| Abdomen 2 views (74019) |
$65.75 |
$131.50 |
0.7× |
| Acute gastrointestinal blood loss imaging (78278) |
$428.50 |
$857 |
1.2× |
| Ankle 2 views (73600) |
$149.50 |
$299 |
2.0× |
| Arthrogram hip (73525) |
$349.50 |
$699 |
1.1× |
| Arthrogram shoulder (73040) |
$349.50 |
$699 |
1.1× |
| Arthrogram wrist (73115) |
$349.50 |
$699 |
1.1× |
| Arthrography knee lt (73580) |
$349.50 |
$699 |
1.1× |
| Bone &/Joint Imaging Limited Area (78300) |
$333.50 |
$667 |
1.0× |
| Bone &/Joint Imaging Multiple Areas (78305) |
$333.50 |
$667 |
1.0× |
| Bone &/joint imaging whole body (78306) |
$700.50 |
$1,401 |
2.0× |
| Bone age studies (77072) |
$30 |
$60 |
0.3× |
| Bone Imaging 3 Phase (78315) |
$910 |
$1,820 |
2.6× |
| Bone survey complete (77075) |
$105 |
$210 |
1.1× |
| Cervical spine 2 or 3 views (72040) |
$322 |
$644 |
4.2× |
| Chest 1 view (71045) |
$43.25 |
$86.50 |
0.6× |
| Chest 3 views (71047) |
$59.50 |
$119 |
0.8× |
| Cine/Vid X-Ray Throat/Esoph - Fl Esoph Barium Swlw W/ Video & Speech (74230) |
$152.50 |
$305 |
1.0× |
| Clavicle complete (73000) |
$174 |
$348 |
2.3× |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
$293 |
$586 |
3.2× |
| CT abdomen and pelvis without and with contrast (74178) |
$1,601.50 |
$3,203 |
5.2× |
| CT abdomen and pelvis without contrast (74176) |
$1,582.50 |
$3,165 |
7.6× |
| CT abdomen w contrast (74160) |
$1,883.50 |
$3,767 |
12.3× |
| CT abdomen w wo contrast (74170) |
$2,121 |
$4,242 |
13.8× |
| CT abdomen w/o contrast (74150) |
$182 |
$364 |
2.0× |
| CT angiography upper extremity lt (73206) |
$751.50 |
$1,503 |
4.9× |
| CT c-spine w/o contrast (72125) |
$431 |
$862 |
4.7× |
| CT cervical spine w&w/o contrast (72127) |
$721.50 |
$1,443 |
4.7× |
| CT cervical spine with contrast (72126) |
$641 |
$1,282 |
2.1× |
| CT chest w/wo contrast (71270) |
$2,969.40 |
$5,938.80 |
19.3× |
| CT chest with contrast (71260) |
$2,168.45 |
$4,336.90 |
14.1× |
| CT head/brain with contrast (70460) |
$449 |
$898 |
2.9× |
| CT head/brain without and with contrast (70470) |
$469.50 |
$939 |
3.1× |
| CT iac w contrast (70481) |
$641 |
$1,282 |
4.2× |
| CT limited/localized follow up study (76380) |
$205 |
$410 |
2.7× |
| CT lower ext w/o (73700) |
$216 |
$432 |
2.4× |
| CT lower extremity w wo contrast (73702) |
$865.75 |
$1,731.50 |
5.6× |
| CT lower extremity with contrast (73701) |
$673 |
$1,346 |
4.4× |
| CT lumbar spine w & w/o contrast (72133) |
$361 |
$722 |
2.3× |
| CT lumbar spine w/o contrast (72131) |
$431 |
$862 |
4.7× |
| CT lumbar spine with contrast (72132) |
$449 |
$898 |
1.5× |
| CT maxillofacial w contrast (70487) |
$545 |
$1,090 |
3.5× |
| CT maxillofacial w/o contrast (70486) |
$192.43 |
$384.86 |
2.1× |
| CT maxillofacial w/wo contrast (70488) |
$613.50 |
$1,227 |
4.0× |
| CT neck soft tissue w contrast (70491) |
$1,883.50 |
$3,767 |
12.3× |
| CT orbit sella/post fossa/ear w/o & w/contr matr (70482) |
