Imaging prices at Tmc- Bonham Hospital

Bonham, TX · every code in this section with a posted price and a Medicare benchmark.

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

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ProcedureCash priceGross charge× Medicare
Abdomen 2 views (74019) $248.60 $829.40 2.4×
Acute gastrointestinal blood loss imaging (78278) $1,056 $3,522.20 2.6×
Acute venous thrombus image (78456) $271.70 $906.40 0.2×
Ankle 2 views (73600) $85.80 $288.20 1.0×
Arthrogram shoulder (73040) $622.60 $2,074.60 1.8×
Bone &/Joint Imaging Limited Area (78300) $1,038.40 $3,459.50 2.6×
Bone &/Joint Imaging Multiple Areas (78305) $700.70 $2,336.40 1.7×
Bone &/joint imaging whole body (78306) $1,007.60 $3,358.30 2.5×
Bone age studies (77072) $83.60 $278.30 0.8×
Bone Imaging 3 Phase (78315) $1,738 $5,793.70 4.3×
Bone Marrow Imaging Limited Area (78102) $381.70 $1,272.70 1.0×
Bone survey complete (77075) $815.10 $2,715.90 7.8×
Cardiac shunt detection (78428) $454.30 $1,513.60 1.1×
Cervical spine 2 or 3 views (72040) $236.50 $787.60 2.7×
Chest 1 view (71045) $170.50 $569.80 2.0×
Chest 3 views (71047) $200.20 $666.60 2.3×
Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) $233.20 $776.60 1.3×
Clavicle complete (73000) $504.90 $1,683 5.8×
Contrast Xray Throat/Cerv Esopha - Fl Esophagus Pharynx (74210) $127.60 $425.70 0.7×
CT abdomen and pelvis without and with contrast (74178) $2,052.60 $6,844.20 5.9×
CT abdomen and pelvis without contrast (74176) $1,268.30 $4,228.40 5.3×
CT abdomen w contrast (74160) $1,406.90 $4,690.40 8.0×
CT abdomen w wo contrast (74170) $1,801.80 $6,008.20 10.2×
CT abdomen w/o contrast (74150) $884.40 $2,948 8.4×
CT angiography upper extremity lt (73206) $1,045 $3,484.80 5.9×
CT c-spine w/o contrast (72125) $2,206.60 $7,354.60 21.0×
CT cervical spine w&w/o contrast (72127) $2,120.80 $7,068.60 12.0×
CT cervical spine with contrast (72126) $1,948.10 $6,493.30 5.6×
CT chest w/wo contrast (71270) $1,709.40 $5,698 9.7×
CT chest with contrast (71260) $1,709.40 $5,698 9.7×
CT head/brain with contrast (70460) $2,315.50 $7,719.80 13.1×
CT head/brain without and with contrast (70470) $2,175.80 $7,251.20 12.3×
CT iac w contrast (70481) $1,381.60 $4,605.70 7.8×
CT limited/localized follow up study (76380) $152.90 $509.30 1.7×
CT lower ext w/o (73700) $1,243 $4,143.70 11.8×
CT lower extremity w wo contrast (73702) $635.80 $2,118.60 3.6×
CT lower extremity with contrast (73701) $1,491.60 $4,972 8.5×
CT lumbar spine w & w/o contrast (72133) $3,098.70 $10,327.90 17.6×
CT lumbar spine w/o contrast (72131) $2,175.80 $7,251.20 20.7×
CT lumbar spine with contrast (72132) $2,707.10 $9,022.20 7.7×
CT maxillofacial w contrast (70487) $574.20 $1,914 3.3×
CT maxillofacial w/o contrast (70486) $322.85 $1,075.80 3.1×
CT maxillofacial w/wo contrast (70488) $635.80 $2,118.60 3.6×
CT neck soft tissue w contrast (70491) $1,709.40 $5,698 9.7×
CT orbit sella/post fossa/ear w/o & w/contr matr (70482) $496.10 $1,652.20 2.8×
CT orbits w/o contrast (70480) $1,269.95 $4,232.25 12.1×
CT pelvis w & w/o contrast (72194) $2,019.60 $6,734.20 11.5×
CT pelvis w/o contrast (72192) $1,243 $4,143.70 11.8×
CT soft tissue neck w/o & w/contrast material (70492) $1,771 $5,904.80 10.1×
CT soft tissue neck w/o contrast (70490) $1,522.40 $5,076.50 14.5×
CT thoracic spine w/contrast (72129) $2,471.70 $8,239 14.0×
CT thoracic spine w/o contrast (72128) $1,716 $5,718.90 16.3×
CT thoracic spine w/wo contrast (72130) $2,087.80 $6,960.80 11.8×
CT thorax w/o contrast (71250) $947.65 $3,158.65 9.0×
