| 3-D radiotherapy plan dose-volume histograms (77295) |
— |
$22,558 |
— |
| Abdomen 1 View (74018) |
— |
$386 |
— |
| Abdomen 2 views (74019) |
— |
$399 |
— |
| Acute Gastrointestinal Blood Loss Imaging (78278) |
— |
$1,486 |
— |
| Angio pulmonary bilat (75743) |
— |
$9,191 |
— |
| Angiography extremity bilateral rs&i (75716) |
— |
$12,354 |
— |
| Angiography extremity unilateral rs&i (75710) |
— |
$9,402 |
— |
| Angrph pulmonary nonslctv cath/ven njx rs&i (75746) |
— |
$8,395 |
— |
| Ankle 2 views (73600) |
— |
$286 |
— |
| Artery X-Rays Abdomen (75726) |
— |
$16,221 |
— |
| Artery X-Rays Pelvis (75736) |
— |
$16,221 |
— |
| Artery X-Rays Spine (75705) |
— |
$16,221 |
— |
| Basic radiation dosimetry calculation (77300) |
— |
$3,539 |
— |
| Bone age studies (77072) |
— |
$711 |
— |
| Bone Imaging 3 Phase (78315) |
— |
$6,707 |
— |
| Bone Imaging Limited Area (78300) |
— |
$1,600 |
— |
| Bone Imaging Whole Body (78306) |
— |
$6,567 |
— |
| Bone marrow imaging limited area (78102) |
— |
$1,321 |
— |
| Bone marrow imaging; multiple areas (78103) |
— |
$4,474 |
— |
| Brain Imaging Min 4 Static Views W Vascular Flow (78606) |
— |
$2,162 |
— |
| Brain Imaging Pet Metabolic Evaluation (78608) |
— |
$6,688 |
— |
| Cardiac MRI w/w/o contrast & further seq (75561) |
— |
$5,987 |
— |
| Cardiac MRI w/w/o contrast w/stress (75563) |
— |
$6,284 |
— |
| Cat Scan Follow-Up Study (76380) |
— |
$1,088 |
— |
| Chest 1 view (71045) |
— |
$825 |
— |
| Chest 2 views (71046) |
— |
$398 |
— |
| Chest 3 views (71047) |
— |
$466 |
— |
| Chest 4 or more views (71048) |
— |
$771 |
— |
| Clavicle complete (73000) |
— |
$386 |
— |
| Computed Tomography Thorax Lw Dose Lng Ca Scr C- (71271) |
— |
$1,993 |
— |
| Continuing medical physics consltj pr wk (77336) |
— |
$2,866 |
— |
| Contrast Exam Abdominl Aorta (75625) |
— |
$9,402 |
— |
| Contrast X-Ray Bladder (74430) |
— |
$1,941 |
— |
| CT abdomen and pelvis without and with contrast (74178) |
— |
$10,199 |
— |
| CT abdomen and pelvis without contrast (74176) |
— |
$3,318 |
— |
| CT abdomen w contrast (74160) |
— |
$2,793 |
— |
| CT abdomen w wo contrast (74170) |
— |
$6,115 |
— |
| CT abdomen w/o contrast (74150) |
— |
$1,748 |
— |
| CT Angio Abdomen and Pelvis (74174) |
— |
$2,451 |
— |
| CT Angio Chest (71275) |
— |
$3,209 |
— |
| CT Angio Head (70496) |
— |
$2,878 |
— |
| CT angio hrt w/3d image (75574) |
— |
$4,724 |
— |
| Ct Angio Lwr Extr W/O&W/Dye (73706) |
— |
$2,363 |
— |
| CT Angio Neck (70498) |
— |
$2,293 |
— |
| Ct Angio Upr Extrm W/O&W/Dye (73206) |
— |
$3,123 |
— |
| CT cervical spine w/ contrast (72126) |
— |
$1,992 |
— |
| CT cervical spine w/o contrast (72125) |
— |
$1,408 |
— |
| CT cervical spine w/wo cont (72127) |
— |
$2,516 |
— |
| CT chest w contrast (71260) |
— |
$2,305 |
— |
| CT chest w/wo contrast (71270) |
— |
$2,841 |
— |
| CT colonography screening (74263) |
— |
$3,963 |
— |
| CT colonogrphy dx image postprocess w/o contrast (74261) |
— |
$2,717 |
— |
| CT head/brain with contrast (70460) |
