|
X-ray cervical spine 4-5 views
|
$510.00 |
$510.00 |
$510.00 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$560.40 |
$560.40 |
$560.40 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$563.40 |
$563.40 |
$563.40 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$703.80 |
$703.80 |
$703.80 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$871.20 |
$871.20 |
$871.20 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$580.80 |
$580.80 |
$580.80 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$531.00 |
$531.00 |
$531.00 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$498.00 |
$498.00 |
$498.00 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$334.20 |
$334.20 |
$334.20 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$385.20 |
$385.20 |
$385.20 |
$517.80
|
|
X-ray exam of arm infant
|
$649.20 |
$649.20 |
$649.20 |
$248.44
|
|
X-ray exam of eye sockets
|
$526.20 |
$526.20 |
$526.20 |
$328.35
|
|
X-ray exam of femur 1
|
$700.20 |
$700.20 |
$700.20 |
$240.00
|
|
X-ray exam of jaw joint
|
$370.80 |
$370.80 |
$370.80 |
$188.40
|
|
X-ray exam of mastoids
|
$612.00 |
$612.00 |
$612.00 |
$193.41
|
|
X-ray exam of sinuses
|
$132.60 |
$132.60 |
$132.60 |
$214.50
|
|
X-ray exam si joints
|
$423.00 |
$423.00 |
$423.00 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$502.20 |
$502.20 |
$502.20 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$435.00 |
$435.00 |
$435.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$532.20 |
$532.20 |
$532.20 |
$381.75
|
|
X-ray fallopian tube
|
$594.60 |
$594.60 |
$594.60 |
$532.38
|
|
X-ray femur >=2 views (both sides)
|
$644.40 |
$644.40 |
$644.40 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$474.00 |
$474.00 |
$474.00 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$580.80 |
$580.80 |
$580.80 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$656.40 |
$656.40 |
$656.40 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$628.20 |
$628.20 |
$628.20 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$489.60 |
$489.60 |
$489.60 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$868.20 |
$868.20 |
$868.20 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$580.20 |
$580.20 |
$580.20 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$614.40 |
$614.40 |
$614.40 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$750.00 |
$750.00 |
$750.00 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$676.20 |
$676.20 |
$676.20 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$610.20 |
$610.20 |
$610.20 |
$309.31
|
|
X-ray joint survey 1 view
|
$415.80 |
$415.80 |
$415.80 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$595.20 |
$595.20 |
$595.20 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$580.80 |
$580.80 |
$580.80 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$681.00 |
$681.00 |
$681.00 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$615.60 |
$615.60 |
$615.60 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$415.80 |
$415.80 |
$415.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$478.20 |
$478.20 |
$478.20 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$540.60 |
$540.60 |
$540.60 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$493.80 |
$493.80 |
$493.80 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$327.00 |
$327.00 |
$327.00 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$442.20 |
$442.20 |
$442.20 |
$274.65
|
|
X-ray neck soft tissue
|
$520.20 |
$520.20 |
$520.20 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$332.40 |
$332.40 |
$332.40 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$327.60 |
$327.60 |
$327.60 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$342.00 |
$342.00 |
$342.00 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$927.00 |
$927.00 |
$927.00 |
$755.50
|
|
X-ray ribs 2 views left
|
$431.40 |
$431.40 |
$431.40 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$540.00 |
$540.00 |
$540.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$583.20 |
$583.20 |
$583.20 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$600.60 |
$600.60 |
$600.60 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$483.00 |
$483.00 |
$483.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$286.80 |
$286.80 |
$286.80 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$588.60 |
$588.60 |
$588.60 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$265.20 |
$265.20 |
$265.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$526.20 |
$526.20 |
$526.20 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$793.20 |
$793.20 |
$793.20 |
$606.89
|
|
X-ray skull < 4 views
|
$396.60 |
$396.60 |
$396.60 |
$292.50
|
|
X-ray skull > 4 views complete
|
$507.60 |
$507.60 |
$507.60 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$484.20 |
$484.20 |
$484.20 |
$557.70
|
|
X-ray small intestine follow-through study
|
$550.80 |
$550.80 |
$550.80 |
$499.50
|
|
X-ray spine single view
|
$324.00 |
$324.00 |
$324.00 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$356.40 |
$356.40 |
$356.40 |
$264.48
|
|
X-ray sternum > 2 views
|
$414.00 |
$414.00 |
$414.00 |
$274.65
|
|
X-ray surgical specimen
|
$340.80 |
$340.80 |
$340.80 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$514.20 |
$514.20 |
$514.20 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$556.80 |
$556.80 |
$556.80 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$405.00 |
$405.00 |
$405.00 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$465.60 |
$465.60 |
$465.60 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$198.00 |
$198.00 |
$198.00 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$260.40 |
$260.40 |
$260.40 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$301.80 |
$301.80 |
$301.80 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$679.20 |
$679.20 |
$679.20 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$447.00 |
$447.00 |
$447.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$718.80 |
$718.80 |
$718.80 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$771.00 |
$771.00 |
$771.00 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$628.20 |
$628.20 |
$628.20 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$356.40 |
$356.40 |
$356.40 |
$99.89
|
|
Zika virus dna/rna amp probe
|
$695.40 |
$695.40 |
$695.40 |
$185.00
|
|
Zika virus igm antibody
|
$525.00 |
$525.00 |
$525.00 |
$85.00
|
