| Angio Adrenal Bilat Select (75733) |
$3,868.20 |
— |
1.2× |
| Angiography extremity bilateral rs&i (75716) |
$3,868.20 |
$11,569.84 |
1.2× |
| Angiography extremity unilateral rs&i (75710) |
$3,868.20 |
$11,569.84 |
1.2× |
| Angiography internal mammary rs&i (75756) |
$1,252.47 |
$11,569.84 |
0.4× |
| Angiography pelvic slctv/supraslctv rs&i (75736) |
$3,868.20 |
$19,962.01 |
0.7× |
| Angiography pulmonary bilateral slctv rs&i (75743) |
$3,868.20 |
— |
1.2× |
| Angiography pulmonary unilateral slctv rs&i (75741) |
$3,868.20 |
$11,569.84 |
1.2× |
| Angiography Spinal Selective Rs&I (75705) |
$3,868.20 |
— |
0.7× |
| Angiography visceral slctv/supraslctv rs&i (75726) |
$3,868.20 |
$19,962.01 |
0.7× |
| Angrph Cath F-Up Std Tcat Other Than Thrombylsis (75898) |
$359.48 |
— |
0.1× |
| Ankle 2 views (73600) |
$93.14 |
$151 |
1.1× |
| Aortogram thoracic (75605) |
$3,868.20 |
$19,962.01 |
0.7× |
| Aortography abdl bi iliofem low extrem cath rs&i (75630) |
$3,868.20 |
$11,569.84 |
1.2× |
| Aortography abdominal serialography rs&i (75625) |
$3,868.20 |
$11,569.84 |
1.2× |
| Aortography Thoracic W/O Serialography Rs&I (75600) |
$3,868.20 |
— |
1.2× |
| Artery X-Rays Adrenal Gland (75731) |
$3,868.20 |
— |
1.2× |
| Arthrogram ankle (73615) |
$536.19 |
$157 |
1.5× |
| Arthrogram elbow (73085) |
$536.19 |
$639 |
1.5× |
| Arthrogram hip (73525) |
$536.19 |
$635 |
1.5× |
| Arthrogram knee (73580) |
$536.19 |
$475 |
1.5× |
| Arthrogram shoulder (73040) |
$536.19 |
$775.50 |
1.5× |
| Arthrogram wrist (73115) |
$536.19 |
$639 |
1.5× |
| Bone age studies (77072) |
$93.14 |
$160.50 |
0.9× |
| Bone survey complete (77075) |
$154.96 |
$253 |
1.5× |
| Bone survey infant (77076) |
$93.14 |
$175 |
0.9× |
| Cardiac magnetic resonance imaging for morphology and function without contrast material(s), followed by contrast… (75563) |
$1,104.56 |
$2,877 |
1.4× |
| Cardiac MRI w/w/o contrast & further seq (75561) |
$1,104.56 |
$1,481 |
3.1× |
| Cervical spine 2 or 3 views (72040) |
$95.06 |
$171 |
1.1× |
| Chest 1 view (71045) |
$93.14 |
$121.50 |
1.1× |
| Chest xray 3 views (71047) |
$93.14 |
$216 |
1.1× |
| Clavicle complete (73000) |
$93.14 |
$168.50 |
1.1× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,369.62 |
$2,024 |
3.9× |
| CT abdomen and pelvis without contrast (74176) |
$806.61 |
$2,415 |
3.3× |
| CT abdomen w contrast (74160) |
$583.53 |
$428 |
3.3× |
| CT abdomen w wo contrast (74170) |
$684.81 |
$1,624 |
3.9× |
| CT abdomen w/o contrast (74150) |
$403.30 |
$296 |
3.8× |
| CT angio hrt w/3d image (75574) |
$3,307.90 |
$2,876 |
9.4× |
| CT angio lwr extr w/o&w/dye (73706) |
$691.71 |
$1,303 |
3.9× |
| CT angiography upper extremity lt (73206) |
$691.71 |
$1,199 |
3.9× |
| CT c-spine w/contrast (72126) |
$583.53 |
$753 |
1.7× |
| CT c-spine w/o contrast (72125) |
$630.40 |
$462 |
6.0× |
| CT cervical spine w&w/o contrast (72127) |
$684.81 |
$1,356 |
3.9× |