CT upper extremity w/o & w/contrast material (73202) $635.80 $2,118.60 3.6×
CT upper extremity w/o contrast rt (73200) $1,087.90 $3,625.60 10.4×
CT upper extremity with contrast (73201) $574.20 $1,914 1.6×
Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) $1,357.40 $4,525.40 7.7×
Cta Abdomen (74175) $1,134.10 $3,780.70 6.4×
CTA chest (71275) $1,134.10 $3,780.70 6.4×
Cta Head (70496) $1,134.10 $3,780.70 6.4×
CTA lwr ext w&w/o contrast (73706) $1,045 $3,484.80 5.9×
Cta Neck (70498) $1,045 $3,484.80 5.9×
Cta Pelvis (72191) $1,134.10 $3,780.70 6.4×
Dxa bone density study 1/> sites axial skel (77080) $233.20 $778.80 2.2×
Dxa bone density study 1/>sites appendiclr skel (77081) $176 $586.30 2.0×
Esophagus (74220) $233.20 $776.60 1.3×
Fluoroscopy up to 1 hr (76000) $613.80 $2,047.10 2.6×
Foot 2 views (73620) $83.60 $278.30 1.0×
Forearm 2 views (73090) $363 $1,212.20 4.2×
Gastric mucosa imaging (78261) $353.10 $1,178.10 0.9×
Gastrointestinal Protein Loss (78282) $27.50 $92.40 0.1×
Gated Heart Planar Single (78472) $370.70 $1,235.30 0.9×
Hand 2 views (73120) $83.60 $278.30 0.8×
Hand 3 views (73130) $262.90 $875.60 3.0×
Heart Infarct Image (78466) $454.30 $1,513.60 1.1×
Heart infarct image w ef (78468) $454.30 $1,513.60 0.8×
Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) $838.20 $2,794 1.5×
Hepatobiliary syst imaging including gallbladder (78226) $520.30 $1,735.80 1.3×
Ht muscle image spect sing (78451) $1,046.65 $3,488.10 0.8×
Humerus Min 2 Views Left (73060) $217.80 $724.90 2.5×
Kidney funcj study non-img radioisotopic study (78725) $239.80 $798.60 0.6×
Kidney imaging morphology (78700) $478.50 $1,595 1.2×
Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) $887.15 $2,956.80 1.6×
Kidney img morphology vascular flow 1 w/rx (78708) $376.20 $1,252.90 0.7×
Kidney Img Morphology Vascular Flow Multiple (78709) $421.30 $1,404.70 0.8×
Knee 3 views (73562) $202.40 $673.20 2.3×
Liver & spleen imaging static only (78215) $685.30 $2,282.50 1.7×
Liver & Spleen Imaging W/Vascular Flow (78216) $726 $2,420 1.8×
Liver imaging static only (78201) $512.60 $1,708.30 0.9×
Liver imaging w/vascular flow (78202) $668.80 $2,228.60 1.2×
Lung perf&ventilat diferentl (78598) $606.10 $2,018.50 1.1×
Lung Ventilation Imaging (78579) $606.10 $2,018.50 1.5×
Lymphoscintigraphy (78195) $489.50 $1,632.40 0.9×
Mammary ductogram or galactogram multiple (77054) $290.40 $966.90 1.2×
Mammary ductogram or galactogram single (77053) $290.40 $966.90 1.2×
Manual appl stress pfrmd phys/qhp joint films (77071) $64.90 $216.70 0.7×
Meckels Diverticulum (78290) $649 $2,164.80 1.6×
MRA head w & w/o contrast (70546) $982.30 $3,273.60 2.8×
MRA head w/o contrast (70544) $1,740.20 $5,801.40 7.3×
MRA head with contrast (70545) $621.50 $2,071.30 1.8×
MRA neck w contrast (70548) $864.60 $2,883.10 2.5×
Mra Neck W/O &W/Contrast Material (70549) $1,262.80 $4,208.60 3.6×
MRA neck w/o contrast (70547) $1,118.70 $3,729 4.7×
MRI abdomen w contrast (74182) $928.40 $3,096.50 2.6×
MRI abdomen w/o & w/contrast material (74183) $1,075.80 $3,586 3.1×
MRI abdomen w/o contrast (74181) $683.10 $2,275.90 2.8×
MRI any jnt lwr ext with con lt (73722) $796.40 $2,656.50 1.0×
MRI any jt upper extremity w/contrast matrl (73222) $1,287 $4,292.20 1.6×
MRI c-spine with contrast (72142) $1,696.20 $5,655.10 4.8×
MRI cervical spine w/o contrast (72141) $2,205.50 $7,352.40 9.2×
MRI chest w/o & w/contrast material (71552) $1,305.70 $4,350.50 3.7×
MRI chest w/o contrast (71550) $848.10 $2,825.90 3.5×
MRI chest with contrast (71551) $949.30 $3,162.50 1.2×