$1,515 |
$3,030 |
9.9× |
| CT orbits w/o contrast (70480) |
$279.50 |
$559 |
3.1× |
| CT pelvis w & w/o contrast (72194) |
$361 |
$722 |
2.3× |
| CT pelvis w/o contrast (72192) |
$201.75 |
$403.50 |
2.2× |
| CT soft tissue neck w/o & w/contrast material (70492) |
$505.50 |
$1,011 |
3.3× |
| CT soft tissue neck w/o contrast (70490) |
$233 |
$466 |
2.5× |
| CT thoracic spine w/contrast (72129) |
$897 |
$1,794 |
5.8× |
| CT thoracic spine w/o contrast (72128) |
$1,339.10 |
$2,678.20 |
14.6× |
| CT thoracic spine w/wo contrast (72130) |
$721.50 |
$1,443 |
4.7× |
| CT thorax w/o contrast (71250) |
$1,425 |
$2,850 |
15.6× |
| CT upper extremity w/o & w/contrast material (73202) |
$721.50 |
$1,443 |
4.7× |
| CT upper extremity w/o contrast rt (73200) |
$228 |
$456 |
2.5× |
| CT upper extremity with contrast (73201) |
$769 |
$1,538 |
2.5× |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
$459.50 |
$919 |
3.0× |
| Cta Abdomen (74175) |
$1,577.50 |
$3,155 |
10.3× |
| CTA abdomen pelvis (74174) |
$484 |
$968 |
1.6× |
| CTA chest (71275) |
$1,086.75 |
$2,173.50 |
7.1× |
| Cta Head (70496) |
$2,129.75 |
$4,259.50 |
13.9× |
| CTA lwr ext w&w/o contrast (73706) |
$426.50 |
$853 |
2.8× |
| Cta Neck (70498) |
$2,413.50 |
$4,827 |
15.7× |
| Cta Pelvis (72191) |
$751.50 |
$1,503 |
4.9× |
| Dxa bone density study 1/> sites axial skel (77080) |
$266.50 |
$533 |
2.9× |
| Esophagus (74220) |
$105.50 |
$211 |
0.7× |
| Fetal biophysical profile non-stress testing (76818) |
$152 |
$304 |
1.7× |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
$138.50 |
$277 |
1.5× |
| Fluoroscopy up to 1 hr (76000) |
$473.50 |
$947 |
2.3× |
| Foot 2 views (73620) |
$189.25 |
$378.50 |
2.5× |
| Forearm 2 views (73090) |
$161.55 |
$323.10 |
2.1× |
| Gastric emptying imaging study (eg, solid, liquid, or both); with small bowel and colon transit, multiple days Age… (78266) |
$579.50 |
$1,159 |
1.2× |
| Hand 2 views (73120) |
$230 |
$460 |
2.5× |
| Hand 3 views (73130) |
$216.30 |
$432.60 |
2.8× |
| Heart Infarct Image (78466) |
$394.50 |
$789 |
1.1× |
| Hepatobil Syst Imag Inc Gb W/Pharma Intervenj (78227) |
$1,127 |
$2,254 |
2.4× |
| Hepatobiliary syst imaging including gallbladder (78226) |
$1,127 |
$2,254 |
3.2× |
| Ht muscle image spect sing (78451) |
$1,187 |
$2,374 |
1.0× |
| Humerus Min 2 Views Left (73060) |
$58.75 |
$117.50 |
0.8× |
| Hysterosalpingogram (74740) |
$327.50 |
$655 |
1.6× |
| Kidney Img Morphology Vascular Flow 1 W/O Rx (78707) |
$429.50 |
$859 |
0.9× |
| Kidney img morphology vascular flow 1 w/rx (78708) |
$429.50 |
$859 |
0.9× |
| Kidney Img Morphology Vascular Flow Multiple (78709) |
$450 |
$900 |
0.9× |
| Knee 3 views (73562) |
$253.50 |
$507 |
3.3× |
| Liver & spleen imaging static only (78215) |
$383.50 |
$767 |
1.1× |
| Liver & Spleen Imaging W/Vascular Flow (78216) |
$383.50 |
$767 |