| CT chest w contrast (71260) |
$583.53 |
$1,510 |
3.3× |
| CT chest w/wo contrast (71270) |
$684.81 |
$1,994 |
3.9× |
| CT head/brain with contrast (70460) |
$583.53 |
$1,309 |
3.3× |
| CT head/brain without and with contrast (70470) |
$684.81 |
$1,696 |
3.9× |
| CT heart contrast eval cardiac structure&morph (75572) |
$2,185.56 |
$2,867 |
6.2× |
| CT heart w/o contrast quant eval coronary calcium (75571) |
$824.58 |
$715 |
9.4× |
| CT hrt w/3d image congen (75573) |
$2,914.42 |
$2,526 |
8.3× |
| CT iac w contrast (70481) |
$583.53 |
$1,065.50 |
3.3× |
| CT lower ext w/o (73700) |
$621.38 |
$1,158 |
5.9× |
| CT lower extremity w wo contrast (73702) |
$684.81 |
$1,587 |
3.9× |
| CT lower extremity w/contrast material (73701) |
$583.53 |
$1,322 |
3.3× |
| CT lumbar spine w & w/o contrast (72133) |
$684.81 |
$1,356 |
3.9× |
| CT lumbar spine w/contrast (72132) |
$583.53 |
$753 |
1.7× |
| CT lumbar spine w/o contrast (72131) |
$623.96 |
$1,200 |
5.9× |
| CT maxillofacial w contrast (70487) |
$583.53 |
$428 |
3.3× |
| CT maxillofacial w/wo contrast (70488) |
$684.81 |
$1,153 |
3.9× |
| CT maxillofacial wo contrast (70486) |
$667.82 |
$1,496.50 |
6.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$684.81 |
$1,980.50 |
3.9× |
| CT orbits w/o contrast (70480) |
$831.64 |
$1,425.50 |
7.9× |
| CT pelvis w/o contrast (72192) |
$403.30 |
$1,007 |
3.8× |
| CT pelvis w/wo contrast (72194) |
$684.81 |
$1,437 |
3.9× |
| CT scan of arm combo (73202) |
$684.81 |
$1,587 |
3.9× |
| CT soft tissue neck w contrast (70491) |
$777.48 |
$570 |
4.4× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$684.81 |
$1,153 |
3.9× |
| CT soft tissue neck w/o contrast (70490) |
$403.30 |
$296 |
3.8× |
| CT thoracic spine w/contrast (72129) |
$583.53 |
$1,153 |
3.3× |
| CT thoracic spine w/o contrast (72128) |
$403.30 |
$296 |
3.8× |
| CT thoracic spine w/wo contrast (72130) |
$684.81 |
$1,356 |
3.9× |
| CT thorax w/o contrast (71250) |
$621.38 |
$1,398 |
5.9× |
| CT upper ext wo (73200) |
$618.81 |
$974 |
5.9× |
| CT upper extremity with contrast (73201) |
$773.61 |
$1,306.50 |
2.2× |
| Cta Abdomen (74175) |
$691.71 |
$1,236 |
3.9× |
| CTA abdomen pelvis (74174) |
$3,798.14 |
$3,292 |
10.8× |
| CTA chest (71275) |
$691.71 |
$1,133 |
3.9× |
| Cta Head (70496) |
$691.71 |
$1,111 |
3.9× |
| Cta Neck (70498) |
$1,672.77 |
$1,450 |
9.4× |
| Cta Pelvis (72191) |
$691.71 |
$1,229 |
3.9× |
| Dilation of ureter(s) or urethra, radiological supervision and interpretation Non-Facility (74485) |
$718.28 |
— |
0.3× |
| Diskogram cervical (72285) |
$2,703.33 |
— |
1.4× |
| Diskography lumbar (72295) |
$2,703.33 |
$1,479 |
1.4× |
| Esophagus (74220) |
$185.28 |
$311.50 |
1.0× |
| Facial bones min 3 views (70150) |
$93.14 |
$235 |
0.9× |
| Fetal biophysical profile non-stress testing (76818) |
$202.17 |
— |
1.9× |
| Fluoroscopy up to 1 hr (76000) |
$177.76 |
$740.97 |
0.7× |
| Foot 2 views (73620) |