— |
$1,761 |
— |
| CT head/brain without and with contrast (70470) |
— |
$1,912 |
— |
| CT heart contrast eval cardiac structure&morph (75572) |
— |
$1,761 |
— |
| CT heart no contrast quant eval coronry calcium (75571) |
— |
$1,447 |
— |
| CT iac w contrast (70481) |
— |
$4,835 |
— |
| CT l-spine w&w/o contrast (72133) |
— |
$2,942 |
— |
| CT lower ext w/o (73700) |
— |
$1,029 |
— |
| CT lower extremity w/contrast material (73701) |
— |
$1,898 |
— |
| CT lumbar spine w contrast (72132) |
— |
$2,382 |
— |
| CT lumbar spine w/o contrast (72131) |
— |
$1,754 |
— |
| CT maxillofacial w contrast (70487) |
— |
$3,988 |
— |
| CT maxillofacial wo contrast (70486) |
— |
$3,541 |
— |
| CT neck tissue combo (70492) |
— |
$5,267 |
— |
| Ct Orbit/Ear/Fossa W/O&W/Dye (70482) |
— |
$5,739 |
— |
| CT orbits w/o contrast (70480) |
— |
$3,728 |
— |
| CT pelvis w&w/o contrast (72194) |
— |
$2,611 |
— |
| CT pelvis w/o contrast (72192) |
— |
$1,029 |
— |
| CT scans face/jaw combo (70488) |
— |
$5,049 |
— |
| CT soft tissue neck w contrast (70491) |
— |
$4,980 |
— |
| CT soft tissue neck w/o contrast (70490) |
— |
$2,393 |
— |
| CT thoracic spine w contrast (72129) |
— |
$1,726 |
— |
| CT thoracic spine w/o contrast (72128) |
— |
$1,103 |
— |
| CT thoracic spine w/wo cont (72130) |
— |
$3,173 |
— |
| CT thorax w/o contrast (71250) |
— |
$1,754 |
— |
| CT upper ext wo (73200) |
— |
$1,682 |
— |
| CT upper extremity with contrast (73201) |
— |
$2,149 |
— |
| Cta Abdl Aorta&Bi Iliofem W/Contrast&Postp (75635) |
— |
$2,010 |
— |
| Cta Abdomen (74175) |
— |
$4,704 |
— |
| CTA pelvis (72191) |
— |
$2,934 |
— |
| Doppler Echo Fetal Puls Spectral F/U/Repeat (76828) |
— |
$500 |
— |
| Doppler Echo Fetal Spectral Display Complete (76827) |
— |
$1,132 |
— |
| Doppler Fetal Mid Cerebral Artery (76821) |
— |
$914 |
— |
| Dxa Bone Density Axial (77080) |
— |
$2,608 |
— |
| Dxa bone density study (77085) |
— |
$2,891 |
— |
| Dxa bone density study 1/>sites appendiclr skel (77081) |
— |
$472 |
— |
| Echo exam uterus (76831) |
— |
$1,535 |
— |
| Echo Guide For Artery Repair (76936) |
— |
$888 |
— |
| Esophagram (74220) |
— |
$1,325 |
— |
| Fetal Biophys Profile W/Nst (76818) |
— |
$2,387 |
— |
| Fetal Biophysical Profile W/O Non-Stress Testing (76819) |
— |
$1,719 |
— |
| Fluoroscopy up to 1 hr (76000) |
— |
$1,740 |
— |
| Follow-Up Angiography (75898) |
— |
$9,402 |
— |
| Foot 2 views (73620) |
— |
$253 |
— |
| Forearm 2 views (73090) |
— |
$286 |
— |
| Gastric emptying imaging study (78264) |
— |
$6,573 |
— |
| Gated Heart Planar Single (78472) |
— |
$1,815 |
— |
| Hand 2 views (73120) |
— |
$426 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx (77771) |
— |
$5,931 |
— |
| Hdr Rdncl Ntrstl/Icav Brchtx 1 Channel (77770) |
— |
$12,612 |
— |
| Hepatc Vngrph Wdg/Fr Hemodyn Eval Rs&I (75889) |
— |
$9,936 |
— |
| Hepatobil Syst Image W/Drug (78227) |
— |
$6,894 |
— |
| Hepatobiliary System Imaging (78226) |
— |
$1,599 |
— |
| Ht Muscle Image Spect Sing (78451) |