1.1× |
| Liver imaging w/vascular flow (78202) |
$383.50 |
$767 |
0.8× |
| Lung perf&ventilat diferentl (78598) |
$931.50 |
$1,863 |
2.0× |
| Lung perfusion differential (78597) |
$249 |
$498 |
0.7× |
| Lymphoscintigraphy (78195) |
$438.50 |
$877 |
0.9× |
| Meckels Diverticulum (78290) |
$333.50 |
$667 |
1.0× |
| MRA head w & w/o contrast (70546) |
$761 |
$1,522 |
2.5× |
| MRA head w/o contrast (70544) |
$1,338 |
$2,676 |
6.4× |
| MRA head with contrast (70545) |
$658.50 |
$1,317 |
2.2× |
| MRA neck w contrast (70548) |
$658.50 |
$1,317 |
2.2× |
| Mra Neck W/O &W/Contrast Material (70549) |
$761 |
$1,522 |
2.5× |
| MRA neck w/o contrast (70547) |
$468 |
$936 |
2.2× |
| MRI abdomen w contrast (74182) |
$658.50 |
$1,317 |
2.2× |
| MRI abdomen w/o & w/contrast material (74183) |
$605 |
$1,210 |
2.0× |
| MRI abdomen w/o contrast (74181) |
$455 |
$910 |
2.2× |
| MRI any jnt lwr ext with con lt (73722) |
$658.50 |
$1,317 |
1.0× |
| MRI any jt upper extremity w/contrast matrl (73222) |
$658.50 |
$1,317 |
1.0× |
| MRI c-spine with contrast (72142) |
$658.50 |
$1,317 |
2.2× |
| MRI cervical spine w/o contrast (72141) |
$1,873.20 |
$3,746.40 |
9.0× |
| MRI chest w/o & w/contrast material (71552) |
$761 |
$1,522 |
2.5× |
| MRI chest w/o contrast (71550) |
$493.50 |
$987 |
2.4× |
| MRI chest with contrast (71551) |
$658.50 |
$1,317 |
1.0× |
| MRI Forearm w/ Contrast Bilateral 73219 (73219) |
$658.50 |
$1,317 |
2.2× |
| MRI lower extrem oth/thn jt w/contrast matrl (73719) |
$570.75 |
$1,141.50 |
1.9× |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
$1,338 |
$2,676 |
6.4× |
| MRI orbit face &/neck w/o contrast (70540) |
$361 |
$722 |
1.7× |
| MRI orbit/face/neck w&w/o cont (70543) |
$1,066 |
$2,132 |
3.5× |
| MRI orbit/face/neck w/contrast (70542) |
$658.50 |
$1,317 |
2.2× |
| MRI pelvis w contrast (72196) |
$658.50 |
$1,317 |
2.2× |
| MRI pelvis w/o & w/contrast material (72197) |
$2,238 |
$4,476 |
7.3× |
| MRI pelvis w/o contrast (72195) |
$955 |
$1,910 |
4.6× |
| MRI scan of arm joint before and after contrast (73223) |
$661.25 |
$1,322.50 |
2.2× |
| MRI scan of leg joint before and after contrast (73723) |
$562 |
$1,124 |
1.8× |
| MRI spinal canal cervical w/o & w/contr matrl (72156) |
$1,598.50 |
$3,197 |
5.2× |
| MRI spinal canal lumbar w/contrast material (72149) |
$658.50 |
$1,317 |
2.2× |
| MRI spinal canal lumbar w/o & w/contr matrl (72158) |
$1,499.50 |
$2,999 |
4.9× |
| MRI spinal canal thoracic w/contrast matrl (72147) |
$658.50 |
$1,317 |
2.2× |
| MRI spinal canal thoracic w/o & w/contr matrl (72157) |
$1,179.75 |
$2,359.50 |
3.9× |
| MRI thoracic spine w/o contrast (72146) |
$273.50 |
$547 |
1.3× |
| MRI tmj (70336) |
$455 |
$910 |
2.2× |
| MRI upper ext joint w/o contrast (73221) |
$1,776.22 |
$3,552.45 |
8.5× |
| MRI upper extrem other than jt w/o & w/contras (73220) |
$761 |
$1,522 |