MRI Forearm w/ Contrast Bilateral 73219 (73219) $796.40 $2,656.50 2.3×
MRI lower extrem oth/thn jt w/contrast matrl (73719) $796.40 $2,656.50 2.3×
MRI lower extrem oth/thn jt w/o contr matrl (73718) $1,718.20 $5,728.80 7.2×
MRI orbit face &/neck w/o contrast (70540) $652.30 $2,175.80 2.7×
MRI orbit/face/neck w&w/o cont (70543) $1,004.30 $3,349.50 2.9×
MRI orbit/face/neck w/contrast (70542) $4,752 $15,841.10 13.6×
MRI pelvis w contrast (72196) $851.40 $2,838 2.4×
MRI pelvis w/o & w/contrast material (72197) $1,073.60 $3,577.20 3.1×
MRI pelvis w/o contrast (72195) $765.60 $2,553.10 3.2×
MRI scan of arm joint before and after contrast (73223) $1,435.50 $4,785 4.1×
MRI scan of leg joint before and after contrast (73723) $1,004.30 $3,349.50 2.9×
MRI spinal canal cervical w/o & w/contr matrl (72156) $2,268.20 $7,561.40 6.5×
MRI spinal canal lumbar w/contrast material (72149) $2,786.30 $9,289.50 8.0×
MRI spinal canal lumbar w/o & w/contr matrl (72158) $2,409 $8,030 6.9×
MRI spinal canal thoracic w/contrast matrl (72147) $782.10 $2,608.10 2.2×
MRI spinal canal thoracic w/o & w/contr matrl (72157) $982.30 $3,273.60 2.8×
MRI thoracic spine w/o contrast (72146) $2,052.60 $6,840.90 8.6×
MRI tmj (70336) $649 $2,163.70 2.7×
MRI upper ext joint w/o contrast (73221) $2,198.90 $7,328.20 9.2×
MRI upper extrem other than jt w/o & w/contras (73220) $1,067 $3,555.20 3.0×
MRI upper extremity oth than jt w/o contr matrl (73218) $838.20 $2,794 3.5×
Myocardial infarct spect (78469) $454.30 $1,513.60 0.8×
Myocardial Spect Multiple Studies (78452) $2,747.80 $9,157.50 2.1×
Neck soft tissue (70360) $496.10 $1,654.40 5.7×
Nm adrenal scan (78075) $1,459.70 $4,864.20 1.1×
Nm bone marrow multiple (78103) $381.70 $1,272.70 1.0×
Nm bone marrow wb (78104) $381.70 $1,272.70 1.0×
Nm gastric emptying study (78264) $959.20 $3,195.50 2.4×
Nm gastroesophageal reflux study (78262) $353.10 $1,178.10 0.9×
Nm red cell sequestration (78140) $581.90 $1,939.30 1.4×
Nm whole blood volume (78122) $581.90 $1,939.30 1.1×
Nuclear medicine of heart pumping function (78473) $583 $1,941.50 1.5×
Nuclear medicine of heart pumping function by first pass technique (78483) $454.30 $1,513.60 0.8×
Nuclear medicine study of heart muscle at rest with stress (78453) $1,288.10 $4,293.30 1.0×
Nuclear medicine study of limited area for thyroid cancer (78015) $434.50 $1,449.80 1.1×
Nuclear medicine study to assess blood clot in vein of both sides (78458) $465.30 $1,553.20 1.2×
Nuclear medicine study to assess blood clot in vein of side (78457) $335.50 $1,116.50 0.6×
Nuclear Rx Oral Admin (79005) $401.50 $1,337.60 1.7×
Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) $91.30 $303.60 0.9×
Osseous survey infant (77076) $138.60 $463.10 1.3×
Osseous survey limited (77074) $138.60 $463.10 1.3×
Parathyrd planar w/wo subtrj (78071) $456.50 $1,521.30 1.1×
Parathyroid imaging (78070) $471.90 $1,573 1.2×
Pelvis 1 or 2 views (72170) $83.60 $278.30 0.8×
Pr heart first pass single,planar (78481) $454.30 $1,513.60 0.8×
Pr MRI, lower extr, w/o contrast f/u by contrast (73720) $1,553.20 $5,178.80 4.4×
Pr red cell survival study (78130) $581.90 $1,939.30 1.4×
Pulmonary Perfusion Imaging Particulate (78580) $425.70 $1,420.10 1.1×
Pulmonary Ventilation & Perfusion Imaging (78582) $502.70 $1,677.50 0.9×
Radex Entir Thrc Lmbr Crv Sac Spi W/Skull 1 Vw - Xr Scoliosis 1 Vw (72081) $83.60 $278.30 1.0×
Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) $138.60 $463.10 1.3×
Radex hips bilateral with pelvis 2 views (73521) $652.30 $2,175.80 6.2×