— |
$4,189 |
— |
| Hysterosalpingogram (74740) |
— |
$3,257 |
— |
| Infant hip ultrasound, limited static exam (76886) |
— |
$1,255 |
— |
| K Flow/Funct Image W/Drug (78708) |
— |
$6,807 |
— |
| K Flow/Funct Image W/O Drug (78707) |
— |
$1,593 |
— |
| Knee 3 Views (73562) |
— |
$324 |
— |
| Lung perfusion differential (78597) |
— |
$1,681 |
— |
| Lung Ventilat&Perfus Imaging (78582) |
— |
$2,026 |
— |
| Lymph System Imaging (78195) |
— |
$8,482 |
— |
| Magnetic Image Jaw Joint (70336) |
— |
$4,242 |
— |
| Magnetic Resonance Elastography (76391) |
— |
$3,682 |
— |
| Meckels Divert Exam (78290) |
— |
$1,886 |
— |
| Mlc imrt design & construction per imrt plan (77338) |
— |
$12,103 |
— |
| Mr safety implant&/fb assmt clin staf 1st 15 min (76014) |
— |
$204 |
— |
| Mra Head W/O & W/Contrast Material (70546) |
— |
$9,983 |
— |
| MRA head w/o contrast (70544) |
— |
$2,006 |
— |
| MRA head with contrast (70545) |
— |
$6,587 |
— |
| MRA neck w contrast (70548) |
— |
$2,781 |
— |
| Mra Neck W/O &W/Contrast Material (70549) |
— |
$3,183 |
— |
| MRA neck w/o contrast (70547) |
— |
$2,006 |
— |
| MRI abdomen w contrast (74182) |
— |
$10,199 |
— |
| MRI abdomen w/o contrast (74181) |
— |
$2,006 |
— |
| MRI any jt lower extrem w/contrast material (73722) |
— |
$11,439 |
— |
| MRI any jt lower extrem w/o & w/contrast matrl (73723) |
— |
$12,543 |
— |
| MRI any jt upper extremity w/contrast matrl (73222) |
— |
$8,628 |
— |
| MRI Breast W/O Contrast Bilateral (77047) |
— |
$2,037 |
— |
| MRI cervical spine w contrast (72142) |
— |
$11,041 |
— |
| MRI cervical spine w/o cont (72141) |
— |
$8,558 |
— |
| MRI chest w/o contrast (71550) |
— |
$4,231 |
— |
| MRI chest wo w contrast (71552) |
— |
$12,271 |
— |
| MRI lower extrem oth/thn jt w/o & w/contr matr (73720) |
— |
$12,129 |
— |
| MRI lower extrem oth/thn jt w/o contr matrl (73718) |
— |
$8,188 |
— |
| MRI lumbar spine w contrast (72149) |
— |
$6,502 |
— |
| Mri Neck Spine W/O & W/Dye (72156) |
— |
$8,955 |
— |
| MRI orbit face &/neck w/o contrast (70540) |
— |
$8,188 |
— |
| MRI orbit face neck w contrast (70542) |
— |
$9,674 |
— |
| Mri Orbt/Fac/Nck W/O &W/Dye (70543) |
— |
$11,602 |
— |
| MRI pelvis w contrast (72196) |
— |
$9,185 |
— |
| MRI pelvis w/o & w contrast (72197) |
— |
$9,573 |
— |
| MRI pelvis w/o contrast (72195) |
— |
$7,942 |
— |
| MRI thoracic spine w/o contrast (72146) |
— |
$5,606 |
— |
| MRI upper extremity oth than jt w/contr matrl (73219) |
— |
$6,243 |
— |
| MRI upper extremity oth than jt w/o contr matrl (73218) |
— |
$6,555 |
— |
| Mri Uppr Extremity W/O&W/Dye (73220) |
— |
$8,462 |
— |
| MRI, abdomen, combo (74183) |
— |
$12,537 |
— |
| MRI, dorsal spine combo (72157) |
— |
$8,983 |
— |
| MRI, dorsal spine contrast (72147) |
— |
$11,843 |
— |
| MRI, joint upper extrem (73221) |
— |
$7,818 |
— |
| MRI, joint upper extrem combo (73223) |
— |
$10,258 |
— |
| MRI, lumbar spine combo (72158) |
— |
$8,929 |
— |
| Myocardial Spect Multiple Studies (78452) |
— |
$5,442 |
