|
X-ray elbow 2 views (both sides)
|
$419.90 |
$419.90 |
$419.90 |
$280.80
|
|
X-ray elbow >= 3 views (both sides)
|
$478.40 |
$478.40 |
$478.40 |
$325.88
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$469.95 |
$469.95 |
$469.95 |
$434.76
|
|
X-ray exam entire spi 4/5 vw
|
$648.05 |
$648.05 |
$648.05 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$731.90 |
$731.90 |
$731.90 |
$562.90
|
|
X-ray exam of arm infant
|
$564.20 |
$564.20 |
$564.20 |
$238.26
|
|
X-ray exam of eye sockets
|
$288.60 |
$288.60 |
$288.60 |
$321.48
|
|
X-ray exam of femur 1
|
$266.50 |
$266.50 |
$266.50 |
$194.40
|
|
X-ray exam of jaw joint
|
$175.50 |
$175.50 |
$175.50 |
$179.54
|
|
X-ray exam of jaw joint
|
$2,522.65 |
$2,522.65 |
$2,522.65 |
$370.89
|
|
X-ray exam of mastoids
|
$350.35 |
$350.35 |
$350.35 |
$187.60
|
|
X-ray exam of perineum
|
$496.60 |
$496.60 |
$496.60 |
$330.96
|
|
X-ray exam of sinuses
|
$185.25 |
$185.25 |
$185.25 |
$192.00
|
|
X-ray exam si joints
|
$291.20 |
$291.20 |
$291.20 |
$198.38
|
|
X-ray exam thorac spine4/>vw
|
$378.95 |
$378.95 |
$378.95 |
$365.00
|
|
X-ray eye detection foreign body (both sides)
|
$339.95 |
$339.95 |
$339.95 |
$227.80
|
|
X-ray facial bones complete > 3 views
|
$256.10 |
$256.10 |
$256.10 |
$336.00
|
|
X-ray fallopian tube
|
$707.20 |
$707.20 |
$707.20 |
$489.00
|
|
X-ray femur >=2 views (both sides)
|
$517.40 |
$517.40 |
$517.40 |
$288.00
|
|
X-ray finger(s) >= 2 views (both sides)
|
$466.70 |
$466.70 |
$466.70 |
$233.55
|
|
X-ray foot 2 views (both sides)
|
$369.85 |
$369.85 |
$369.85 |
$270.40
|
|
X-ray forearm 2 views (both sides)
|
$515.45 |
$515.45 |
$515.45 |
$317.62
|
|
X-ray hand 2 views (both sides)
|
$355.55 |
$355.55 |
$355.55 |
$267.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$432.90 |
$432.90 |
$432.90 |
$243.10
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$365.95 |
$365.95 |
$365.95 |
$300.00
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$514.15 |
$514.15 |
$514.15 |
$313.45
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$681.85 |
$681.85 |
$681.85 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$871.65 |
$871.65 |
$871.65 |
$477.10
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$262.60 |
$262.60 |
$262.60 |
$186.60
|
|
X-ray humerus >= 2 views left
|
$540.80 |
$540.80 |
$540.80 |
$285.00
|
|
X-ray joint survey 1 view
|
$193.70 |
$193.70 |
$193.70 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$435.50 |
$435.50 |
$435.50 |
$271.70
|
|
X-ray knee 3 views (both sides)
|
$442.00 |
$442.00 |
$442.00 |
$319.24
|
|
X-ray knee ap standing bilateral
|
$202.15 |
$202.15 |
$202.15 |
$238.80
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$267.15 |
$267.15 |
$267.15 |
$227.92
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$405.60 |
$405.60 |
$405.60 |
$342.55
|
|
X-ray lumbosacral spine >= 4 views
|
$545.35 |
$545.35 |
$545.35 |
$475.04
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$384.80 |
$384.80 |
$384.80 |
$513.63
|
|
X-ray mandible complete > 4 views
|
$270.40 |
$270.40 |
$270.40 |
$320.90
|
|
X-ray mandible ltd <4 views
|
$212.55 |
$212.55 |
$212.55 |
$200.20
|
|
X-ray nasal bones complete > 3 views
|
$193.70 |
$193.70 |
$193.70 |
$260.52
|
|
X-ray neck soft tissue
|
$234.65 |
$234.65 |
$234.65 |
$221.10
|
|
X-ray nose to rectum for foreign body child
|
$287.95 |
$287.95 |
$287.95 |
$201.00
|
|
X-ray of mammary ducts
|
$1,066.65 |
$1,066.65 |
$1,066.65 |
$437.00
|
|
X-ray optic foramina
|