Radex mastoids compl minimum 3 views pr side (70130) $366.30 $1,223.20 3.5×
Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) $818.40 $2,726.90 7.8×
Radiolog exam mandible compl minimum 4 views (70110) $484 $1,611.50 4.6×
Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) $198 $661.10 2.3×
Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) $248.60 $829.40 2.4×
Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) $193.60 $644.60 2.2×
Radiologic exam colon single contrast study (74270) $962.50 $3,208.70 5.5×
Radiologic exam upr gi trc double contrast study (74246) $1,086.80 $3,622.30 6.2×
Radiologic exam upr gi trc single contrast study (74240) $1,109.90 $3,699.30 6.3×
Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) $497.20 $1,657.70 5.7×
Radiological examination surgical specimen (76098) $490.60 $1,634.60 0.9×
Red Cell Volume Determination Spx 1 Sampling (78120) $581.90 $1,939.30 1.4×
Red Cell Volume Determination Spx Mult Samplings (78121) $581.90 $1,939.30 1.1×
Ribs bilateral 3 views (71110) $497.20 $1,657.70 4.7×
Rp loclzj tum plnr 2+area 1+d img/1 area img>2+d (78801) $819.50 $2,733.50 2.0×
Rp loclzj tum plnr whole body single day imaging (78802) $341 $1,137.40 0.6×
Rp loclzj tum spect 1 area single day imaging (78803) $482.90 $1,610.40 0.9×
Rp Therapy Intravenous Administration (79101) $312.40 $1,042.80 1.3×
Sacroiliac Joints < 3 Views (72200) $83.60 $278.30 0.8×
Scanogram (77073) $64.90 $216.70 0.6×
Scapula complete (73010) $183.70 $611.60 1.7×
Sella turcica (70240) $64.90 $216.70 0.7×
Small bowel series (74250) $800.80 $2,669.70 4.5×
Spine thoracic 3 views (72072) $226.60 $756.80 2.2×
Spleen imaging only (78185) $381.70 $1,272.70 1.0×
Thoracolumbar 2 views (72080) $64.90 $216.70 0.7×
Thyroid carcinoma metastases img addl study (78016) $434.50 $1,449.80 1.1×
Thyroid Imaging With Vascular Flow (78013) $572 $1,906.30 1.4×
Thyroid uptake measurement (78012) $639.65 $2,132.35 1.6×
Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) $572 $1,906.30 1.4×
Tmj unilateral (70328) $78.10 $258.50 0.9×
Tumor Imaging, Limited Area - Nm Tumor Localization Limited (78800) $506 $1,688.50 1.3×
Ultrasound, abdomen limited (76705) $541.20 $1,805.10 5.2×
Umbilical-artery Doppler (OB) (76820) $137.50 $458.70 1.3×
Upper Extremity Infant (73092) $83.60 $278.30 0.8×
Ureteral Reflux Study Rp Voiding Cystogram (78740) $478.50 $1,595 1.2×
Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) $763.40 $2,544.30 4.3×
Us abdl aorta screen aaa (76706) $732.60 $2,442 7.0×
Us breast unilateral complete (76641) $451 $1,504.80 4.3×
Us breast unilateral limited (76642) $34.10 $113.30 0.4×
Us chest (76604) $515.90 $1,719.30 4.9×
Us compl joint r-t w/image documentation (76881) $579.70 $1,933.80 5.5×
Us infant hips dynamic (76885) $91.30 $303.60 1.0×
Us infant hips limited static (76886) $91.30 $303.60 1.0×
Us kidney transplant (76776) $182.60 $607.20 1.7×
Us ob detailed single fetus (76811) $223.30 $742.50 0.9×
Us ob transvaginal (76817) $169.40 $564.30 1.6×
Us pelvic non ob complete (76856) $644.60 $2,149.40 6.1×
Us pelvic nonobstetric image dcmtn limited/f/u (76857) $387.20 $1,289.20 3.7×
Us pregnancy ltd (76815) $91.30 $303.60 0.9×
Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) $212.30 $707.30 2.0×
Us retroperitoneal complete (76770) $721.60 $2,406.80 6.9×
Us retroperitoneal limited (76775) $709.50 $2,363.90 6.8×
Us scrotum and contents (76870) $579.70 $1,933.80 5.5×
Us soft tissue head/neck (76536) $515.90 $1,719.30 4.9×
Us spinal canal and contents (76800) $141.90 $474.10 1.4×
