| 73564 | In this procedure, the provider takes four or more X–ray views of the knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 30 | $30 | $930 |
| 73030 | This particular procedure is for a minimum of 2 X–ray views of the complete shoulder. | 80 | $10 | $910 |
| 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. | 100 | $10 | $670 |
| 72100 | The technician takes 2 or 3 views of the vertebrae in the lumbar region which is the lower part of the spine and the sacrum, the area that connects the spine to the pelvis. Lumbosacral spine X–rays… | 50 | $10 | $520 |
| 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 | $410 |
| 72081 | In this diagnostic procedure, the provider captures the entire thoracic (upper and middle) and lumbar (lower) spine in an X–ray image from a single projection (direction or angle) to evaluate the… | 30 | $10 | $390 |
| 73560 | In this procedure, the provider takes one or two X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 60 | $10 | $370 |
| 73562 | In this procedure, the provider takes three X–ray images of a patient’s knee joint to check for any fracture, swelling, or reason for pain in the knee area. | 50 | $10 | $360 |
| 73200 | In this procedure, the provider performs computer tomographic imaging of the upper extremity without using contrast. | 10 | $30 | $340 |
| 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 | $300 |