Ref ID CPT Code Description Charge Amount

CT THORACIC SPINE W/O CONTRAST MATERIAL. $6,488.48. 100377. CT THORACIC SPINE W ... MRI COMPATIBLE SYSTEM. $3,863.34. 100933. LSO FULL CORSET. $458.50. 100934.







BILL_ITEM_ID LONG_DESCRIPTION CPT Base Facility Price ...
... MRI TMJ W/O Contrast. 70336. 3,455.00. $. 3,455.00. $. 2,073.00. $. 6581265. MRI TMJ ... Sacrum Coccyx W/O Contrast. 72195. 5,025.00. $. 5,025.00. $. 3,015.00.
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