Imaging prices at T.J. Samson Community Hospital

Glasgow, KY · every code in this section with a posted price and a Medicare benchmark.

287 codes. Prices are the hospital's own posted facility charges.

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $109.20 $168 1.1×
Acute gastrointestinal blood loss imaging (78278) $559.32 $860.50 1.5×
Angiography extremity bilateral rs&i (75716) $3,355.30 $2,701 1.1×
Angiography extremity unilateral rs&i (75710) $3,625.05 $2,896 1.2×
Angiography visceral slctv/supraslctv rs&i (75726) $5,913.05 $9,097 1.1×
Ankle 2 views (73600) $72.80 $112 0.9×
Antegrade urography radiological supvj & interpj (74425) $229.45 $353 0.7×
Aortogram thoracic (75605) $5,913.05 $9,097 1.1×
Aortography abdl bi iliofem low extrem cath rs&i (75630) $3,355.30 $2,703.50 1.1×
Aortography abdominal serialography rs&i (75625) $3,355.30 $2,667.50 1.1×
Arthrogram elbow (73085) $272.68 $419.50 0.8×
Arthrogram shoulder (73040) $87.10 $134 0.3×
Arthrogram wrist (73115) $88.40 $136 0.3×
Arthrography knee lt (73580) $273.32 $420.50 0.8×
Bone &/Joint Imaging Limited Area (78300) $414.05 $637 1.1×
Bone &/Joint Imaging Multiple Areas (78305) $364.49 $560.75 1.0×
Bone &/joint imaging whole body (78306) $510.25 $785 1.3×
Bone age studies (77072) $65.98 $101.50 0.7×
Bone Imaging 3 Phase (78315) $585 $900 1.5×
Bone survey complete (77075) $251.88 $387.50 2.5×
Brain Imaging Minimum 4 Static Views (78605) $309.08 $475.50 0.6×
Brain Imaging Pet Metabolic Evaluation (78608) $2,985.13 $4,592.50 2.2×
Brain Imaging Vascular Flow Only (78610) $577.20 $461 1.1×
Cervical spine 2 or 3 views (72040) $94.58 $145.50 1.1×
Chest 1 view (71045) $65 $100 0.8×
Chest 3 views (71047) $108.22 $166.50 1.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $207.68 $319.50 1.2×
Clavicle complete (73000) $71.50 $110 0.9×
Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) $99.45 $153 1.0×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $149.18 $229.50 0.9×
CT abdomen and pelvis without and with contrast (74178) $1,799.85 $2,769 5.4×
CT abdomen and pelvis without contrast (74176) $1,346.80 $2,072 5.9×
CT abdomen w contrast (74160) $688.52 $1,059.25 4.1×
CT abdomen w wo contrast (74170) $882.38 $1,357.50 5.3×
CT abdomen w/o contrast (74150) $685.26 $1,054.25 6.9×
CT angiography upper extremity lt (73206) $275.60 $424 1.7×
CT c-spine w/o contrast (72125) $573.62 $882.50 5.8×
CT cervical spine w&w/o contrast (72127) $599.62 $922.50 3.6×
CT cervical spine with contrast (72126) $589.88 $907.50 1.8×
CT chest w/wo contrast (71270) $876.52 $1,348.50 5.3×
CT chest with contrast (71260) $684.78 $1,053.50 4.1×
CT head/brain with contrast (70460) $590.20 $908 3.5×
CT head/brain without and with contrast (70470) $925.60 $1,424 5.6×
CT heart no contrast quant eval coronry calcium (75571) $69.22 $106.50 0.8×
CT iac w contrast (70481) $586.62 $902.50 3.5×
CT limited/localized follow up study (76380) $74.10 $114 0.9×
CT lower ext w/o (73700) $531.38 $817.50 5.4×
CT lower extremity w wo contrast (73702) $185.90 $286 1.1×
CT lower extremity with contrast (73701) $543.08 $835.50 3.3×
CT lumbar spine w & w/o contrast (72133) $823.22 $1,266.50 4.9×
CT lumbar spine w/o contrast (72131) $577.52 $888.50 5.8×
CT lumbar spine with contrast (72132) $884.98 $1,361.50 2.7×
CT maxillofacial w contrast (70487) $610.02 $938.50 3.7×
CT maxillofacial w/o contrast (70486) $544.70 $838 5.5×
CT maxillofacial w/wo contrast (70488) $767.32 $1,180.50 4.6×
CT neck soft tissue w contrast (70491) $646.75 $995 3.9×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $823.22 $1,266.50 4.9×