— |
| Myocrd Img Pet Prfuj Mlt Std Rst&Strs Cncrnt CT (78431) |
— |
$5,095 |
— |
| Neck soft tissue (70360) |
— |
$386 |
— |
| Ntsty modul radthx pln dose-vol histos (77301) |
— |
$22,922 |
— |
| Nuclear Rx Intra-Arterial (79445) |
— |
$2,890 |
— |
| Nuclear Rx Oral Admin (79005) |
— |
$4,293 |
— |
| Ob us nuchal meas 1 gest (76813) |
— |
$1,840 |
— |
| Parathyroid imaging w/tomographic spect & CT (78072) |
— |
$5,356 |
— |
| Parathyroid Planar Imaging (78070) |
— |
$5,804 |
— |
| Pelvis 1 or 2 views (72170) |
— |
$550 |
— |
| PET image w/CT, full body (78816) |
— |
$13,113 |
— |
| PET imaging CT attenuation skull base mid-thigh (78815) |
— |
$10,366 |
— |
| Pulmonary Perfusion Imaging Particulate (78580) |
— |
$1,402 |
— |
| Radex abscess/fistula/sinus tract rs&i (76080) |
— |
$2,420 |
— |
| Radex Ankle Complete Minimum 3 Views (73610) |
— |
$332 |
— |
| Radex Calcaneus Minimum 2 Views (73650) |
— |
$276 |
— |
| Radex elbow complete minimum 3 views (73080) |
— |
$283 |
— |
| Radex fingr minimum 2 views (73140) |
— |
$979 |
— |
| Radex foot complete minimum 3 views (73630) |
— |
$286 |
— |
| Radex Hand Minimum 3 Views (73130) |
— |
$438 |
— |
| Radex lower extremity infant minimum 2 views (73592) |
— |
$346 |
— |
| Radex Nasal Bones Complete Minimum 3 Views (70160) |
— |
$286 |
— |
| Radex Ribs Unilateral 2 Views (71100) |
— |
$365 |
— |
| Radex shoulder complete minimum 2 views (73030) |
— |
$331 |
— |
| Radex Spine 1 View Specify Level (72020) |
— |
$347 |
— |
| Radex Sternum Minimum 2 Views (71120) |
— |
$281 |
— |
| Radex Temporomandble Jt Opn & Clsd Mouth Bilat (70330) |
— |
$415 |
— |
| Radex Toe Minimum 2 Views (73660) |
— |
$301 |
— |
| Radex upper extremity infant minimum 2 views (73092) |
— |
$560 |
— |
| Radex Wrist Complete Minimum 3 Views (73110) |
— |
$1,083 |
— |
| Radex X-Ray Exam Entire Spi 6/> Vw - Xr Entire Spine 6+ Vw (72084) |
— |
$1,120 |
— |
| Radiation Delivery Stereotactic Cranial Linear (77372) |
— |
$73,498 |
— |
| Radiation treatment delivery level 1 (77402) |
— |
$1,171 |
— |
| Radiation treatment delivery level 3 (77412) |
— |
$5,471 |
— |
| Radiolog exam mandible compl minimum 4 views (70110) |
— |
$415 |
— |
| Radiologic exam colon double contrast study (74280) |
— |
$1,352 |
— |
| Radiologic exam colon single contrast study (74270) |
— |
$975 |
— |
| Radiologic Exam Esophagus Double Contrast Study (74221) |
— |
$1,474 |
— |
| Radiologic exam knee complete 4/more views (73564) |
— |
$429 |
— |
| Radiologic exam pelvis compl minimum 3 views (72190) |
— |
$505 |
— |
| Radiologic Exam Small Int Single Contrast Study (74250) |
— |
$570 |
— |
| Radiologic exam swallow function contrast study (74230) |
— |
$570 |
— |
| Radiologic exam upr gi trc double contrast study (74246) |
— |
$2,670 |
— |
| Radiologic examination femur minimum 2 views (73552) |
— |
$362 |
— |
| Radiologic examination knee 1/2 views (73560) |
— |
$314 |
— |
| Radiologic examination tibia & fibula 2 views (73590) |
— |
$398 |
— |