2.5× |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
$435 |
$870 |
2.1× |
| Myelogram Cervical (72240) |
$615 |
$1,230 |
0.9× |
| Myelogram Lumbar (72265) |
$615 |
$1,230 |
0.9× |
| Myelogram thoracic (72255) |
$615 |
$1,230 |
0.9× |
| Myocardial infarct spect (78469) |
$394.50 |
$789 |
0.8× |
| Myocardial Spect Multiple Studies (78452) |
$2,840.50 |
$5,681 |
2.5× |
| Neck soft tissue (70360) |
$149.50 |
$299 |
2.0× |
| Nm adrenal scan (78075) |
$1,191.50 |
$2,383 |
1.1× |
| Nm gastric emptying study (78264) |
$980.50 |
$1,961 |
2.8× |
| Nuclear medicine of heart pumping function by first pass technique (78483) |
$1,187 |
$2,374 |
2.5× |
| Nuclear medicine study of stomach to assess emptying small bowel movement (78265) |
$489.50 |
$979 |
1.4× |
| Ob Us Follow-Up Per Fetus - Us Ob Follow Up Transabdominal Approach (76816) |
$141.50 |
$283 |
1.5× |
| Osseous survey infant (77076) |
$117 |
$234 |
1.3× |
| Parathyrd planar w/wo subtrj (78071) |
$1,043 |
$2,086 |
3.0× |
| Parathyroid imaging (78070) |
$391.25 |
$782.50 |
1.1× |
| Pelvis 1 or 2 views (72170) |
$72.75 |
$145.50 |
0.8× |
| Pr heart first pass single,planar (78481) |
$394.50 |
$789 |
0.8× |
| Pr MRI, lower extr, w/o contrast f/u by contrast (73720) |
$599 |
$1,198 |
2.0× |
| Pulmonary Perfusion Imaging Particulate (78580) |
$249 |
$498 |
0.7× |
| Radex abscess/fistula/sinus tract rs&i (76080) |
$245.75 |
$491.50 |
0.5× |
| Radex mastoids compl minimum 3 views pr side (70130) |
$66 |
$132 |
0.7× |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
$382.90 |
$765.80 |
4.2× |
| Radiolog exam mandible compl minimum 4 views (70110) |
$197 |
$394 |
2.2× |
| Radiologic Exam Abdomen 1 View - Xr Abdomen 1 View (74018) |
$142.50 |
$285 |
1.9× |
| Radiologic Exam Chest 2 Views - Xr Chest 2 Views (71046) |
$225.25 |
$450.50 |
3.0× |
| Radiologic exam colon single contrast study (74270) |
$457 |
$914 |
3.0× |
| Radiologic exam upr gi trc double contrast study (74246) |
$457 |
$914 |
3.0× |
| Radiologic exam upr gi trc single contrast study (74240) |
$444 |
$888 |
2.9× |
| Radiologic Examination Femur Minimum 2 Views - Xr Femur 2+ Vw Lt (73552) |
$191 |
$382 |
2.5× |
| Radiological examination surgical specimen (76098) |
$327.50 |
$655 |
0.7× |
| Ribs bilateral 3 views (71110) |
$66 |
$132 |
0.7× |
| Rp loclzj tum plnr whole body single day imaging (78802) |
$676.50 |
$1,353 |
1.4× |
| Rp loclzj tum spect 1 area single day imaging (78803) |
$676.50 |
$1,353 |
1.4× |
| Sacroiliac Joints < 3 Views (72200) |
$59.50 |
$119 |
0.6× |
| Saline Infus Sonohysterography W/Color Doppler (76831) |
$194 |
$388 |
0.9× |
| Scanogram (77073) |
$59.50 |
$119 |
0.6× |
| Scapula complete (73010) |
$42 |
$84 |
0.5× |
| Screening digital breast tomosynthesis (77063) |
$71.75 |
$143.50 |
3.1× |
| Small bowel series (74250) |
$300.50 |
$601 |
2.0× |
| Speech evaluation complex (70371) |