CT orbits w/o contrast (70480) $462.15 $711 4.7×
CT pelvis w & w/o contrast (72194) $959.40 $1,476 5.8×
CT pelvis w/o contrast (72192) $538.52 $828.50 5.4×
CT soft tissue neck w/o & w/contrast material (70492) $882.05 $1,357 5.3×
CT soft tissue neck w/o contrast (70490) $483.28 $743.50 4.9×
CT thoracic spine w/contrast (72129) $172.90 $266 1.0×
CT thoracic spine w/o contrast (72128) $529.10 $814 5.3×
CT thoracic spine w/wo contrast (72130) $296.08 $455.50 1.8×
CT thorax w/o contrast (71250) $578.18 $889.50 5.8×
CT upper extremity w/o & w/contrast material (73202) $187.20 $288 1.1×
CT upper extremity w/o contrast rt (73200) $487.18 $749.50 4.9×
CT upper extremity with contrast (73201) $485.88 $747.50 1.5×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $626.28 $963.50 3.8×
Cta Abdomen (74175) $709.48 $1,091.50 4.3×
CTA abdomen pelvis (74174) $1,363.38 $2,097.50 4.1×
CTA chest (71275) $709.80 $1,092 4.3×
Cta Head (70496) $686.08 $1,055.50 4.1×
CTA lwr ext w&w/o contrast (73706) $288.60 $444 1.7×
Cta Neck (70498) $630.50 $970 3.8×
Cta Pelvis (72191) $588.58 $905.50 3.5×
Cystography minimum 3 views rs&i (74430) $209.62 $322.50 0.6×
Dxa bone density study 1/> sites axial skel (77080) $66.30 $102 0.7×
Dxa bone density study 1/>sites appendiclr skel (77081) $54.60 $84 0.7×
Dxa bone density study axial skeleton (77085) $81.25 $125 0.8×
Echoencephalography real time imaging (76506) $192.89 $296.75 1.9×
Esophagus (74220) $149.50 $230 0.9×
Fetal biophysical profile non-stress testing (76818) $108.22 $166.50 1.1×
Fetal Biophysical Profile W/O Non-Stress Testing (76819) $100.75 $155 1.0×
Fluoroscopy up to 1 hr (76000) $279.82 $430.50 1.2×
Foot 2 views (73620) $75.08 $115.50 0.9×
Forearm 2 views (73090) $89.05 $137 1.1×
Gated Heart Planar Single (78472) $820.95 $1,263 2.2×
Hand 2 views (73120) $89.05 $137 0.9×
Hand 3 views (73130) $89.70 $138 1.1×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $541.29 $832.75 1.1×
Hepatobiliary syst imaging including gallbladder (78226) $297.38 $457.50 0.8×
Ht muscle image spect sing (78451) $759.52 $1,168.50 0.6×
Humerus Min 2 Views Left (73060) $26 $40 0.3×
Hysterosalpingogram (74740) $194.35 $299 0.9×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $455.98 $701.50 0.9×
Kidney img morphology vascular flow 1 w/rx (78708) $334.10 $514 0.6×
Kidney Img Morphology Vascular Flow Multiple (78709) $341.25 $525 0.7×
Knee 3 views (73562) $91 $140 1.1×
Liver & spleen imaging static only (78215) $415.68 $639.50 1.1×
Liver imaging static only (78201) $305.18 $469.50 0.6×
Lung perf&ventilat diferentl (78598) $320.45 $493 0.6×
Lung perfusion differential (78597) $247 $380 0.7×
Lung Ventilation Imaging (78579) $237.90 $366 0.6×
Lymphoscintigraphy (78195) $549.90 $846 1.1×
Mammary ductogram or galactogram multiple (77054) $34.45 $53 0.2×
Mammary ductogram or galactogram single (77053) $27.95 $43 0.1×
Meckels Diverticulum (78290) $238.55 $367 0.6×
Mr safety determination physician/other qhp (76016) $67.92 $104.50 0.8×
Mr safety implant pos&/immoblj supvj phys/qhp (76019) $52.65 $81 0.9×
Mr safety implant&/fb assmt clin staf 1st 15 min (76014) $31.20 $48 1.1×
Mr safety implt electronics prepj supvj phys/qhp (76018) $77.68 $119.50 0.9×
Mr safety med physics xm customization plng&mntr (76017) $154.38 $237.50 0.7×
MRA head w & w/o contrast (70546) $1,428.86 $2,198.25 4.3×
MRA head w/o contrast (70544) $815.10 $1,254 3.6×
MRA head with contrast (70545) $815.26 $1,254.25 2.5×
MRA neck w contrast (70548) $828.42 $1,274.50 2.5×
