|
X-ray fallopian tube
|
$337.35 |
$337.35 |
$337.35 |
$489.00
|
|
X-ray femur >=2 views (both sides)
|
$426.40 |
$426.40 |
$426.40 |
$290.44
|
|
X-ray finger(s) >= 2 views (both sides)
|
$226.20 |
$226.20 |
$226.20 |
$233.55
|
|
X-ray foot 2 views (both sides)
|
$375.70 |
$375.70 |
$375.70 |
$270.40
|
|
X-ray forearm 2 views (both sides)
|
$257.40 |
$257.40 |
$257.40 |
$317.62
|
|
X-ray hand 2 views (both sides)
|
$258.05 |
$258.05 |
$258.05 |
$270.00
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$248.95 |
$248.95 |
$248.95 |
$243.10
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$260.65 |
$260.65 |
$260.65 |
$300.00
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$170.95 |
$170.95 |
$170.95 |
$313.45
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$204.75 |
$204.75 |
$204.75 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$333.45 |
$333.45 |
$333.45 |
$477.10
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$131.95 |
$131.95 |
$131.95 |
$187.20
|
|
X-ray humerus >= 2 views left
|
$331.50 |
$331.50 |
$331.50 |
$285.00
|
|
X-ray joint survey 1 view
|
$241.15 |
$241.15 |
$241.15 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$271.70 |
$271.70 |
$271.70 |
$271.70
|
|
X-ray knee 3 views (both sides)
|
$357.50 |
$357.50 |
$357.50 |
$319.24
|
|
X-ray knee ap standing bilateral
|
$169.00 |
$169.00 |
$169.00 |
$243.09
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$220.35 |
$220.35 |
$220.35 |
$227.92
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$117.65 |
$117.65 |
$117.65 |
$345.15
|
|
X-ray lumbosacral spine >= 4 views
|
$336.05 |
$336.05 |
$336.05 |
$475.04
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$393.90 |
$393.90 |
$393.90 |
$513.63
|
|
X-ray male genital tract
|
$197.60 |
$197.60 |
$197.60 |
$267.55
|
|
X-ray mandible complete > 4 views
|
$215.80 |
$215.80 |
$215.80 |
$323.70
|
|
X-ray mandible ltd <4 views
|
$159.25 |
$159.25 |
$159.25 |
$200.20
|
|
X-ray nasal bones complete > 3 views
|
$211.25 |
$211.25 |
$211.25 |
$260.52
|
|
X-ray neck soft tissue
|
$192.40 |
$192.40 |
$192.40 |
$221.10
|
|
X-ray nose to rectum for foreign body child
|
$135.20 |
$135.20 |
$135.20 |
$201.00
|
|
X-ray of mammary ducts
|
$351.65 |
$351.65 |
$351.65 |
$437.00
|
|
X-ray optic foramina
|
$128.05 |
$128.05 |
$128.05 |
$165.09
|
|
X-ray pelvis 1-2 views
|
$241.15 |
$241.15 |
$241.15 |
$242.58
|
|
X-ray pelvis complete > 3 views
|
$252.85 |
$252.85 |
$252.85 |
$299.46
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$317.20 |
$317.20 |
$317.20 |
$663.18
|
|
X-ray ribs 2 views left
|
$189.80 |
$189.80 |
$189.80 |
$281.45
|
|
X-ray ribs 3 views bilateral
|
$239.20 |
$239.20 |
$239.20 |
$361.20
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$213.85 |
$213.85 |
$213.85 |
$327.21
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$265.85 |
$265.85 |
$265.85 |
$466.80
|
|
X-ray sacroiliac joints >= 3 views
|
$167.05 |
$167.05 |
$167.05 |
$270.40
|
|
X-ray sacrum/coccyx >= 2 views
|
$213.85 |
$213.85 |
$213.85 |
$260.65
|
|
X-ray scapula complete (both sides)
|
$349.05 |
$349.05 |
$349.05 |
$264.80
|
|
X-ray sella turcica
|
$124.15 |
$124.15 |
$124.15 |
$144.00
|
|
X-ray shoulder 1 view (both sides)
|
$274.30 |
$274.30 |
$274.30 |
$242.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$189.80 |
$189.80 |
$189.80 |
$324.53
|
|
X-ray sinus tract/fistula/abscess
|
$389.35 |
$389.35 |
$389.35 |
$539.50
|
|
X-ray skull < 4 views
|
$177.45 |
$177.45 |
$177.45 |
$277.54
|
|
X-ray skull > 4 views complete
|
$321.10 |
$321.10 |
$321.10 |
$404.30
|
|
X-ray slg plne bdy sect without urogr
|
$339.95 |
$339.95 |
$339.95 |
$370.64
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$337.35 |
$337.35 |
$337.35 |
$511.38
|
|
X-ray small intestine follow-through study
|
$411.45 |
$411.45 |
$411.45 |
$470.16
|
|
X-ray spine single view
|
$145.60 |
$145.60 |
$145.60 |
$225.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$177.45 |
$177.45 |
$177.45 |
$236.88
|
|
X-ray sternum > 2 views
|
$130.65 |
$130.65 |
$130.65 |
$230.00
|
|
X-ray surgical specimen
|
$308.75 |
$308.75 |
$308.75 |
$457.47
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$396.50 |
$396.50 |
$396.50 |
$463.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$168.35 |
$168.35 |
$168.35 |
$276.00
|
|
X-ray thoracic spine 2 views
|
$202.15 |
$202.15 |
$202.15 |
$286.65
|
|
X-ray thoracic spine 3 views
|
$218.40 |
$218.40 |
$218.40 |
$343.00
|
|
X-ray thoracolumbar spine >=2 views
|
$187.85 |
$187.85 |
$187.85 |
$269.10
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$164.45 |
$164.45 |
$164.45 |
$211.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$359.45 |
$359.45 |
$359.45 |
$346.50
|
|
X-ray tibia/fibula 2 views (both sides)
|
$300.30 |
$300.30 |
$300.30 |
$306.47
|
|
X-ray toe(s) > 2 views (both sides)
|
$206.05 |
$206.05 |
$206.05 |
$225.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$471.25 |
$471.25 |
$471.25 |
$590.20
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$612.30 |
$612.30 |
$612.30 |
$497.93
|
|
X-ray wrist 2 views (both sides)
|
$403.00 |
$403.00 |
$403.00 |
$268.49
|
|
X-ray xm phrnx&/crv esoph c+
|
$233.35 |
$233.35 |
$233.35 |
$256.03
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$90.15 |
$90.15 |
$90.15 |
$90.15
|
|
Zidovudine, oral, 100 mg
|
$76.05 |
$76.05 |
$76.05 |
$75.35
|
|
Zika virus dna/rna amp probe
|
$587.60 |
$587.60 |
$587.60 |
$197.25
|
|
Zika virus igm antibody
|
$240.50 |
$240.50 |
$240.50 |
$84.83
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$101.24 |
$101.24 |
$101.24 |
$83.13
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$7,286.50 |
$7,286.50 |
$7,286.50 |
$31.69
|
|
Zolbetuximab-clzb 100 mg intravenous solution
|
$3,682.90 |
$3,682.90 |
$3,682.90 |
$33.56
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$604.50 |
$604.50 |
$604.50 |
$201.50
|