| 73700 | In this procedure, the provider performs a computed tomography scan of a patient’s lower extremity without using contrast material to diagnose a fracture or disease of the lower extremity. | 20 | $40 | $760 |
| 73701 | In this procedure, the provider performs a computed tomography, or CT, scan of a patient’s lower extremity using contrast material. The provider performs this radiology procedure for diagnosis of a… | 20 | $40 | $620 |
| 71045 | In this diagnostic procedure, the provider performs a single radiological view of the chest. He performs this study for the assessment of conditions affecting the chest, its contents, and nearby… | 80 | $10 | $590 |
| 73200 | In this procedure, the provider performs computer tomographic imaging of the upper extremity without using contrast. | 10 | $40 | $420 |
| 72192 | In this procedure, the provider performs computer tomographic (CT) imaging of the pelvis without using contrast. | 10 | $40 | $400 |
| 72084 | In this diagnostic procedure, the provider takes a minimum six X–ray images of the entire thoracic (upper and middle) and lumbar (lower) spine from different projections (directions or angles) to… | 30 | $20 | $380 |
| 73502 | In this diagnostic procedure, the provider takes X–ray images of one hip, either left or right, from two or three projections (directions or angles) to check for any fracture, swelling, or other… | 40 | $10 | $330 |
| 72170 | In this procedure, the provider takes one or two X–ray images of the pelvic bone to check for any fracture, swelling, or reason of pain in the pelvis. | 50 | $10 | $320 |
| 73630 | In this diagnostic procedure, the provider takes a minimum of three views of the foot to assess injury, fracture, arthritis, tumor, or congenital abnormality. | 50 | $10 | $280 |
| 73610 | In this procedure, the provider takes three or more X–ray images of the ankle joint to check for any fracture, swelling, or reason for pain in the ankle area. | 40 | $10 | $260 |