Mra Neck W/O &W/Contrast Material (70549) $1,442.68 $2,219.50 4.4×
MRA neck w/o contrast (70547) $706.22 $1,086.50 3.1×
MRI abdomen w contrast (74182) $964.60 $1,484 2.9×
MRI abdomen w/o & w/contrast material (74183) $1,059.18 $1,629.50 3.2×
MRI abdomen w/o contrast (74181) $882.05 $1,357 3.9×
MRI any jnt lwr ext with con lt (73722) $997.10 $1,534 1.3×
MRI any jt upper extremity w/contrast matrl (73222) $997.10 $1,534 1.3×
MRI c-spine with contrast (72142) $897.98 $1,381.50 2.7×
MRI cervical spine w/o contrast (72141) $871 $1,340 3.8×
MRI chest w/o & w/contrast material (71552) $172.90 $266 0.5×
MRI chest w/o contrast (71550) $764.56 $1,176.25 3.4×
MRI chest with contrast (71551) $133.25 $205 0.2×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $996.45 $1,533 3.0×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $996.45 $1,533 3.0×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $811.85 $1,249 3.6×
MRI orbit face &/neck w/o contrast (70540) $708.82 $1,090.50 3.1×
MRI orbit/face/neck w&w/o cont (70543) $1,455.68 $2,239.50 4.4×
MRI orbit/face/neck w/contrast (70542) $829.40 $1,276 2.5×
MRI pelvis w contrast (72196) $893.10 $1,374 2.7×
MRI pelvis w/o & w/contrast material (72197) $1,560.32 $2,400.50 4.7×
MRI pelvis w/o contrast (72195) $866.78 $1,333.50 3.8×
MRI scan of arm joint before and after contrast (73223) $1,199.25 $1,845 3.6×
MRI scan of leg joint before and after contrast (73723) $1,198.60 $1,844 3.6×
MRI spinal canal cervical w/o & w/contr matrl (72156) $1,781.32 $2,740.50 5.4×
MRI spinal canal lumbar w/contrast material (72149) $897.98 $1,381.50 2.7×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $1,781.32 $2,740.50 5.4×
MRI spinal canal thoracic w/contrast matrl (72147) $949.65 $1,461 2.9×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $1,035.12 $1,592.50 3.1×
MRI thoracic spine w/o contrast (72146) $886.28 $1,363.50 3.9×
MRI tmj (70336) $113.75 $175 0.5×
MRI upper ext joint w/o contrast (73221) $813.15 $1,251 3.6×
MRI upper extrem other than jt w/o & w/contras (73220) $1,198.60 $1,844 3.6×
MRI upper extremity oth than jt w/o contr matrl (73218) $812.50 $1,250 3.6×
Myocardial Imaging Pet Metabolic Evaluation (78459) $117.65 $181 0.1×
Myocardial Spect Multiple Studies (78452) $1,267.50 $1,950 1.0×
Neck soft tissue (70360) $83.20 $128 1.0×
Nm gastric emptying study (78264) $427.05 $657 1.1×
Nm red cell sequestration (78140) $231.72 $356.50 0.6×
Nuclear medicine study of stomach to assess emptying small bowel movement (78265) $249.60 $384 0.7×
Nuclear Rx Oral Admin (79005) $402.02 $618.50 1.8×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $129.68 $199.50 1.3×
Orthopantogram (70355) $54.60 $84 0.7×
Osseous survey infant (77076) $257.08 $395.50 2.6×
Osseous survey limited (77074) $263.90 $406 2.7×
Parathyrd planar w/spect&CT (78072) $347.75 $535 0.7×
Parathyrd planar w/wo subtrj (78071) $335.72 $516.50 0.9×
Parathyroid imaging (78070) $327.92 $504.50 0.9×
Pelvis 1 or 2 views (72170) $82.88 $127.50 0.8×
PET image w/CT, skull-thigh (78815) $1,976.65 $3,041 1.5×
PET imaging CT for attenuation limited area (78814) $1,966.58 $3,025.50 1.4×
PET imaging for CT attenuation whole body (78816) $1,977.30 $3,042 1.5×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,198.60 $1,844 3.6×
Pulmonary Perfusion Imaging Particulate (78580) $380.90 $586 1.0×
Pulmonary Ventilation & Perfusion Imaging (78582) $550.39 $846.75 1.1×
Radex abscess/fistula/sinus tract rs&i (76080) $311.02 $478.50 0.6×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $178.42 $274.50 1.8×