$93.14 |
$146 |
1.1× |
| Forearm 2 views (73090) |
$93.14 |
$129 |
1.1× |
| Hand 2 views (73120) |
$93.14 |
$129 |
0.9× |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
$3,868.20 |
— |
1.2× |
| Hepatc vngrph wdg/fr w/o hemodyn eval rs&i (75891) |
$3,868.20 |
— |
1.2× |
| Hysterosalpingogram (74740) |
$359.48 |
— |
1.5× |
| Knee 3 views (73562) |
$110.52 |
$167 |
1.3× |
| Lymphangiography Pelvic/Abdominal Bilateral Rs&I (75807) |
$718.28 |
— |
0.2× |
| Lymphangiography Pelvic/Abdominal Unilat Rs&I (75805) |
$718.28 |
— |
0.2× |
| Magnetic resonance (eg, proton) imaging, any joint of upper extremity; with contrast material(s) Non-Facility (73222) |
$1,379.92 |
$2,901 |
1.7× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; with contrast material(s) Non-Facility (73219) |
$835.14 |
$2,628 |
2.4× |
| Magnetic resonance (eg, proton) imaging, upper extremity, other than joint; without contrast material(s), followed by… (73220) |
$1,810.80 |
$2,692 |
5.1× |
| Mammary ductogram or galactogram single (77053) |
$359.48 |
— |
1.5× |
| Manual Appl Stress Pfrmd Phys/Qhp Joint Films (77071) |
$93.14 |
— |
1.1× |
| MRA head w & w/o contrast (70546) |
$1,104.56 |
$4,141 |
3.1× |
| MRA head w/o contrast (70544) |
$722.40 |
$2,433 |
3.0× |
| MRA head with contrast (70545) |
$835.14 |
$3,341 |
2.4× |
| MRA neck w contrast (70548) |
$835.14 |
$3,341 |
2.4× |
| Mra Neck W/O &W/Contrast Material (70549) |
$1,104.56 |
$5,081 |
3.1× |
| MRA neck w/o contrast (70547) |
$722.40 |
$2,890 |
3.0× |
| MRI abdomen w contrast (74182) |
$835.14 |
— |
2.4× |
| MRI abdomen w/o & w/contrast material (74183) |
$1,104.56 |
$810 |
3.1× |
| MRI abdomen w/o contrast (74181) |
$722.40 |
$1,954.50 |
3.0× |
| MRI any jt lower extrem w/contrast material (73722) |
$1,401.87 |
$2,763 |
1.8× |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
$1,683.09 |
$3,232 |
4.8× |
| MRI c-spine with contrast (72142) |
$835.14 |
$753 |
2.4× |
| MRI cardiac w/o cont stress (75559) |
$722.40 |
$1,954 |
1.3× |
| MRI cardiac w/o contrast (75557) |
$722.40 |
$1,136 |
3.0× |
| MRI cervical spine w/o contrast (72141) |
$1,173.52 |
$2,648 |
4.9× |
| MRI chest w/o & w/contrast material (71552) |
$1,104.56 |
$2,076 |
3.1× |
| MRI chest w/o contrast (71550) |
$722.40 |
$530 |
3.0× |
| MRI chest with contrast (71551) |
$835.14 |
$2,136 |
1.1× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$835.14 |
$2,628 |
2.4× |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
$1,104.56 |
$2,696 |
3.1× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,352.84 |
$2,236 |
5.6× |
| MRI orbit face &/neck w/o contrast (70540) |
$1,323.16 |
$1,795 |
5.5× |
| MRI orbit face neck w contrast (70542) |
$835.14 |
$2,131 |
2.4× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,778.54 |
$2,682 |
5.0× |
| MRI pelvis w/contrast (72196) |
$835.14 |
$3,056.50 |
2.4× |
| MRI pelvis w/o & w/contrast material (72197) |