| Ribs bilateral 3 views (71110) |
— |
$706 |
— |
| Rp loclzj tum plnr 1 area single day imaging (78800) |
— |
$1,677 |
— |
| Rp Loclzj Tum Plnr Whole Body 2+ Days Imaging (78804) |
— |
$5,935 |
— |
| Rp Loclzj Tum Plnr Whole Body Single Day Imaging (78802) |
— |
$4,189 |
— |
| Rp Loclzj Tum Spect 1 Area Single Day Imaging (78803) |
— |
$4,189 |
— |
| Rp loclzj tum spect CT 2area 1d img/1 ar img>2+d (78832) |
— |
$8,273 |
— |
| Rp loclzj tum spect w/CT 1 area/acquisj 1day img (78830) |
— |
$7,171 |
— |
| Scapula (73010) |
— |
$243 |
— |
| Screening Digital Breast Tomosynthesis Bi (77063) |
— |
$412 |
— |
| Shoulder 1 view (73020) |
— |
$235 |
— |
| Shoulder Arthrography (73040) |
— |
$2,539 |
— |
| Skull less than 4 views (70250) |
— |
$619 |
— |
| Special dosimetry (77331) |
— |
$473 |
— |
| Special Physics Consult (77370) |
— |
$1,093 |
— |
| Special treatment procedure (77470) |
— |
$8,075 |
— |
| Stereotactic Body Radiation Delivery (77373) |
— |
$15,319 |
— |
| Sternoclavicular joints (71130) |
— |
$353 |
— |
| Telethx isodose pln cplx w/basic dosimetry (77307) |
— |
$8,293 |
— |
| Telethx isodose pln smpl w/dosimetry calculation (77306) |
— |
$2,858 |
— |
| Ther Rad Simulaj-Aided Field Setting Complex (77290) |
— |
$13,425 |
— |
| Ther Rad Simulaj-Aided Field Setting Intermed (77285) |
— |
$5,160 |
— |
| Ther rad simulaj-aided field setting simple (77280) |
— |
$6,012 |
— |
| Thoracic spine 2 views (72070) |
— |
$1,447 |
— |
| Thyroid Met Imaging Body (78018) |
— |
$6,747 |
— |
| Thyroid Uptake W/Blood Flow Sngle/Mult Quan Meas (78014) |
— |
$4,805 |
— |
| Tx Devices Design & Construction Complex (77334) |
— |
$6,930 |
— |
| Tx devices design & construction intermediate (77333) |
— |
$3,145 |
— |
| Tx devices design & construction simple (77332) |
— |
$3,037 |
— |
| Ultrasound Breast Limited (76642) |
— |
$1,393 |
— |
| Ultrasound Exam Aaa Screen (76706) |
— |
$656 |
— |
| Ultrasound, abdomen limited (76705) |
— |
$590 |
— |
| Umbilical-artery Doppler (OB) (76820) |
— |
$353 |
— |
| Unlisted fluoroscopic procedure (76496) |
— |
$447 |
— |
| Unlisted magnetic resonance procedure (76498) |
— |
$276 |
— |
| Unlisted Miscellaneous Px Dx Nuclear Medicine (78999) |
— |
$9,298 |
— |
| Upper gi w/o kub (74240) |
— |
$987 |
— |
| Urethrocystogram voiding (74455) |
— |
$1,137 |
— |
| Us breast unilateral complete (76641) |
— |
$1,923 |
— |
| Us chest (76604) |
— |
$519 |
— |
| Us complete joint (76881) |
— |
$1,535 |
— |
| Us exam, pelvic, limited (76857) |
— |
$838 |
— |
| Us head (76506) |
— |
$1,479 |
— |
| Us kidney transplant (76776) |
— |
$620 |
— |
| Us lmtd joint/oth nonvasc xtr strux r-t w/img (76882) |
— |
$1,382 |
— |
| Us ob detailed single fetus (76811) |
— |
$3,399 |
— |
| Us ob limited 1 or more fetuses (76815) |
— |
$1,485 |
— |
| Us ob transvaginal (76817) |
— |
$1,937 |
— |
| Us pelvic non ob complete (76856) |
— |
$2,317 |
— |
| Us pg uter img f&mat 14 wk tabdl 1/1st gestation (76801) |
— |
$1,934 |
— |
