| Item Number | Description | Schedule Fee |
|---|---|---|
| 56301 | Computed tomography—scan of chest, including lungs, mediastinum, chest wall and pleura, with or without scans of the upper abdomen, without intravenous contrast medium, not being a service to which item 56801 or 57001 applies and not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) |
$332.00 |
| Total: | $332.00 | |