$1,104.56 |
$3,350 |
3.1× |
| MRI pelvis w/o contrast (72195) |
$1,368.30 |
$2,720 |
5.7× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,104.56 |
$810 |
3.1× |
| MRI spinal canal lumbar w/contrast material (72149) |
$835.14 |
$753 |
2.4× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,686.96 |
$2,927 |
4.8× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$835.14 |
$753 |
2.4× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,104.56 |
$810 |
3.1× |
| MRI temporomandibular joint (70336) |
$654.06 |
$2,200 |
2.7× |
| MRI thoracic spine w/o contrast (72146) |
$1,176.10 |
$2,150 |
4.9× |
| MRI up ext w/o contrast (73218) |
$1,363.16 |
$2,236 |
5.7× |
| MRI upper ext joint w/o contrast (73221) |
$816.18 |
$2,087 |
3.4× |
| MRI, joint upper extrem combo (73223) |
$1,104.56 |
$3,232 |
3.1× |
| Myelogram Cervical (72240) |
$1,012.48 |
$1,438 |
1.3× |
| Myelogram Lumbar (72265) |
$1,012.48 |
— |
1.3× |
| Myelogram thoracic (72255) |
$1,012.48 |
— |
1.3× |
| Myelography 2 or more regions (72270) |
$1,012.48 |
— |
1.3× |
| Neck soft tissue (70360) |
$93.14 |
$158 |
1.1× |
| Nonvascular shunt X-ray (75809) |
$359.48 |
— |
3.4× |
| Pelvis 1 or 2 views (72170) |
$93.14 |
$186 |
0.9× |
| Peritoneogram after injection (74190) |
$718.28 |
— |
1.3× |
| Prq Transhepatc Portograpy Hemodyn Eval Rs&I (75885) |
$3,868.20 |
— |
1.2× |
| Prq transhepatc portograpy w/o hemodyn evl intrp (75887) |
$1,252.47 |
— |
0.4× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$359.48 |
$328 |
0.7× |
| Radex Ankle Compl Minimum 3 Views (73610) |
$93.14 |
$150 |
1.1× |
| Radex Calcaneus Minimum 2 Views (73650) |
$93.14 |
$129 |
1.1× |
| Radex Elbw Compl Minimum 3 Views (73080) |
$98.92 |
$158 |
1.1× |
| Radex entir thrc lmbr crv sac spi w/skull 2/3 vw (72082) |
$93.14 |
$446 |
0.9× |
| Radex fingr minimum 2 views (73140) |
$93.14 |
$108 |
1.1× |
| Radex Foot Compl Minimum 3 Views (73630) |
$93.14 |
$129 |
1.1× |
| Radex Hand Minimum 3 Views (73130) |
$93.14 |
$144 |
1.1× |
| Radex Hip Unilateral With Pelvis 1 View (73501) |
$93.14 |
$128 |
1.1× |
| Radex Hip Unilateral With Pelvis Minimum 4 Views (73503) |
$111.82 |
$128 |
1.1× |
| Radex Hips Bilateral With Pelvis 2 Views (73521) |
$154.96 |
$164 |
1.5× |
| Radex Humerus Minimum 2 Views (73060) |
$93.14 |
$144.50 |
1.1× |
| Radex Kne 1/2 Views (73560) |
$93.14 |
$144 |
1.1× |
| Radex Kne Compl 4/More Views (73564) |
$127.29 |
$186 |
1.2× |
| Radex Mndbl Compl Minimum 4 Views (70110) |
$93.14 |
$195 |
0.9× |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
$93.14 |
$128 |
1.1× |
| Radex Pelvis Compl Minimum 3 Views (72190) |
$93.14 |
$214 |
0.9× |
| Radex Sho Compl Minimum 2 Views (73030) |
$93.14 |
$169 |
1.1× |
| Radex Sinuses Paransl < 3 Views (70210) |
$93.14 |
$141 |
1.1× |
| Radex Spine Lumbosacral Only Bending 2/3 Views (72120) |
$154.96 |
$214 |
1.5× |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