Radex hips bilateral with pelvis 2 views (73521) $219.05 $337 2.2×
Radex mastoids compl minimum 3 views pr side (70130) $39.98 $61.50 0.4×
Radiolog exam mandible compl minimum 4 views (70110) $77.68 $119.50 0.8×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $80.28 $123.50 1.0×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $137.48 $211.50 1.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $92.30 $142 1.1×
Radiologic exam colon single contrast study (74270) $226.20 $348 1.4×
Radiologic Exam Esophagus Double Contrast Study (74221) $121.88 $187.50 0.7×
Radiologic exam upr gi trc double contrast study (74246) $226.85 $349 1.4×
Radiologic exam upr gi trc single contrast study (74240) $212.55 $327 1.3×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $90.35 $139 1.1×
Radiological examination surgical specimen (76098) $581.10 $466 1.1×
Ribs bilateral 3 views (71110) $107.25 $165 1.1×
Rp loclzj tum plnr whole body single day imaging (78802) $734.50 $1,130 1.4×
Rp loclzj tum spect 1 area single day imaging (78803) $744.58 $1,145.50 1.4×
Rp loclzj tum spect 2 area/sep acquisj img (78831) $134.55 $207 0.1×
Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) $865.48 $1,331.50 0.6×
Rp loclzj tum spect w/CT 1 area 1 day imaging (78830) $759.52 $1,168.50 0.6×
Rp Therapy Intravenous Administration (79101) $209.95 $323 0.9×
Sacroiliac Joints < 3 Views (72200) $100.42 $154.50 1.0×
Scanogram (77073) $69.22 $106.50 0.7×
Scapula complete (73010) $72.80 $112 0.7×
Screening digital breast tomosynthesis (77063) $46.80 $72 2.0×
Shuntogram indwelling nonvascular shunt rs&i (75809) $78 $120 0.8×
Small bowel series (74250) $170.95 $263 1.0×
Spine thoracic 3 views (72072) $126.10 $194 1.3×
Testicular Imaging With Vascular Flow (78761) $425.10 $654 1.1×
Therapeutic Enema (74283) $465.40 $716 2.8×
Thoracolumbar 2 views (72080) $54.92 $84.50 0.7×
Thyroid carcinoma metastases img whole body (78018) $487.50 $750 0.9×
Thyroid Imaging With Vascular Flow (78013) $226.52 $348.50 0.6×
Thyroid uptake measurement (78012) $425.10 $338 1.1×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $246.68 $379.50 0.6×
Tumor Imaging Whole Body - Nm Tumor Local Whole Body Mult Days (78804) $741.98 $1,141.50 1.4×
Ultrasound, abdomen limited (76705) $301.28 $463.50 3.0×
Umbilical-artery Doppler (OB) (76820) $91.98 $141.50 0.9×
Unlisted Ultrasound Procedure (76999) $103.35 $159 1.3×
Upper Extremity Infant (73092) $106.28 $163.50 1.1×
Urethrocystography retrograde rs&i (74450) $140.40 $216 0.6×
Urethrocystography voiding (74455) $178.10 $274 0.8×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $165.75 $255 1.0×
Urograpy infusion drip &/bolus techq w/wo tomo (74415) $523.90 $806 3.1×
Us abdl aorta screen aaa (76706) $80.28 $123.50 0.8×
Us breast unilateral complete (76641) $150.48 $231.50 1.5×
Us breast unilateral limited (76642) $147.22 $226.50 1.8×
Us chest (76604) $94.90 $146 1.0×
Us compl joint r-t w/image documentation (76881) $89.70 $138 0.9×
Us elastography parenchyma (76981) $77.35 $119 0.8×
Us infant hips dynamic (76885) $247 $380 3.0×
Us infant hips limited static (76886) $70.20 $108 0.8×
Us ob detailed single fetus (76811) $259.02 $398.50 1.1×
Us ob transvaginal (76817) $121.88 $187.50 1.2×
Us pelvic non ob complete (76856) $283.08 $435.50 2.9×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $76.05 $117 0.8×
Us pregnancy ltd (76815) $111.80 $172 1.1×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $111.80 $172 1.1×
Us retroperitoneal complete (76770) $335.08 $515.50 3.4×
