| Item Number | Description | Schedule Fee |
|---|---|---|
| 63401 | MRA—if the request for the scan specifically identifies the clinical indication for the scan—scan of cardiovascular system for vascular abnormality in a patient with a previous anaphylactic reaction to an iodinated contrast medium (R) (Contrast) (Anaes.) |
$452.05 |
| Total: | $452.05 | |