|
X-ray cervical spine 2-3 views
|
$395.20 |
$395.20 |
$395.20 |
$308.40
|
|
X-ray cervical spine 4-5 views
|
$521.95 |
$521.95 |
$521.95 |
$439.14
|
|
X-ray cervical spine >= 6 views
|
$495.95 |
$495.95 |
$495.95 |
$479.05
|
|
X-ray clavicle complete (both sides)
|
$414.05 |
$414.05 |
$414.05 |
$277.00
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$904.80 |
$904.80 |
$904.80 |
$594.68
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$904.80 |
$904.80 |
$904.80 |
$785.86
|
|
X-ray elbow 2 views (both sides)
|
$440.70 |
$440.70 |
$440.70 |
$281.40
|
|
X-ray elbow >= 3 views (both sides)
|
$395.85 |
$395.85 |
$395.85 |
$325.88
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$495.95 |
$495.95 |
$495.95 |
$434.76
|
|
X-ray exam of eye sockets
|
$289.90 |
$289.90 |
$289.90 |
$321.48
|
|
X-ray eye detection foreign body (both sides)
|
$216.45 |
$216.45 |
$216.45 |
$227.80
|
|
X-ray facial bones complete > 3 views
|
$329.55 |
$329.55 |
$329.55 |
$337.95
|
|
X-ray femur >=2 views (both sides)
|
$526.50 |
$526.50 |
$526.50 |
$290.44
|
|
X-ray finger(s) >= 2 views (both sides)
|
$304.20 |
$304.20 |
$304.20 |
$233.55
|
|
X-ray foot 2 views (both sides)
|
$408.20 |
$408.20 |
$408.20 |
$270.40
|
|
X-ray forearm 2 views (both sides)
|
$297.70 |
$297.70 |
$297.70 |
$317.62
|
|
X-ray hand 2 views (both sides)
|
$345.80 |
$345.80 |
$345.80 |
$270.00
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$414.05 |
$414.05 |
$414.05 |
$243.10
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$526.50 |
$526.50 |
$526.50 |
$313.45
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$526.50 |
$526.50 |
$526.50 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$526.50 |
$526.50 |
$526.50 |
$477.10
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$220.35 |
$220.35 |
$220.35 |
$187.20
|
|
X-ray humerus >= 2 views left
|
$454.35 |
$454.35 |
$454.35 |
$285.00
|
|
X-ray knee 1-2 views (both sides)
|
$493.35 |
$493.35 |
$493.35 |
$271.70
|
|
X-ray knee 3 views (both sides)
|
$517.40 |
$517.40 |
$517.40 |
$319.24
|
|
X-ray knee ap standing bilateral
|
$311.35 |
$311.35 |
$311.35 |
$243.09
|
|
X-ray lumbosacral spine >= 4 views
|
$521.95 |
$521.95 |
$521.95 |
$475.04
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$495.95 |
$495.95 |
$495.95 |
$513.63
|
|
X-ray mandible complete > 4 views
|
$289.90 |
$289.90 |
$289.90 |
$323.70
|
|
X-ray mandible ltd <4 views
|
$248.30 |
$248.30 |
$248.30 |
$200.20
|
|
X-ray nasal bones complete > 3 views
|
$329.55 |
$329.55 |
$329.55 |
$260.52
|
|
X-ray neck soft tissue
|
$217.10 |
$217.10 |
$217.10 |
$221.10
|
|
X-ray nose to rectum for foreign body child
|
$206.70 |
$206.70 |
$206.70 |
$201.00
|
|
X-ray pelvis 1-2 views
|
$211.90 |
$211.90 |
$211.90 |
$242.58
|
|
X-ray ribs 2 views left
|
$237.90 |
$237.90 |
$237.90 |
$281.45
|
|
X-ray ribs 3 views bilateral
|
$273.65 |
$273.65 |
$273.65 |
$361.20
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$264.55 |
$264.55 |
$264.55 |
$327.21
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$351.65 |
$351.65 |
$351.65 |
$466.80
|
|
X-ray sacroiliac joints >= 3 views
|
$329.55 |
$329.55 |
$329.55 |
$270.40
|
|
X-ray sacrum/coccyx >= 2 views
|
$329.55 |
$329.55 |
$329.55 |
$260.65
|
|
X-ray scapula complete (both sides)
|
$454.35 |
$454.35 |
$454.35 |
$264.80
|
|
X-ray shoulder 1 view (both sides)
|
$414.05 |
$414.05 |
$414.05 |
$242.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$440.70 |
$440.70 |
$440.70 |
$324.53
|
|
X-ray sinus tract/fistula/abscess
|
$908.05 |
$908.05 |
$908.05 |
$539.50
|
|
X-ray skull < 4 views
|
$264.55 |
$264.55 |
$264.55 |
$277.54
|
|
X-ray skull > 4 views complete
|
$384.80 |
$384.80 |
$384.80 |
$404.30
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$824.20 |
$824.20 |
$824.20 |
$511.38
|
|
X-ray small intestine follow-through study
|
$824.20 |
$824.20 |
$824.20 |
$470.16
|
|
X-ray spine single view
|
$276.25 |
$276.25 |
$276.25 |
$225.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$304.20 |
$304.20 |
$304.20 |
$236.88
|
|
X-ray sternum > 2 views
|
$304.20 |
$304.20 |
$304.20 |
$230.00
|
|
X-ray surgical specimen
|
$824.20 |
$824.20 |
$824.20 |
$457.47
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$770.25 |
$770.25 |
$770.25 |
$463.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$329.55 |
$329.55 |
$329.55 |
$276.00
|
|
X-ray thoracic spine 2 views
|
$366.60 |
$366.60 |
$366.60 |
$286.65
|
|
X-ray thoracic spine 3 views
|
$395.20 |
$395.20 |
$395.20 |
$343.00
|
|
X-ray thoracolumbar spine >=2 views
|
$393.90 |
$393.90 |
$393.90 |
$269.10
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$276.25 |
$276.25 |
$276.25 |
$211.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$276.25 |
$276.25 |
$276.25 |
$346.50
|
|
X-ray tibia/fibula 2 views (both sides)
|
$373.10 |
$373.10 |
$373.10 |
$306.47
|
|
X-ray toe(s) > 2 views (both sides)
|
$469.95 |
$469.95 |
$469.95 |
$225.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$908.05 |
$908.05 |
$908.05 |
$590.20
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$757.25 |
$757.25 |
$757.25 |
$497.93
|
|
X-ray wrist 2 views (both sides)
|
$220.35 |
$220.35 |
$220.35 |
$268.49
|
|
Zidovudine in d5w IV syringe 4 mg/ml (neo/peds) - cnr
|
$123.37 |
$123.37 |
$123.37 |
$90.15
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$198.57 |
$198.57 |
$198.57 |
$83.13
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$682.50 |
$682.50 |
$682.50 |
$201.50
|
