| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$5,105.63 |
$7,293.75 |
30% |
| CT scan of abdomen and pelvis, with contrast dye
CPT 74177
CT ABD/PEL W CONT |
$5,105.63 |
$7,293.75 |
30% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT ABD/PEL W CONT |
$3,447.00 |
$9,575.00 |
64% |
| CT scan of abdomen and pelvis, with contrast dye inpatient
CPT 74177
CT ABD/PEL W CONT |
$5,105.63 |
$7,293.75 |
30% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT PEDI |
$1,521.98 |
$2,174.25 |
30% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT PEDI |
$1,521.98 |
$2,174.25 |
30% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$2,619.58 |
$3,742.25 |
30% |
| CT scan of the head or brain, no contrast dye
CPT 70450
CT HEAD WO CONT |
$2,619.58 |
$3,742.25 |
30% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT |
$1,347.21 |
$3,742.25 |
64% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT PEDI |
$1,521.98 |
$2,174.25 |
30% |
| CT scan of the head or brain, no contrast dye inpatient
CPT 70450
CT HEAD WO CONT |
$2,619.58 |
$3,742.25 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT, PELVIS; W CONTR |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT, PELVIS; W CONTR |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$2,641.80 |
$3,774.00 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$2,641.80 |
$3,774.00 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS W CONT |
$2,641.80 |
$3,774.00 |
30% |
| CT scan of the pelvis, with contrast dye
CPT 72193
CT PELVIS LTD W |
$2,641.80 |
$3,774.00 |
30% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT, PELVIS; W CONTR |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W |
$1,358.64 |
$3,774.00 |
64% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W PEDI |
$1,858.33 |
$2,654.75 |
30% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS LTD W |
$2,641.80 |
$3,774.00 |
30% |
| CT scan of the pelvis, with contrast dye inpatient
CPT 72193
CT PELVIS W CONT |
$2,641.80 |
$3,774.00 |
30% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$347.38 |
$496.25 |
30% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$347.38 |
$496.25 |
30% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAMMO DIAG BILAT |
$368.38 |
$526.25 |
30% |
| Diagnostic mammogram, both breasts both sides
CPT 77066
MAMMO DIAG BILAT |
$368.38 |
$526.25 |
30% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
MAM DIAG DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
DIAG MAM DIR DIGITAL - BILAT |
$347.38 |
$496.25 |
30% |
| Diagnostic mammogram, both breasts inpatient both sides
CPT 77066
MAMMO DIAG BILAT |
$368.38 |
$526.25 |
30% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIAG DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, both breasts inpatient
CPT 77066
MAM DIR DIG BIL CON |
$189.45 |
$526.25 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$273.18 |
$390.25 |
30% |
| Diagnostic mammogram, one breast
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$273.18 |
$390.25 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CON RT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG UNI RT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CON LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CON RT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG UNI LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG UNI LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG UNI RT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast one side
CPT 77065
MAMMO DIAG CON LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast inpatient
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient
CPT 77065
DIAG MAM DIR DIGITAL - UNIL |
$273.18 |
$390.25 |
30% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG UNI RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIR DIG UNI LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON RT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAM DIAG DIR DIG CON LT |
$146.88 |
$408.00 |
64% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAMMO DIAG CON RT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAMMO DIAG UNI LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAMMO DIAG CON LT |
$285.60 |
$408.00 |
30% |
| Diagnostic mammogram, one breast inpatient one side
CPT 77065
MAMMO DIAG UNI RT |
$285.60 |
$408.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,L,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,L,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,R,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,R,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,L,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,L,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,R,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
LO EXTR,JNT,R,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J R PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye
CPT 73721
MR LW EXT WO J L PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
LO EXTR,JNT,R,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
LO EXTR,JNT,L,LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R LTD |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L |
$728.19 |
$2,022.75 |
64% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R LTD |
$1,267.88 |
$1,811.25 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L |
$1,415.93 |
$2,022.75 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J R PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
MR LW EXT WO J L PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
LO EXTR,JNT,R,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, no contrast dye inpatient
CPT 73721
LO EXTR,JNT,L,LTD PEDI |
$2,344.30 |
$3,349.00 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J L PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye
CPT 73723
MR LW EXT WOW J R PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R |
$1,188.81 |
$3,302.25 |
64% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R |
$2,311.58 |
$3,302.25 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J L PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of knee or other lower-limb joint, without and then with contrast dye inpatient
CPT 73723
MR LW EXT WOW J R PEDI |
$2,918.65 |
$4,169.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$1,100.23 |
$1,571.75 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD |
$1,100.23 |
$1,571.75 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO LTD PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MRI BRAIN FOR IAC WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$2,903.60 |
$4,148.00 |
30% |
| MRI of the brain, no contrast dye
CPT 70551
MR BRAIN WO |
$2,903.60 |
$4,148.00 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD |
$611.10 |
$1,697.50 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD |
$1,100.23 |
$1,571.75 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR IAC WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$1,493.28 |
$4,148.00 |
64% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR PITUITARY WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MRI BRAIN FOR IAC WO |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO LTD PEDI |
$2,641.45 |
$3,773.50 |
30% |
| MRI of the brain, no contrast dye inpatient
CPT 70551
MR BRAIN WO |
$2,903.60 |
$4,148.00 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$3,149.13 |
$4,498.75 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD |
$3,149.13 |
$4,498.75 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD PEDI |
$4,007.50 |
$5,725.00 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW LTD PEDI |
$4,007.50 |
$5,725.00 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW PEDI |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW PEDI |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MRI BRAIN FOR IAC WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$5,271.35 |
$7,530.50 |
30% |
| MRI of the brain, with and without contrast dye
CPT 70553
MR BRAIN WOW |
$5,271.35 |
$7,530.50 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD |
$1,749.15 |
$4,858.75 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR IAC WOW |
$2,710.98 |
$7,530.50 |
64% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD |
$3,149.13 |
$4,498.75 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW LTD PEDI |
$4,007.50 |
$5,725.00 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR IAC WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW PEDI |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MRI BRAIN FOR PITUITARY WOW |
$4,358.38 |
$6,226.25 |
30% |
| MRI of the brain, with and without contrast dye inpatient
CPT 70553
MR BRAIN WOW |
$5,271.35 |
$7,530.50 |
30% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$2,225.13 |
$3,178.75 |
30% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO |
$2,225.13 |
$3,178.75 |
30% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO PEDI |
$2,416.93 |
$3,452.75 |
30% |
| MRI of the lower back, no contrast dye
CPT 72148
MR L SPN CANL WO PEDI |
$2,416.93 |
$3,452.75 |
30% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO |
$1,144.35 |
$3,178.75 |
64% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO |
$2,225.13 |
$3,178.75 |
30% |
| MRI of the lower back, no contrast dye inpatient
CPT 72148
MR L SPN CANL WO PEDI |
$2,416.93 |
$3,452.75 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST PEDI |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST PEDI |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$1,110.73 |
$1,586.75 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby
CPT 76805
US PREG 2/3 TRIMST |
$1,110.73 |
$1,586.75 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST PEDI |
$555.45 |
$793.50 |
30% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
OB US >/= 14 WKS SNGL FETUS |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST |
$571.23 |
$1,586.75 |
64% |
| Pregnancy ultrasound after 14 weeks, one baby inpatient
CPT 76805
US PREG 2/3 TRIMST |
$1,110.73 |
$1,586.75 |
30% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts both sides
CPT 77067
MAMMO SCREENING BILAT |
$262.85 |
$375.50 |
30% |
| Screening mammogram, both breasts both sides
CPT 77067
MAMMO SCREENING BILAT |
$262.85 |
$375.50 |
30% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$474.25 |
$677.50 |
30% |
| Screening mammogram, both breasts both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$474.25 |
$677.50 |
30% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$237.13 |
$338.75 |
30% |
| Screening mammogram, both breasts one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$237.13 |
$338.75 |
30% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
MAM SCRN DIR DIGITAL - BILAT |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
MAMMO SCREENING BILAT |
$262.85 |
$375.50 |
30% |
| Screening mammogram, both breasts inpatient both sides
CPT 77067
SCRN MAM DIR DIGITAL - BILAT |
$474.25 |
$677.50 |
30% |
| Screening mammogram, both breasts inpatient
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$173.70 |
$482.50 |
64% |
| Screening mammogram, both breasts inpatient
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts inpatient
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts inpatient
CPT 77067
MOBILE MAM SCREEN DIGITAL |
$192.78 |
$535.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
MAM SCRN DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$135.18 |
$375.50 |
64% |
| Screening mammogram, both breasts inpatient one side
CPT 77067
SCRN MAM DIR DIGITAL-UNILAT |
$237.13 |
$338.75 |
30% |
| Sleep study in a lab (polysomnography)
CPT 95810
POLYSOMNOGRAM PLUS 4 |
$2,971.68 |
$4,245.25 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRNSVAG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRNSVAG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$516.60 |
$738.00 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$516.60 |
$738.00 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
US TRSVAG NONPREG |
$516.60 |
$738.00 |
30% |
| Transvaginal pelvic ultrasound
CPT 76830
EDUS NON-OB TRANSVAG |
$516.60 |
$738.00 |
30% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRANSVAG |
$265.68 |
$738.00 |
64% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRNSVAG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG PEDI |
$356.13 |
$508.75 |
30% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
EDUS NON-OB TRANSVAG |
$516.60 |
$738.00 |
30% |
| Transvaginal pelvic ultrasound inpatient
CPT 76830
US TRSVAG NONPREG |
$516.60 |
$738.00 |
30% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT PEDI |
$808.33 |
$1,154.75 |
30% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$808.33 |
$1,154.75 |
30% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT PEDI |
$808.33 |
$1,154.75 |
30% |
| Ultrasound of the abdomen, complete
CPT 76700
US ABDOMEN CMPLT |
$808.33 |
$1,154.75 |
30% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT |
$292.23 |
$811.75 |
64% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT |
$808.33 |
$1,154.75 |
30% |
| Ultrasound of the abdomen, complete inpatient
CPT 76700
US ABDOMEN CMPLT PEDI |
$808.33 |
$1,154.75 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB PEDI MIN 4 VWS |
$432.95 |
$618.50 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB PEDI MIN 4 VWS |
$432.95 |
$618.50 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$547.40 |
$782.00 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$547.40 |
$782.00 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB 4+V |
$547.40 |
$782.00 |
30% |
| X-ray of the lower back, 4 or more views
CPT 72110
XR SP COMP LUMB 4+V |
$547.40 |
$782.00 |
30% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB PEDI MIN 4 VWS |
$432.95 |
$618.50 |
30% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$514.71 |
$1,429.75 |
64% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB 4+V |
$547.40 |
$782.00 |
30% |
| X-ray of the lower back, 4 or more views inpatient
CPT 72110
XR SP COMP LUMB MIN 4 VWS |
$547.40 |
$782.00 |
30% |