$397.80 |
$397.80 |
$397.80 |
$165.09
|
|
X-ray pelvis 1-2 views
|
$348.40 |
$348.40 |
$348.40 |
$242.58
|
|
X-ray pelvis complete > 3 views
|
$342.55 |
$342.55 |
$342.55 |
$295.75
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$793.65 |
$793.65 |
$793.65 |
$663.18
|
|
X-ray ribs 2 views left
|
$281.45 |
$281.45 |
$281.45 |
$281.45
|
|
X-ray ribs 3 views bilateral
|
$292.50 |
$292.50 |
$292.50 |
$361.20
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$583.70 |
$583.70 |
$583.70 |
$327.21
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$463.45 |
$463.45 |
$463.45 |
$463.45
|
|
X-ray sacroiliac joints >= 3 views
|
$227.50 |
$227.50 |
$227.50 |
$270.40
|
|
X-ray sacrum/coccyx >= 2 views
|
$289.90 |
$289.90 |
$289.90 |
$260.00
|
|
X-ray scapula complete (both sides)
|
$458.25 |
$458.25 |
$458.25 |
$264.80
|
|
X-ray sella turcica
|
$224.25 |
$224.25 |
$224.25 |
$144.00
|
|
X-ray shoulder 1 view (both sides)
|
$334.10 |
$334.10 |
$334.10 |
$242.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$237.25 |
$237.25 |
$237.25 |
$324.53
|
|
X-ray sinus tract/fistula/abscess
|
$529.10 |
$529.10 |
$529.10 |
$529.75
|
|
X-ray skull < 4 views
|
$322.40 |
$322.40 |
$322.40 |
$277.54
|
|
X-ray skull > 4 views complete
|
$319.80 |
$319.80 |
$319.80 |
$404.30
|
|
X-ray slg plne bdy sect without urogr
|
$702.65 |
$702.65 |
$702.65 |
$370.64
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$426.40 |
$426.40 |
$426.40 |
$511.38
|
|
X-ray small intestine follow-through study
|
$910.00 |
$910.00 |
$910.00 |
$470.16
|
|
X-ray spine single view
|
$308.75 |
$308.75 |
$308.75 |
$225.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$338.65 |
$338.65 |
$338.65 |
$236.88
|
|
X-ray sternum > 2 views
|
$196.30 |
$196.30 |
$196.30 |
$230.00
|
|
X-ray surgical specimen
|
$516.10 |
$516.10 |
$516.10 |
$457.47
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$482.30 |
$482.30 |
$482.30 |
$463.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$319.80 |
$319.80 |
$319.80 |
$276.00
|
|
X-ray thoracic spine 2 views
|
$377.00 |
$377.00 |
$377.00 |
$286.65
|
|
X-ray thoracic spine 3 views
|
$469.30 |
$469.30 |
$469.30 |
$343.00
|
|
X-ray thoracolumbar spine >=2 views
|
$302.90 |
$302.90 |
$302.90 |
$269.10
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$229.45 |
$229.45 |
$229.45 |
$211.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$333.45 |
$333.45 |
$333.45 |
$346.50
|
|
X-ray tibia/fibula 2 views (both sides)
|
$516.10 |
$516.10 |
$516.10 |
$306.47
|
|
X-ray toe(s) > 2 views (both sides)
|
$472.55 |
$472.55 |
$472.55 |
$225.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$458.90 |
$458.90 |
$458.90 |
$590.20
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$635.05 |
$635.05 |
$635.05 |
$497.93
|
|
X-ray wrist 2 views (both sides)
|
$471.90 |
$471.90 |
$471.90 |
$268.49
|
|
Xyntha inj
|
$7,669.48 |
$7,669.48 |
$7,669.48 |
$2.14
|
|
Yttrium y-90 ibritumomab ther
|
$62,955.10 |
$62,955.10 |
$62,955.10 |
$56,824.55
|
|
Zidovudine, oral, 100 mg
|
$75.35 |
$75.35 |
$75.35 |
$75.35
|
|
Zika virus dna/rna amp probe
|
$422.50 |
$422.50 |
$422.50 |
$194.40
|
|
Zika virus igm antibody
|
$163.15 |
$163.15 |
$163.15 |
$84.83
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$142.06 |
$142.06 |
$142.06 |
$83.13
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$6,975.80 |
$6,975.80 |
$6,975.80 |
$31.69
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$403.65 |
$403.65 |
$403.65 |
$195.65
|
