| Item Number | Description | Schedule Fee |
|---|---|---|
| 56801 | Computed tomography—scan of chest, abdomen and pelvis with or without scans of soft tissues of neck without intravenous contrast medium, not including a study performed to exclude coronary artery calcification or image the coronary arteries (R) (Anaes.) |
$525.00 |
| Total: | $525.00 | |