|
X-ray abdomen 1 view
|
$203.50 |
$203.50 |
$245.30 |
$255.00
|
|
X-ray abdomen 2 views
|
$242.00 |
$242.00 |
$327.80 |
$312.36
|
|
X-ray abdomen >=3 views
|
$312.40 |
$312.40 |
$381.46 |
$332.15
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$338.80 |
$338.80 |
$404.25 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$291.91 |
$291.91 |
$465.30 |
$271.44
|
|
X-ray ankle 2 views (both sides)
|
$231.00 |
$231.00 |
$269.50 |
$283.00
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$789.36 |
$789.36 |
$831.60 |
$768.30
|
|
X-ray bone age studies
|
$189.20 |
$189.20 |
$242.55 |
$246.75
|
|
X-ray bone length studies
|
$332.97 |
$332.97 |
$617.10 |
$287.25
|
|
X-ray bone survey complete
|
$437.25 |
$437.25 |
$592.90 |
$666.60
|
|
X-ray bone survey infant
|
$599.86 |
$599.86 |
$599.86 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$275.00 |
$275.00 |
$289.85 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$363.00 |
$363.00 |
$519.02 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$521.59 |
$521.59 |
$719.40 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$220.00 |
$220.00 |
$248.60 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$413.05 |
$413.05 |
$595.65 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$459.25 |
$459.25 |
$757.88 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$231.00 |
$231.00 |
$242.55 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$298.10 |
$298.10 |
$323.40 |
$342.00
|
|
Xray endovasc thor ao repr
|
$1,768.25 |
$1,768.25 |
$1,768.25 |
$1,889.01
|
|
Xray endovasc thor ao repr
|
$1,768.25 |
$1,768.25 |
$1,768.25 |
$2,266.32
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$275.00 |
$275.00 |
$432.85 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$392.70 |
$392.70 |
$653.76 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$448.80 |
$448.80 |
$673.65 |
$575.76
|
|
X-ray exam of arm infant
|
$309.88 |
$309.88 |
$309.88 |
$248.82
|
|
X-ray exam of eye sockets
|
$162.80 |
$162.80 |
$392.64 |
$349.05
|
|
X-ray exam of femur 1
|
$220.00 |
$220.00 |
$296.45 |
$232.36
|
|
X-ray exam of jaw joint
|
$134.75 |
$134.75 |
$134.75 |
$192.39
|
|
X-ray exam of mastoids
|
$280.50 |
$280.50 |
$280.50 |
$191.91
|
|
X-ray exam of sinuses
|
$249.57 |
$249.57 |
$268.95 |
$211.00
|
|
X-ray exam of teeth
|
$59.66 |
$59.66 |
$59.66 |
$104.19
|
|
X-ray exam of teeth
|
$341.96 |
$341.96 |
$341.96 |
$286.04
|
|
X-ray exam si joints
|
$200.20 |
$200.20 |
$300.89 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$360.25 |
$360.25 |
$415.09 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$126.50 |
$126.50 |
$126.50 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$437.25 |
$437.25 |
$451.66 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$247.50 |
$247.50 |
$315.15 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$187.00 |
$187.00 |
$221.10 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$176.00 |
$176.00 |
$235.40 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$220.00 |
$220.00 |
$261.25 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$190.85 |
$190.85 |
$263.04 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$192.50 |
$192.50 |
$209.55 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$352.86 |
$352.86 |
$491.70 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$303.05 |
$303.05 |
$353.10 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$392.70 |
$392.70 |
$467.06 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$478.50 |
$478.50 |
$552.20 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$212.30 |
$212.30 |
$214.50 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$214.50 |
$214.50 |
$241.45 |
$304.15
|
|
X-ray joint survey 1 view
|
$151.25 |
$151.25 |
$363.77 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$220.00 |
$220.00 |
$246.40 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$269.50 |
$269.50 |
$327.80 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$275.00 |
$275.00 |
$320.14 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$249.57 |
$249.57 |
$249.57 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$101.20 |
$101.20 |
$382.37 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$418.00 |
$418.00 |
$470.25 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$518.65 |
$518.65 |
$554.31 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$336.82 |
$336.82 |
$448.80 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$312.44 |
$312.44 |
$392.70 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$291.50 |
$291.50 |
$309.88 |
$277.70
|
|
X-ray neck soft tissue
|
$212.30 |
$212.30 |
$272.21 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$238.73 |
$238.73 |
$238.73 |
$225.96
|
|
X-ray pelvis 1-2 views
|
$236.50 |
$236.50 |
$346.50 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$342.10 |
$342.10 |
$362.45 |
$342.30
|
|
Xray place dist ext thor ao
|
$1,665.40 |
$1,665.40 |
$1,665.40 |
$1,323.14
|
|
Xray place prox ext thor ao
|
$1,665.40 |
$1,665.40 |
$1,665.40 |
$1,005.84
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$499.40 |
$499.40 |
$795.85 |
$742.00
|
|
X-ray ribs 2 views left
|
$229.90 |
$229.90 |
$287.42 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$240.90 |
$240.90 |
$363.77 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$336.60 |
$336.60 |
$394.56 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$398.20 |
$398.20 |
$478.61 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$258.50 |
$258.50 |
$341.00 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$268.95 |
$268.95 |
$330.41 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$286.00 |
$286.00 |
$303.46 |
$292.50
|
|
X-ray shoulder 1 view (both sides)
|
$145.75 |
$145.75 |
$239.30 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$286.00 |
$286.00 |
$363.77 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$643.57 |
$643.57 |
$660.00 |
$601.30
|
|
X-ray skull < 4 views
|
$286.00 |
$286.00 |
$320.65 |
$291.78
|
|
X-ray skull > 4 views complete
|
$359.15 |
$359.15 |
$439.47 |
$414.60
|
|
X-ray slg plne bdy sect without urogr
|
$398.75 |
$398.75 |
$398.75 |
$387.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$310.20 |
$310.20 |
$477.46 |
$557.70
|
|
X-ray small intestine follow-through study
|
$310.20 |
$310.20 |
$1,061.03 |
$504.14
|
|
X-ray spine single view
|
$198.00 |
$198.00 |
$263.45 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$123.20 |
$123.20 |
$320.78 |
$263.49
|
|
X-ray sternum > 2 views
|
$151.25 |
$151.25 |
$330.41 |
$269.75
|
|
X-ray surgical specimen
|
$743.60 |
$743.60 |
$743.60 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$368.50 |
$368.50 |
$482.35 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$268.95 |
$268.95 |
$417.66 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$258.50 |
$258.50 |
$329.45 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$330.00 |
$330.00 |
$343.75 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$231.00 |
$231.00 |
$242.55 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$280.50 |
$280.50 |
$323.40 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$336.60 |
$336.60 |
$485.02 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$231.00 |
$231.00 |
$275.00 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$212.85 |
$212.85 |
$222.20 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$574.20 |
$574.20 |
$574.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$482.35 |
$482.35 |
$626.45 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$214.50 |
$214.50 |
$234.85 |
$290.40
|
|
X-ray xm phrnx&/crv esoph c+
|
$332.21 |
$332.21 |
$332.21 |
$324.20
|
|
Xtrnl ecg rec up to 48 hrs
|
$469.15 |
$469.15 |
$469.15 |
$253.60
|
|
Zika virus dna/rna amp probe
|
$35.20 |
$35.20 |
$165.00 |
$175.00
|