$93.14 |
$265 |
1.1× |
| Radex Toe Minimum 2 Views (73660) |
$93.14 |
$116 |
1.1× |
| Radex Wrst Compl Minimum 3 Views (73110) |
$115.70 |
$144 |
1.3× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$93.14 |
$150 |
1.1× |
| Radiologic Exam Abdomen 3+ Views - Xr Abdomen 3+ Views (74021) |
$100.54 |
$206 |
1.0× |
| Radiologic exam chest 2 views (71046) |
$93.14 |
$248 |
1.1× |
| Radiologic exam colon single contrast study (74270) |
$185.28 |
$457 |
1.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$185.28 |
$417 |
1.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$185.28 |
$471 |
1.0× |
| Radiologic examination femur 1 view (73551) |
$93.14 |
$229 |
1.1× |
| Radiologic examination tibia & fibula 2 views (73590) |
$93.14 |
$154 |
1.1× |
| Radiologic examination, mastoids; complete, minimum of 3 views per side Non-Facility (70130) |
$93.14 |
— |
0.9× |
| Scapula (73010) |
$93.14 |
$178 |
0.9× |
| Screening Digital Breast Tomosynthesis Bi (77063) |
$127.84 |
— |
5.5× |
| Shoulder 1 view (73020) |
$93.14 |
$150 |
1.1× |
| Sialogram (70390) |
$359.48 |
— |
1.5× |
| Small bowel series (74250) |
$185.28 |
$352 |
1.0× |
| Spine thoracic 3 views (72072) |
$93.14 |
$202 |
0.9× |
| Superior sagittal sinus venogram (75870) |
$1,252.47 |
— |
0.4× |
| Temporomandibular joint arthrography, radiological supervision and interpretation Non-Facility (70332) |
$536.19 |
— |
2.2× |
| Thoracolumbar 2 views (72080) |
$93.14 |
$131 |
1.1× |
| Ultrasound breast complete (76641) |
$494.91 |
— |
4.7× |
| Ultrasound, abdomen limited (76705) |
$310.48 |
$245 |
2.9× |
| Unlisted Diagnostic Radiographic Procedure (76499) |
$93.14 |
— |
1.1× |
| Unlisted fluoroscopic procedure (76496) |
$177.76 |
— |
2.0× |
| Urethrocystogram voiding (74455) |
$349.89 |
— |
1.5× |
| Urethrocystography retrograde rs&i (74450) |
$349.89 |
— |
1.5× |
| Us chest (76604) |
$128.20 |
$230 |
1.2× |
| Us compl joint r-t w/image documentation (76881) |
$202.17 |
$250 |
1.9× |
| Us encephalogram (76506) |
$128.20 |
$338 |
1.2× |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
$108.63 |
$284 |
1.0× |
| Us ob limited (76815) |
$128.20 |
$352 |
1.2× |
| Us ob transvaginal (76817) |
$128.20 |
— |
1.2× |
| Us pelvic non ob complete (76856) |
$202.17 |
$214 |
1.9× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$128.20 |
$229 |
1.2× |
| Us retroperitoneal complete (76770) |
$202.17 |
$214 |
1.9× |
| Us retroperitoneal limited (76775) |
$202.17 |
$214 |
1.9× |
| Us scrotum and contents (76870) |
$202.17 |
$214 |
1.9× |
| Us soft tissue head/neck (76536) |
$369.82 |
$271 |
3.5× |
| Us transrectal (76872) |
$202.17 |
— |
1.9× |
| Venogram adrenal unilat (75840) |
$3,868.20 |
— |
1.2× |
| Venogram extremity bilateral (75822) |
$1,252.47 |
$5,778.57 |
0.8× |
| Venogram Extremity Unilateral (75820) |
$1,252.47 |
$5,778.57 |
0.8× |
| Venography caval inferior serialography rs&i (75825) |
$3,868.20 |
