|
X-ray eye detection foreign body (both sides)
|
$152.00 |
$152.00 |
$152.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$220.16 |
$220.16 |
$220.16 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$281.60 |
$281.60 |
$281.60 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$182.88 |
$182.88 |
$182.88 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$198.24 |
$198.24 |
$198.24 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$212.64 |
$212.64 |
$212.64 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$228.96 |
$228.96 |
$228.96 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$196.32 |
$196.32 |
$196.32 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$206.72 |
$206.72 |
$206.72 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$177.92 |
$177.92 |
$177.92 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$196.48 |
$196.48 |
$196.48 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$251.68 |
$251.68 |
$251.68 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$119.20 |
$119.20 |
$119.20 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$235.04 |
$235.04 |
$235.04 |
$309.31
|
|
X-ray joint survey 1 view
|
$773.76 |
$773.76 |
$773.76 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$227.84 |
$227.84 |
$227.84 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$242.72 |
$242.72 |
$242.72 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$99.20 |
$99.20 |
$99.20 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$59.04 |
$59.04 |
$59.04 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$341.44 |
$341.44 |
$341.44 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$293.92 |
$293.92 |
$293.92 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$341.44 |
$341.44 |
$341.44 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$174.88 |
$174.88 |
$174.88 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$77.60 |
$77.60 |
$77.60 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$152.32 |
$152.32 |
$152.32 |
$274.65
|
|
X-ray neck soft tissue
|
$146.40 |
$146.40 |
$146.40 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$60.80 |
$60.80 |
$60.80 |
$225.60
|
|
X-ray of mammary ducts
|
$534.88 |
$534.88 |
$534.88 |
$568.26
|
|
X-ray pelvis 1-2 views
|
$132.48 |
$132.48 |
$132.48 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$138.88 |
$138.88 |
$138.88 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$337.60 |
$337.60 |
$337.60 |
$755.50
|
|
X-ray ribs 2 views left
|
$169.92 |
$169.92 |
$169.92 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$209.44 |
$209.44 |
$209.44 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$176.32 |
$176.32 |
$176.32 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$244.16 |
$244.16 |
$244.16 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$115.36 |
$115.36 |
$115.36 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$178.72 |
$178.72 |
$178.72 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$243.36 |
$243.36 |
$243.36 |
$285.00
|
|
X-ray sella turcica
|
$160.32 |
$160.32 |
$160.32 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$185.76 |
$185.76 |
$185.76 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$154.08 |
$154.08 |
$154.08 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$301.28 |
$301.28 |
$301.28 |
$606.89
|
|
X-ray skull < 4 views
|
$200.64 |
$200.64 |
$200.64 |
$292.50
|
|
X-ray skull > 4 views complete
|
$244.64 |
$244.64 |
$244.64 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$242.40 |
$242.40 |
$242.40 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$317.28 |
$317.28 |
$317.28 |
$557.70
|
|
X-ray small intestine follow-through study
|
$231.52 |
$231.52 |
$231.52 |
$499.50
|
|
X-ray spine single view
|
$132.00 |
$132.00 |
$132.00 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$69.76 |
$69.76 |
$69.76 |
$264.48
|
|
X-ray sternum > 2 views
|
$177.60 |
$177.60 |
$177.60 |
$274.65
|
|
X-ray surgical specimen
|
$270.24 |
$270.24 |
$270.24 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$342.40 |
$342.40 |
$342.40 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$135.20 |
$135.20 |
$135.20 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$146.56 |
$146.56 |
$146.56 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$208.32 |
$208.32 |
$208.32 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$223.04 |
$223.04 |
$223.04 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$73.60 |
$73.60 |
$73.60 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$157.60 |
$157.60 |
$157.60 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$266.88 |
$266.88 |
$266.88 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$194.88 |
$194.88 |
$194.88 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$305.28 |
$305.28 |
$305.28 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$147.20 |
$147.20 |
$147.20 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$212.16 |
$212.16 |
$212.16 |
$290.40
|
|
X-ray xm phrnx&/crv esoph c+
|
$103.36 |
$103.36 |
$103.36 |
$354.00
|
|
Xtrnl ecg rec up to 48 hrs
|
$53.28 |
$53.28 |
$53.28 |
$253.60
|
|
Yersinia antibody
|
$1.88 |
$1.88 |
$1.88 |
$55.80
|
|
Zika virus dna/rna amp probe
|
$7.30 |
$7.30 |
$7.30 |
$185.00
|
|
Zika virus igm antibody
|
$2.40 |
$2.40 |
$2.40 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$49.50 |
$49.50 |
$49.50 |
$122.45
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$66.00 |
$66.00 |
$66.00 |
$452.69
|