ROOM & BOARD
SERVICE CHARGE CODE	SERVICE DESCRIPTION	SERVICE CHARGE PRICE
2070540	MRI-ORBIT, FACE & NECK	900.00
2070544	MRA-HEAD, W/O CONTRAST	1,104.00
2070545	MRA-HEAD, W/ CONTRAST	1,344.00
2070546	MRA-HEAD, W/O & W/ CONTRAST	1,584.00
2070547	MRA-NECK, W/O CONTRAST	1,104.00
2070548	MRA-NECK, W/ CONTRAST	1,344.00
2070549	MRA-NECK, W/O & W/ CONTRAST	1,584.00
2070551	MRI-BRAIN, W/O CONTRAST	900.00
2070552	MRI-BRAIN, WITH CONTRAST	1,008.00
2070553	MRI-BRAIN, W/O & WITH CONTRAST	1,440.00
2071555	MRA-CHEST EXC MYOCARDIUM	1,148.70
2072141	MRI-SPINE, CERVICAL, W/O CONTRAST	1,008.00
2072142	MRI-SPINE, CERVICAL, WITH CONTRAST	1,104.00
2072146	MRI-SPINE, THORACIC, W/O CONTRAST	1,008.00
2072147	MRI-SPINE, THORACIC, WITH CONTRAST	1,104.00
2072148	MRI-SPINE, LUMBAR, W/O CONTRAST	1,008.00
2072149	MRI-SPINE, LUMBAR, WITH CONTRAST	1,104.00
2072156	MRI-SPINE, CERVICAL, W/O & WITH CONTRAST	1,440.00
2072157	MRI-SPINE, THORACIC, W/O & WITH CONTRAST	1,440.00
2072158	MRI-SPINE, LUMBAR, W/O & WITH CONTRAST	1,440.00
2072159	MRA-SPINE	1,252.90
2072196	MRI-PELVIS	900.00
2072198	MRA-PELVIS	1,153.47
2073220	MRI-UPPER EXTREMITY, EXCLUDING JOINT	900.00
2073221	MRI-UPPER EXTREMITY JOINT	900.00
2073225	MRA-UPPER EXTREMITY	1,066.64
2073720	MRI-LOWER EXTREMITY, EXCLUDING JOINT	900.00
2073721	MRI-LOWER EXTREMITY JOINT	900.00
2073725	MRA-LOWER EXTREMITY	1,213.50
2074181	MRI-ABDOMEN	900.00
2074185	MRA-ABDOMEN	1,223.15
2075552	MRI-CARDIAC MORPHOLOGY, W/O CONTRAST	1,202.79
2075553	MRI-CARDIAC MORPHOLOGY, W/ CONTRAST	1,236.01
2075554	MRI-CARDIAC FUNCTION, COMPLETE	1,223.15
2075555	MRI-CARDIAC FUNCTION, LIMITED	1,216.72
2075556	MRI-CARDIAC VELOCITY MAPPING	1,200.00
2076093	MRI-BREAST, UNILATERAL	1,336.54
2076094	MRI-BREAST, BILATERAL	1,760.23
2076390	MR SPECTROSCOPY	1,075.22
2076400	MRI-BONE MARROW BLOOD SUPPLY	1,066.64