$161.50 |
$323 |
0.8× |
| Spine thoracic 3 views (72072) |
$386.40 |
$772.80 |
4.2× |
| Testicular Imaging With Vascular Flow (78761) |
$429.50 |
$859 |
1.2× |
| Therapeutic Enema (74283) |
$255 |
$510 |
1.7× |
| Thyroid Imaging With Vascular Flow (78013) |
$234.50 |
$469 |
0.7× |
| Thyroid uptake measurement (78012) |
$304 |
$608 |
0.9× |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
$868.50 |
$1,737 |
2.5× |
| Tmj unilateral (70328) |
$59.50 |
$119 |
0.8× |
| Tomogram (76100) |
$107.50 |
$215 |
1.2× |
| Ultrasound, abdomen limited (76705) |
$242.50 |
$485 |
2.6× |
| Unlisted Ultrasound Procedure (76999) |
$111.50 |
$223 |
1.5× |
| Upper Extremity Infant (73092) |
$131.50 |
$263 |
1.4× |
| Urethrocystography retrograde rs&i (74450) |
$265 |
$530 |
1.3× |
| Urethrocystography voiding (74455) |
$265 |
$530 |
1.3× |
| Urography (pyelography), intravenous, with or without KUB, with or without tomography (74400) |
$265 |
$530 |
1.7× |
| Urograpy infusion drip &/bolus techq w/wo tomo (74415) |
$265 |
$530 |
1.7× |
| Us abdl aorta screen aaa (76706) |
$113.50 |
$227 |
1.2× |
| Us breast unilateral complete (76641) |
$523.50 |
$1,047 |
5.7× |
| Us breast unilateral limited (76642) |
$108 |
$216 |
1.4× |
| Us chest (76604) |
$194 |
$388 |
2.1× |
| Us kidney transplant (76776) |
$191.50 |
$383 |
2.1× |
| Us ob transvaginal (76817) |
$407.50 |
$815 |
4.4× |
| Us pelvic non ob complete (76856) |
$300.75 |
$601.50 |
3.3× |
| Us pelvic nonobstetric image dcmtn limited/f/u (76857) |
$194.25 |
$388.50 |
2.1× |
| Us pregnancy ltd (76815) |
$121.25 |
$242.50 |
1.3× |
| Us pregnant uterus 14 wk transabdl 1/1st gestat (76801) |
$407.50 |
$815 |
4.4× |
| Us retroperitoneal complete (76770) |
$166.25 |
$332.50 |
1.8× |
| Us retroperitoneal limited (76775) |
$118 |
$236 |
1.3× |
| Us scrotum and contents (76870) |
$242.50 |
$485 |
2.6× |
| Us soft tissue head/neck (76536) |
$230.25 |
$460.50 |
2.5× |
| Us transrectal (76872) |
$138.50 |
$277 |
1.5× |
| Us xtr non-vasc lmtd (76882) |
$272.50 |
$545 |
3.0× |
| Venogram extremity bilateral (75822) |
$760 |
$1,520 |
0.6× |
| Venography extremity unilateral rs&i (75820) |
$851 |
$1,702 |
0.6× |
| Vertebral fracture assessment via dxa (77086) |
$59.50 |
$119 |
0.8× |
| Wrist 2 views (73100) |
$43.88 |
$87.75 |
0.6× |
| X-Ray Abdomen,Comp Acute Series - Xr Abdomen 2 Vws With Chest 1 View (74022) |
$212.25 |
$424.50 |
2.3× |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
$83 |
$166 |
1.1× |
| X-Ray Ankle 3+ Vw - Xr Ankle 3+ Views Right (73610) |
$243.60 |
$487.20 |
3.2× |
| X-Ray Colon Air Contrast - Fl Barium Enema Air Contrast (74280) |
$255 |
$510 |
1.7× |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
$37.50 |
$75 |
0.5× |
| X-Ray Elbow 3+ Vw - Xr Elbow 3+ Views Right (73080) |
$220.92 |
$441.85 |
2.9× |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
$185.25 |
