| Item Number | Description | Schedule Fee |
|---|---|---|
| 58916 | Small bowel enema, barium or other opaque study of the small bowel, including duodenal intubation, with or without preliminary plain films, not being a service associated with a service to which item 30488 applies (R) (Anaes.) |
$159.05 |
| Total: | $159.05 | |