|
X-ray bone length studies
|
$182.10 |
$182.10 |
$532.00 |
$285.30
|
|
X-ray bone survey complete
|
$319.95 |
$319.95 |
$1,444.80 |
$660.00
|
|
X-ray bone survey infant
|
$164.85 |
$164.85 |
$1,024.80 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$212.70 |
$212.70 |
$537.60 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$283.95 |
$283.95 |
$677.60 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$318.75 |
$318.75 |
$739.20 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$181.35 |
$181.35 |
$610.40 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$520.50 |
$520.50 |
$1,232.00 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$492.75 |
$492.75 |
$1,355.20 |
$820.15
|
|
X-ray consultation
|
$26.10 |
$26.10 |
$40.88 |
$40.88
|
|
X-ray elbow 2 views (both sides)
|
$180.60 |
$180.60 |
$532.00 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$302.85 |
$302.85 |
$616.00 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$273.15 |
$273.15 |
$1,047.20 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$179.55 |
$179.55 |
$733.60 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$192.90 |
$192.90 |
$1,092.00 |
$517.80
|
|
X-ray exam of arm infant
|
$109.35 |
$109.35 |
$716.80 |
$248.44
|
|
X-ray exam of eye sockets
|
$240.30 |
$240.30 |
$784.00 |
$328.35
|
|
X-ray exam of femur 1
|
$21.90 |
$21.90 |
$464.80 |
$240.00
|
|
X-ray exam of jaw joint
|
$380.80 |
$380.80 |
$380.80 |
$188.40
|
|
X-ray exam of jaw joint
|
$1,758.40 |
$1,758.40 |
$1,758.40 |
$452.00
|
|
X-ray exam of mastoids
|
$120.30 |
$120.30 |
$739.20 |
$193.41
|
|
X-ray exam of middle ear
|
$1,495.20 |
$1,495.20 |
$1,495.20 |
$345.66
|
|
X-ray exam of penis
|
$1,629.60 |
$1,629.60 |
$1,629.60 |
$593.46
|
|
X-ray exam of perineum
|
$1,758.40 |
$1,758.40 |
$1,758.40 |
$577.85
|
|
X-ray exam of salivary gland
|
$319.20 |
$319.20 |
$319.20 |
$162.60
|
|
X-ray exam of sinuses
|
$156.15 |
$156.15 |
$257.04 |
$214.50
|
|
X-ray exam of tear duct
|
$2,161.60 |
$2,161.60 |
$2,161.60 |
$467.50
|
|
X-ray exam of teeth
|
$616.00 |
$616.00 |
$616.00 |
$119.66
|
|
X-ray exam of teeth
|
$1,232.00 |
$1,232.00 |
$1,232.00 |
$328.08
|
|
X-ray exam si joints
|
$144.00 |
$144.00 |
$347.20 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$213.75 |
$213.75 |
$677.60 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$128.85 |
$128.85 |
$257.04 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$240.15 |
$240.15 |
$492.80 |
$381.75
|
|
X-ray fallopian tube
|
$2,223.20 |
$2,223.20 |
$2,223.20 |
$532.38
|
|
X-ray femur >=2 views (both sides)
|
$293.85 |
$293.85 |
$492.80 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$207.90 |
$207.90 |
$492.80 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$244.35 |
$244.35 |
$470.40 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$178.20 |
$178.20 |
$588.00 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$257.85 |
$257.85 |
$431.20 |
$291.20
|
|
X-ray head for orthodontia
|
$554.40 |
$554.40 |
$554.40 |
$158.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$184.35 |
$184.35 |
$532.00 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$223.35 |
$223.35 |
$492.80 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$266.70 |
$266.70 |
$526.40 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$285.45 |
$285.45 |
$571.20 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$239.70 |
$239.70 |
$739.20 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$185.40 |
$185.40 |
$352.80 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$277.95 |
$277.95 |
$604.80 |
$309.31
|
|
X-ray joint survey 1 view
|
$145.65 |
$145.65 |
$375.20 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$262.80 |
$262.80 |
$403.20 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$308.55 |
$308.55 |
$459.20 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$183.75 |
$183.75 |
$238.56 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$94.65 |
$94.65 |
$604.80 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$342.60 |
$342.60 |
$996.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$310.65 |
$310.65 |
$588.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$359.70 |
$359.70 |
$677.60 |
$535.91
|
|
X-ray male genital tract
|
$2,083.20 |
$2,083.20 |
$2,083.20 |
$603.50
|
|
X-ray mandible complete > 4 views
|
$246.30 |
$246.30 |
$968.80 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$168.60 |
$168.60 |
$604.80 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$204.00 |
$204.00 |
$604.80 |
$274.65
|
|
X-ray neck soft tissue
|
$159.30 |
$159.30 |
$464.80 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$102.45 |
$102.45 |
$604.80 |
$225.60
|
|
X-ray of mammary ducts
|
$694.40 |
$694.40 |
$694.40 |
$568.26
|
|
X-ray optic foramina
|
$267.30 |
$267.30 |
$604.80 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$205.80 |
$205.80 |
$526.40 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$243.45 |
$243.45 |
$554.40 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$586.65 |
$586.65 |
$1,052.80 |
$755.50
|
|
X-ray ribs 2 views left
|
$208.80 |
$208.80 |
$431.20 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$294.60 |
$294.60 |
$616.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$226.65 |
$226.65 |
$616.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$293.55 |
$293.55 |
$739.20 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$188.85 |
$188.85 |
$728.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$199.35 |
$199.35 |
$515.20 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$285.30 |
$285.30 |
$879.20 |
$285.00
|
|
X-ray sella turcica
|
$77.85 |
$77.85 |
$604.80 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$185.40 |
$185.40 |
$599.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$200.70 |
$200.70 |
$308.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$665.40 |
$665.40 |
$1,383.20 |
$606.89
|
|
X-ray skull < 4 views
|
$221.55 |
$221.55 |
$683.20 |
$292.50
|
|
X-ray skull > 4 views complete
|
$272.55 |
$272.55 |
$1,002.40 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$220.35 |
$220.35 |
$974.40 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$365.70 |
$365.70 |
$481.60 |
$557.70
|
|
X-ray small intestine follow-through study
|
$160.20 |
$160.20 |
$1,540.00 |
$499.50
|
|
X-ray spine single view
|
$159.30 |
$159.30 |
$498.40 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$177.45 |
$177.45 |
$644.00 |
$264.48
|
|
X-ray sternum > 2 views
|
$257.10 |
$257.10 |
$560.00 |
$274.65
|
|
X-ray surgical specimen
|
$470.25 |
$470.25 |
$1,383.20 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$343.95 |
$343.95 |
$1,170.40 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$240.75 |
$240.75 |
$565.60 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$189.00 |
$189.00 |
$554.40 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$202.35 |
$202.35 |
$588.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$203.70 |
$203.70 |
$352.80 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$135.60 |
$135.60 |
$257.04 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$171.90 |
$171.90 |
$341.60 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$259.65 |
$259.65 |
$576.80 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$139.20 |
$139.20 |
$330.40 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$490.95 |
$490.95 |
$739.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$403.65 |
$403.65 |
$616.00 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$233.40 |
$233.40 |
$509.60 |
$290.40
|
|
X-ray xm phrnx&/crv esoph c+
|
$968.80 |
$968.80 |
$968.80 |
$354.00
|
|
Xtrnl ecg rec>48hr<7d
|
$789.60 |
$789.60 |
$789.60 |
$789.60
|