$370.50 |
2.4× |
| X-Ray Exam Hips Bi 5/> Views (73523) |
$365.03 |
$730.06 |
4.0× |
| X-Ray Facial Bones 3+ Vw - Xr Facial Bones 3+ Views (70150) |
$197 |
$394 |
2.2× |
| X-Ray Foot 3+ Vw - Xr Foot 3+ Views Right (73630) |
$243.60 |
$487.20 |
3.2× |
| X-Ray Heel - Xr Calcaneus 2 Views Right (73650) |
$82.75 |
$165.50 |
1.1× |
| X-ray IV pyelogram+drip infusn (74410) |
$133 |
$266 |
0.9× |
| X-Ray Jaw <4 Vw - Xr Mandible < 4 Views (70100) |
$40 |
$80 |
0.5× |
| X-Ray Knee 4+ View - Xr Knee 4+ Views Right (73564) |
$59.50 |
$119 |
0.6× |
| X-Ray Leg, Infant - Xr Lower Extremity 2+ Views Infant Left (73592) |
$59.50 |
$119 |
0.8× |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
$187.25 |
$374.50 |
2.0× |
| X-Ray Lumbar Spine 6+ Vw - Xr Lumbar Spine 6+ Vws Including Bending (72114) |
$276 |
$552 |
3.0× |
| X-Ray Lumbar Spine Flex/Exten - Xr Lumbar Spine 4+ Views W/ Flex Ext (72120) |
$52.50 |
$105 |
0.6× |
| X-Ray Nasal Bones - Xr Nasal Bones (70160) |
$174 |
$348 |
2.3× |
| X-Ray Nose-Rectum Child F.B. - Xr Nose to Rectum Foreign Body Peds (76010) |
$59.50 |
$119 |
0.8× |
| X-ray of voice box or throat (70370) |
$161.50 |
$323 |
2.1× |
| X-Ray Orbits - Xr Orbits Complete 4+ Views (70200) |
$51 |
$102 |
0.6× |
| X-Ray Retrograde Pyelogram - Fl Pyelogram Retrograde (74420) |
$265 |
$530 |
0.9× |
| X-Ray Ribs 2 Vw Unilat - Xr Ribs 2 Views Right (71100) |
$184 |
$368 |
2.4× |
| X-Ray Ribs, Chest 3+ Vw - Xr Ribs 2 Vws Lt W/ Chest Anteroposterior (71101) |
$166.27 |
$332.54 |
1.8× |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
$58.50 |
$117 |
0.6× |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
$55.50 |
$111 |
0.6× |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
$174 |
$348 |
2.3× |
| X-Ray Shoulder 2+ Vw - Xr Shoulder 2+ Views Right (73030) |
$243.60 |
$487.20 |
3.2× |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
$174 |
$348 |
2.3× |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
$56.50 |
$113 |
0.6× |
| X-Ray Skull <4 Vw - Xr Skull 1-3 Views (70250) |
$110 |
$220 |
1.2× |
| X-Ray Spine One View - Xr Spine (72020) |
$59.50 |
$119 |
0.8× |
| X-Ray Sterno-Clavicluar Jt - Xr Sternoclavicular Joints 3+ Views (71130) |
$59.50 |
$119 |
0.8× |
| X-Ray Sternum 2+ Vw - Xr Sternum 2+ Views (71120) |
$42 |
$84 |
0.6× |
| X-Ray Toe(S) - Xr Toes 2+ Views Right (73660) |
$59.50 |
$119 |
0.8× |
| X-Ray Wrist 3+ Vw - Xr Wrist 3+ Views Right (73110) |
$243.60 |
$487.20 |
3.2× |
| Xr c-spine 6 or more views (72052) |
$294.50 |
$589 |
3.2× |
| Xr chest 4+ views (71048) |
$50.50 |
$101 |
0.6× |
| Xr finger(s) 2+ views (73140) |
$125 |
$250 |
1.6× |
| Xr spine cervical 4 or 5 views (72050) |
$386.40 |
$772.80 |
4.2× |
| Xr tibia/fibula 2 views (73590) |
$76.62 |
$153.25 |
1.0× |
| Xr tmj bilateral (70330) |
$83 |
$166 |
1.1× |
| Xray knee 1 or 2 views rt (73560) |
$155.62 |
$311.25 |
2.0× |