|
Wrist X-ray
|
$118.35 |
$118.35 |
$118.35 |
$351.20
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$2,382.30 |
$2,382.30 |
$2,382.30 |
$2,508.24
|
|
Xm archive tissue molec anal
|
$16.65 |
$16.65 |
$16.65 |
$48.38
|
|
X-ray abdomen 1 view
|
$129.60 |
$129.60 |
$129.60 |
$257.10
|
|
X-ray abdomen 2 views
|
$138.60 |
$138.60 |
$138.60 |
$316.30
|
|
X-ray abdomen >=3 views
|
$147.60 |
$147.60 |
$147.60 |
$338.25
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$162.45 |
$162.45 |
$162.45 |
$406.90
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$124.65 |
$124.65 |
$124.65 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$283.00
|
|
X-ray assay calculus
|
$64.80 |
$64.80 |
$64.80 |
$33.60
|
|
X-ray bone age studies
|
$264.15 |
$264.15 |
$264.15 |
$248.85
|
|
X-ray bone survey complete
|
$270.45 |
$270.45 |
$270.45 |
$660.00
|
|
X-ray bone survey infant
|
$174.60 |
$174.60 |
$174.60 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$236.70 |
$236.70 |
$236.70 |
$333.11
|
|
X-ray cervical spine 4-5 views
|
$272.25 |
$272.25 |
$272.25 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$283.95 |
$283.95 |
$283.95 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$94.50 |
$94.50 |
$94.50 |
$305.00
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$279.45 |
$279.45 |
$279.45 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$90.90 |
$90.90 |
$90.90 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$103.95 |
$103.95 |
$103.95 |
$367.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$153.90 |
$153.90 |
$153.90 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$294.75 |
$294.75 |
$294.75 |
$436.80
|
|
X-ray exam entire spi 6/> vw
|
$283.50 |
$283.50 |
$283.50 |
$517.80
|
|
X-ray exam of arm infant
|
$75.60 |
$75.60 |
$75.60 |
$245.40
|
|
X-ray exam of eye sockets
|
$112.95 |
$112.95 |
$112.95 |
$328.35
|
|
X-ray exam of femur 1
|
$106.20 |
$106.20 |
$106.20 |
$236.14
|
|
X-ray exam of jaw joint
|
$77.85 |
$77.85 |
$77.85 |
$194.46
|
|
X-ray exam of mastoids
|
$192.60 |
$192.60 |
$192.60 |
$193.41
|
|
X-ray exam of sinuses
|
$212.40 |
$212.40 |
$212.40 |
$211.00
|
|
X-ray exam si joints
|
$131.85 |
$131.85 |
$131.85 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$236.70 |
$236.70 |
$236.70 |
$395.00
|
|
X-ray facial bones complete > 3 views
|
$141.30 |
$141.30 |
$141.30 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$127.35 |
$127.35 |
$127.35 |
$316.00
|
|
X-ray finger(s) >= 2 views (both sides)
|
$78.75 |
$78.75 |
$78.75 |
$241.50
|
|
X-ray foot 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$290.40
|
|
X-ray forearm 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$323.20
|
|
X-ray hand 2 views (both sides)
|
$264.15 |
$264.15 |
$264.15 |
$294.90
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$277.50
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$222.30 |
$222.30 |
$222.30 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$306.00 |
$306.00 |
$306.00 |
$419.50
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$106.20 |
$106.20 |
$106.20 |
$219.60
|
|
X-ray humerus >= 2 views left
|
$118.35 |
$118.35 |
$118.35 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$294.25
|
|
X-ray knee 3 views (both sides)
|
$118.35 |
$118.35 |
$118.35 |
$363.60
|
|
X-ray knee ap standing bilateral
|
$94.50 |
$94.50 |
$94.50 |
$253.35
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$253.60
|
|
X-ray lumbosacral spine >= 4 views
|
$192.60 |
$192.60 |
$192.60 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$482.85 |
$482.85 |
$482.85 |
$540.60
|
|
X-ray mandible complete > 4 views
|
$153.90 |
$153.90 |
$153.90 |
$362.05
|
|
X-ray mandible ltd <4 views
|
$142.20 |
$142.20 |
$142.20 |
$237.60
|
|
X-ray nasal bones complete > 3 views
|
$153.90 |
$153.90 |
$153.90 |
$274.65
|
|
X-ray neck soft tissue
|
$182.70 |
$182.70 |
$182.70 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$86.40 |
$86.40 |
$86.40 |
$223.00
|
|
X-ray pelvis 1-2 views
|
$112.95 |
$112.95 |
$112.95 |
$279.96
|
|
X-ray pelvis complete > 3 views
|
$131.40 |
$131.40 |
$131.40 |
$349.57
|
|
X-ray ribs 2 views left
|
$127.35 |
$127.35 |
$127.35 |
$289.80
|
|
X-ray ribs 3 views bilateral
|
$136.35 |
$136.35 |
$136.35 |
$393.60
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$136.35 |
$136.35 |
$136.35 |
$357.50
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$148.05 |
$148.05 |
$148.05 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$148.05 |
$148.05 |
$148.05 |
$309.11
|
|
X-ray sacrum/coccyx >= 2 views
|
$140.40 |
$140.40 |
$140.40 |
$288.60
|
|
X-ray scapula complete (both sides)
|
$99.90 |
$99.90 |
$99.90 |
$285.78
|
|
X-ray shoulder 1 view (both sides)
|
$84.60 |
$84.60 |
$84.60 |
$260.40
|
|
X-ray sinuses paranasal complete > 3 views
|
$142.20 |
$142.20 |
$142.20 |
$345.24
|
|
X-ray skull < 4 views
|
$210.15 |
$210.15 |
$210.15 |
$291.78
|
|
X-ray skull > 4 views complete
|
$144.00 |
$144.00 |
$144.00 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$162.90 |
$162.90 |
$162.90 |
$546.84
|
|
X-ray spine single view
|
$134.10 |
$134.10 |
$134.10 |
$251.40
|
|
X-ray sternum > 2 views
|
$127.35 |
$127.35 |
$127.35 |
$274.65
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$264.15 |
$264.15 |
$264.15 |
$511.10
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$144.00 |
$144.00 |
$144.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$127.35 |
$127.35 |
$127.35 |
$321.10
|
|
X-ray thoracic spine 3 views
|
$136.35 |
$136.35 |
$136.35 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$161.10 |
$161.10 |
$161.10 |
$286.65
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$171.90 |
$171.90 |
$171.90 |
$256.32
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$229.05 |
$229.05 |
$229.05 |
$341.60
|
|
X-ray tibia/fibula 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$106.20 |
$106.20 |
$106.20 |
$258.65
|
|
X-ray wrist 2 views (both sides)
|
$75.60 |
$75.60 |
$75.60 |
$290.40
|