Us transrectal (76872) $704 $2,345.20 6.7×
Us transrectal prostate volume (76873) $223.30 $742.50 2.1×
Us xtr non-vasc lmtd (76882) $89.10 $297 0.8×
Vascular flow imaging (78445) $271.70 $906.40 0.7×
Wrist 2 views (73100) $85.80 $288.20 1.0×
X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) $326.70 $1,089 3.1×
X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) $308 $1,027.40 3.5×
X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) $214.50 $716.10 2.5×
X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) $1,133 $3,777.40 6.4×
X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) $488.40 $1,626.90 5.6×
X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) $83.60 $278.30 1.0×
X-ray exam hip uni 1 view (73501) $83.60 $278.30 1.0×
X-Ray Exam Hip Uni 2-3 Views (73502) $236.50 $787.60 2.7×
X-ray exam of femur 1 (73551) $435.05 $1,450.90 5.0×
X-ray eye for foreign body (70030) $83.60 $278.30 1.0×
X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) $445.50 $1,486.10 4.2×
X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) $352 $1,172.60 4.0×
X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) $224.40 $750.20 2.6×
X-Ray Heel - Xr Calcaneus 2 Views Right (73650) $381.70 $1,273.80 4.4×
X-ray IV pyelogram+drip infusn (74410) $253 $843.70 1.4×
X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) $83.60 $278.30 1.0×
X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) $83.60 $278.30 1.0×
X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) $83.60 $278.30 1.0×
X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) $213.40 $711.70 2.0×
X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) $138.60 $463.10 1.3×
X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) $123.20 $411.95 1.2×
X-Ray Nasal Bones - Xr Nasal Bones (70160) $432.30 $1,439.90 4.9×
X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) $709.50 $2,363.90 6.8×
X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) $342.10 $1,139.60 3.9×
X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) $83.60 $278.30 0.8×
X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) $537.90 $1,791.90 5.1×
X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) $458.70 $1,531.20 5.2×
X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) $236.50 $787.60 2.7×
X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) $880 $2,932.60 10.1×
X-Ray Sinuses <3 Vw - Xr Paranasal Sinuses 1-2 Views (70210) $111.10 $368.50 1.3×
X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) $885.50 $2,950.20 8.4×
X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) $467.50 $1,559.80 4.5×
X-Ray Spine One View - Xr Spine (72020) $83.60 $278.30 1.0×
X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) $300.30 $1,002.10 3.4×
X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) $374 $1,247.40 4.3×
X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) $599.50 $1,998.70 5.7×
X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) $83.60 $278.30 0.8×
X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) $282.70 $943.80 3.2×
X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) $254.10 $845.90 2.9×
Xr c-spine 6 or more views (72052) $814 $2,714.80 7.8×
Xr finger(s) 2+ views (73140) $326.70 $1,089 3.7×
XR Mastoids < 3 Views Bilateral (70120) $83.60 $278.30 0.8×
Xr shoulder 1 view (73020) $83.60 $278.30 1.0×
Xr spine cervical 4 or 5 views (72050) $189.20 $630.30 1.8×
Xr tibia/fibula 2 views (73590) $413.60 $1,378.30 4.7×
Xr tmj bilateral (70330) $257.40 $860.20 2.9×
Xray knee 1 or 2 views rt (73560) $152.35 $508.75 1.7×