Us retroperitoneal limited (76775) $327.92 $504.50 3.3×
Us scrotum and contents (76870) $206.70 $318 2.1×
Us soft tissue head/neck (76536) $95.22 $146.50 1.0×
Us spinal canal and contents (76800) $214.34 $329.75 2.2×
Us transrectal (76872) $55.25 $85 0.6×
Us xtr non-vasc lmtd (76882) $83.20 $128 0.8×
Vascular flow imaging (78445) $232.38 $357.50 0.6×
Venography caval inferior serialography rs&i (75825) $3,355.30 $5,162 1.1×
Venography extremity unilateral rs&i (75820) $1,673.10 $1,347 1.1×
Vertebral fracture assessment via dxa (77086) $53.30 $82 0.6×
Wrist 2 views (73100) $69.22 $106.50 0.8×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $191.75 $295 1.9×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $73.12 $112.50 0.9×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $89.70 $138 1.1×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $291.52 $448.50 1.8×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $82.55 $127 1.0×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $89.70 $138 1.1×
X-ray exam hip uni 1 view (73501) $61.75 $95 0.7×
X-Ray Exam Hip Uni 2-3 Views (73502) $113.75 $175 1.4×
X-ray exam of small bowel - fl small bowel series enteroclysis tube (74251) $203.45 $313 1.2×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $104.32 $160.50 1.1×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $89.70 $138 1.1×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $71.50 $110 0.9×
X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) $105.95 $163 1.1×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $106.28 $163.50 1.3×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $105.95 $163 1.1×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $184.28 $283.50 1.9×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $130.65 $201 1.3×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $53.30 $82 0.6×
X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) $68.90 $106 0.8×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $74.75 $115 0.8×
X-Ray Pelvis 3+ Vw - Xr Pelvis 3+ Views (72190) $124.15 $191 1.3×
X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) $248.62 $382.50 0.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $93.28 $143.50 1.1×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $111.48 $171.50 1.1×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $162.18 $249.50 1.6×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $82.88 $127.50 1.0×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $91 $140 1.1×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $102.05 $157 1.2×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $74.75 $115 0.9×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $131.95 $203 1.3×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $75.08 $115.50 0.8×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $33.80 $52 0.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $66.30 $102 0.8×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $16.25 $25 0.2×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $72.15 $111 0.9×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $89.70 $138 1.1×
Xr arthrogram ankle (73615) $232.38 $357.50 0.7×
Xr c-spine 6 or more views (72052) $240.82 $370.50 2.4×
Xr chest 4+ views (71048) $135.85 $209 1.4×
Xr finger(s) 2+ views (73140) $87.10 $134 1.1×
XR Mastoids < 3 Views Bilateral (70120) $21.45 $33 0.2×
Xr spine cervical 4 or 5 views (72050) $200.20 $308 2.0×
Xr tibia/fibula 2 views (73590) $89.05 $137 1.1×
Xr tmj bilateral (70330) $99.12 $152.50 1.2×
Xray knee 1 or 2 views rt (73560) $74.10 $114 0.9×