CPT |
PROCEDURE |
COST |
70336 |
MRI, temporomandibular joint(s) |
$499.00 |
70540 |
MRI, orbit, face, and/or neck; without contrast |
$499.00 |
70543 |
MRI, orbit, face, and/or neck; without and with contrast |
$680.00 |
70551 |
MRI, brain (including brain stem); without contrast |
$499.00 |
70553 |
MRI, brain (including brain stem); without and with contrast |
$680.00 |
71550 |
MRI, chest; without contrast (MUSCLES AND STERNUM; NO HEART OR LUNGS) |
$499.00 |
71552 |
MRI, chest; without and with contrast (MUSCLES AND STERNUM, NO HEART OR LUNGS) |
$680.00 |
72141 |
MRI, spinal canal and contents, cervical; without contrast |
$499.00 |
72146 |
MRI, spinal canal and contents, thoracic; without contrast |
$499.00 |
72148 |
MRI, spinal canal and contents, lumbar; without contrast |
$499.00 |
72156 |
MRI, spinal canal and contents, without and with contrast; cervical |
$680.00 |
72157 |
MRI, spinal canal and contents, without and with contrast; thoracic |
$680.00 |
72158 |
MRI, spinal canal and contents, without and with contrast; lumbar |
$680.00 |
72195 |
MRI, pelvis; without contrast (bony pelvis) |
$499.00 |
72195 |
MRI, pelvis; without contrast (soft tissue pelvis) |
$499.00 |
72197 |
MRI, pelvis, without and with contrast (bony pelvis) |
$680.00 |
72197 |
MRI, pelvis; without and with contrast (soft tissue pelvis) |
$680.00 |
73218 |
MRI, upper extremity, other than joint; without contrast |
$499.00 |
73220 |
MRI, upper extremity, other than joint; without and with contrast |
$680.00 |
73221 |
MRI, any joint of upper extremity; without contrast |
$499.00 |
73223 |
MRI, any joint of upper extremity; without and with contrast |
$680.00 |
73718 |
MRI, lower extremity other than joint; without contrast |
$499.00 |
73720 |
MRI, lower extremity other than joint; without and with contrast |
$680.00 |
73721 |
MRI, any joint of lower extremity; without contrast |
$499.00 |
73723 |
MRI, any joint of lower extremity; without and with contrast |
$680.00 |
74181 |
MRI, abdomen; without contrast |
$499.00 |
74183 |
MRI, abdomen; without and with contrast |
$780.00 |