$11,569.84 |
1.2× |
| Venography caval superior serialography rs&i (75827) |
$1,252.47 |
$5,778.57 |
0.8× |
| Venography Orbital Rs&I (75880) |
$1,252.47 |
— |
2.0× |
| Venography Renal Bilateral (75833) |
$3,868.20 |
— |
1.2× |
| Venography renal unilateral selective rs&i (75831) |
$3,868.20 |
— |
1.2× |
| Venography venous sinus/jugular cath rs&i (75860) |
$1,252.47 |
— |
0.4× |
| Venous sampling by catheter (75893) |
$3,868.20 |
— |
0.7× |
| Wrist 2 views (73100) |
$93.14 |
$124 |
1.1× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$154.96 |
$214 |
1.5× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$297.66 |
$594 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$93.14 |
$144 |
1.1× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$111.82 |
$122 |
1.3× |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
$154.96 |
$200 |
1.5× |
| X-ray exam of femur 2/> (73552) |
$93.14 |
$181.50 |
1.1× |
| X-ray eye for foreign body (70030) |
$93.14 |
$169 |
1.1× |
| X-Ray Facial Bones <3 Vw - Xr Facial Bones 1-2 Views (70140) |
$93.14 |
$169 |
1.1× |
| X-ray IV pyelogram (ivp) (74400) |
$349.89 |
$482.50 |
2.0× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$93.14 |
$117 |
1.1× |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
$93.14 |
$249 |
1.1× |
| X-ray leg, infant (73592) |
$93.14 |
$154 |
1.1× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$96.33 |
$178 |
0.9× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$154.96 |
$287 |
1.5× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$93.14 |
$206 |
0.9× |
| X-ray retrograde pyelogram (74420) |
$349.89 |
$549 |
1.0× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$93.14 |
$176 |
1.1× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$93.14 |
$224 |
0.9× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$154.96 |
$253 |
1.5× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$93.14 |
$1,437 |
0.9× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$93.14 |
$200 |
1.1× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$93.14 |
$131 |
1.1× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$154.96 |
$214 |
1.5× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$93.14 |
$167 |
0.9× |
| X-Ray Spine One View - Xr Spine (72020) |
$93.14 |
$139 |
1.1× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$93.14 |
$135 |
1.1× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$93.14 |
$169 |
1.1× |
| X-Ray Thoracic Spine 2 Vw - Xr Thoracic Spine 2 Views (72070) |
$93.14 |
$131 |
0.9× |
| X-Ray Thoracic Spine 4 Vw - Xr Thoracic Spine Complete 4+ Views (72074) |
$93.14 |
$214 |
0.9× |
| Xr bone length studies (77073) |
$93.14 |
$320 |
0.9× |
| Xr c-spine 4 or 5 views (72050) |
$154.96 |
$311 |
1.5× |
| Xr c-spine 6 or more views (72052) |
$154.96 |
$260 |
1.5× |
| Xr chest 4+ views (71048) |
$93.14 |
$242 |
0.9× |
| Xr urogram antegrade (74425) |
$349.89 |
— |
1.0× |