spine cervical 4 or 5 views (72050) |
$104 |
$1,348.15 |
1.0× |
| Xr tibia/fibula 2 views (73590) |
$86 |
$876.59 |
1.0× |
| Xr tmj bilateral (70330) |
$86 |
$1,155.39 |
1.0× |
| Xray knee 1 or 2 views rt (73560) |
$86 |
$815.78 |
1.0× |