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Days | BS Description E | ICD | IOS BS | CPT | PACKAGE | Price | Center |
|---|---|---|---|---|---|---|---|
0 | MASTOID (BILATERAL) 4V | 240281 | 310 | ||||
0 | MODIFIED BARIUM SWALLOW | 240282 | 74246 | 576 | |||
0 | MR - ANGIO | 240283 | 1,100.00 | ||||
0 | MR - CHOLANGIOGRAM | 240284 | 1,100.00 | ||||
0 | MRA - CAROTIDS (NECK) WITH CONTRAST | 573550-00[1966] | 240285 | 70541 | 2,000.00 | ||
0 | MRA - CHEST & ABDOMEN WITH CONTRAST | 240286 | 74185 | 2,000.00 | |||
0 | MRA - EXTREMITIES WITH CONTRAST | 57350-07[1966] | 240287 | 73225 | 2,000.00 | ||
0 | MRA - PERIPHERAL | 59970-03[1989] | 240288 | 73725 | 2,000.00 | ||
0 | MRA- CAROTIDSW/O CONTRAST(NECK) | 57350-00[1966] | 240289 | 70541 | 1,760.00 | ||
0 | MRI - 3 REGIONS OR 3 STUDIES | 240290 | 70540 | 3,400.00 | |||
0 | MRI - ABDOMEN WITH PRIMOVIST | 90901-05[2015] | 240291 | 74182 | 2,800.00 | ||
0 | MRI - ANGIO SHOULDER WITH & W/OUT CONTRAST | 90901-08[2015] | 240292 | 23350 | 760 |
MASTOID (BILATERAL) 4V
310
MODIFIED BARIUM SWALLOW
576
MR - ANGIO
1,100.00
MR - CHOLANGIOGRAM
1,100.00
MRA - CAROTIDS (NECK) WITH CONTRAST
2,000.00
MRA - CHEST & ABDOMEN WITH CONTRAST
2,000.00
MRA - EXTREMITIES WITH CONTRAST
2,000.00
MRA - PERIPHERAL
2,000.00
MRA- CAROTIDSW/O CONTRAST(NECK)
1,760.00
MRI - 3 REGIONS OR 3 STUDIES
3,400.00
MRI - ABDOMEN WITH PRIMOVIST
2,800.00
MRI - ANGIO SHOULDER WITH & W/OUT CONTRAST
760
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