| Us preg uterus real time f/u trnsabdl per fetus (76816) |
— |
$1,732 |
— |
| Us retroperitoneal complete (76770) |
— |
$1,163 |
— |
| Us retroperitoneal limited (76775) |
— |
$605 |
— |
| Us scrotum and contents (76870) |
— |
$2,239 |
— |
| Us spinal canal and contents (76800) |
— |
$1,942 |
— |
| Us thyroid (76536) |
— |
$2,286 |
— |
| Vein X-Ray Liver W/O Hemodyn (75887) |
— |
$9,402 |
— |
| Venography caval inferior serialography rs&i (75825) |
— |
$9,402 |
— |
| Venography extremity bilateral rs&i (75822) |
— |
$4,697 |
— |
| Venography extremity unilateral rs&i (75820) |
— |
$4,049 |
— |
| Venography Renal Unilateral (75831) |
— |
$8,395 |
— |
| Venous sampling by catheter (75893) |
— |
$20,419 |
— |
| Vertebral fracture assessment via dxa (77086) |
— |
$388 |
— |
| Wrist 2 views (73100) |
— |
$383 |
— |
| X-Ray Ac Jts - Xr Acromioclavicular Joints Bilateral (73050) |
— |
$277 |
— |
| X-ray antegrade pyelogram tube (74425) |
— |
$1,379 |
— |
| X-Ray Aorta Leg Arteries (75630) |
— |
$8,808 |
— |
| X-Ray Bend Only L-S Spine (72120) |
— |
$1,470 |
— |
| X-Ray Elbow 2 Vw - Xr Elbow 1-2 Views Right (73070) |
— |
$286 |
— |
| X-Ray Exam Breast Specimen (76098) |
— |
$3,257 |
— |
| X-Ray Exam Entire Spi 2/3 Vw (72082) |
— |
$731 |
— |
| X-Ray Exam Entire Spi 4/5 Vw (72083) |
— |
$858 |
— |
| X-Ray Exam Hip Uni 1 View (73501) |
— |
$312 |
— |
| X-Ray Exam Hip Uni 2-3 Views (73502) |
— |
$400 |
— |
| X-Ray Exam Hips Bi 2 Views (73521) |
— |
$549 |
— |
| X-Ray Exam Hips Bi 3-4 Views (73522) |
— |
$524 |
— |
| X-Ray Exam L-S Spine Bending (72114) |
— |
$1,404 |
— |
| X-Ray Exam Neck Spine 2-3 Vw (72040) |
— |
$920 |
— |
| X-Ray Exam Neck Spine 6/>Vws (72052) |
— |
$1,531 |
— |
| X-Ray Exam Unilat Ribs/Chest (71101) |
— |
$538 |
— |
| X-ray humerus (73060) |
— |
$286 |
— |
| X-ray IV pyelogram (ivp) (74400) |
— |
$1,480 |
— |
| X-Ray Knee Bilat Standing - Xr Knees Anteroposterior Standing Bilat (73565) |
— |
$388 |
— |
| X-Ray Lumbar Spine 2/3 Vw - Xr Lumbar Spine 2-3 Views (72100) |
— |
$1,206 |
— |
| X-ray nose-rectum child f.b. (76010) |
— |
$276 |
— |
| X-Ray Ribs, Chest 4+ Vw - Xr Ribs 3 Vws Bil W/ Chest Posteroanterior (71111) |
— |
$739 |
— |
| X-Ray Sacroiliac Jts 3+ Vw - Xr Sacroiliac Joints 3+ Views (72202) |
— |
$1,019 |
— |
| X-Ray Sacroiliac Jts <3 Vw - Xr Sacroiliac Joints 1-2 Views (72200) |
— |
$400 |
— |
| X-Ray Sacrum/Coccyx 2+ Vw - Xr Sacrum Coccyx 2+ Views (72220) |
— |
$417 |
— |
| X-Ray Sinuses 3+ Vw - Xr Paranasal Sinuses 3+ Views (70220) |
— |
$562 |
— |
| X-Ray Skull 4+ Vw - Xr Skull Complete 4+ Views (70260) |
— |
$1,732 |
— |
| X-Ray Urinary Tract Exam With Contrast Material (74420) |
— |
$1,793 |
— |
| X-Rays Bone Length Studies (77073) |
— |
$808 |
— |
| X-Rays Bone Survey Complete (77075) |
— |
$1,664 |
— |
| Xr c-spine 4 or 5 views (72050) |
— |
$1,283 |
— |
| Xr facial bones less than 3 views (70140) |
— |
$362 |
— |
| Xr orbits complete 4 views (70200) |
— |
$582 |
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