Medical Procedure Costs

73630

X-ray exam of foot

Radiology

$34

—

73650

X-ray exam of heel

Radiology

$28

—

73660

X-ray exam of toe(s)

Radiology

$29

—

73700

Ct lower extremity w/o dye

Radiology

$130

—

73701

Ct lower extremity w/dye

Radiology

$166

—

73702

Ct lwr extremity w/o&w/dye

Radiology

$195

—

73706

Ct angio lwr extr w/o&w/dye

Radiology

$322

—

73718

Mri lower extremity w/o dye

Radiology

$222

—

73719

Mri lower extremity w/dye

Radiology

$261

—

73720

Mri lwr extremity w/o&w/dye

Radiology

$335

—

73721

Mri jnt of lwr extre w/o dye

Radiology

$204

—

73722

Mri joint of lwr extr w/dye

Radiology

$315

—

73723

Mri joint lwr extr w/o&w/dye

Radiology

$381

—

73725

Mr ang lwr ext w or w/o dye

Radiology

$337

—

74018

Radex abdomen 1 view

Radiology

$30

—

74019

Radex abdomen 2 views

Radiology

$36

—

74021

Radex abdomen 3+ views

Radiology

$42

—

74022

Radex compl aqt abd series

Radiology

$49

—

74150

Ct abdomen w/o contrast

Radiology

$136

—

74157000660

AMCINONIDE 0.1% CREAM

Prescription Drug - Generic

$5

—

74157001390

GABARONE 100 MG TABLET

Prescription Drug - Brand

$9

—

74160

Ct abdomen w/contrast

Radiology

$230

—

74170

Ct abd wo cntrst flwd cntrst

Radiology

$259

—

74174

Cta abd&plvs w/contrast

Radiology

$378

—

74175

Cta abdomen w/contrast

Radiology

$304

—

74176

Ct abd & pelvis w/o contrast

Radiology

$183

—

74177

Ct abd & pelvis w/contrast

Radiology

$300

—

74178

Ct abd&plv wo cntr flwd cntr

Radiology

$338

—

74181

Mri abdomen w/o contrast

Radiology

$194

—

74182

Mri abdomen w/contrast

Radiology

$300

—

74183

Mri abd w/o cntr flwd cntr

Radiology

$336

—

74185

Mra abd w or w/o cntrst

Radiology

$336

—

74210

X-ray xm phrnx&/crv esoph c+

Radiology

$91

—

74220

X-ray xm esophagus 1cntrst

Radiology

$94

—

74221

X-ray xm esophagus 2cntrst

Radiology

$106

—

74230

X-ray xm swlng funcj c+

Radiology

$120

—

74240

X-ray xm upr gi trc 1cntrst

Radiology

$122

—

74246

X-ray xm upr gi trc 2cntrst

Radiology

$135

—

74248

X-ray sm int f-thru std

Radiology

$79

—

74250

X-ray xm sm int 1cntrst std

Radiology

$118

—

74251

X-ray xm sm int 2cntrst std

Radiology

$344

—

74261

Ct colonography dx

Radiology

$409

—

74262

Ct colonography dx w/dye

Radiology

$460

—

74263

Ct colonography screening

Radiology

$835

—

74270

X-ray xm colon 1cntrst std

Radiology

$149

—

74280

X-ray xm colon 2cntrst std

Radiology

$211

—

74283

Ther nma rdctj intus/obstrcj

Radiology

$280

—

74290

Contrast x-ray gallbladder

Radiology

$81

—

74400

Urography iv +-kub tomog

Radiology

$132

—

74410

Urography nfs drip&/bolus

Radiology

$145

—

My Cost List