|
Xpos opn fmrl eprst aor uni add-on
|
$230.00 |
$230.00 |
$230.00 |
$2,087.40
|
|
X-ray abdomen 1 view
|
$170.00 |
$170.00 |
$170.00 |
$258.50
|
|
X-ray abdomen 2 views
|
$331.50 |
$331.50 |
$331.50 |
$316.47
|
|
X-ray abdomen >=3 views
|
$365.00 |
$365.00 |
$365.00 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$375.00 |
$375.00 |
$375.00 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$127.00 |
$127.00 |
$127.00 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$173.00 |
$173.00 |
$173.00 |
$282.50
|
|
X-ray bone age studies
|
$175.00 |
$175.00 |
$175.00 |
$251.40
|
|
X-ray bone length studies
|
$210.00 |
$210.00 |
$210.00 |
$285.30
|
|
X-ray bone survey complete
|
$290.50 |
$290.50 |
$290.50 |
$660.00
|
|
X-ray cervical spine 2-3 views
|
$232.00 |
$232.00 |
$232.00 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$267.50 |
$267.50 |
$267.50 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$17.50 |
$17.50 |
$17.50 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$305.00 |
$305.00 |
$305.00 |
$300.05
|
|
X-ray elbow 2 views (both sides)
|
$197.50 |
$197.50 |
$197.50 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$224.00 |
$224.00 |
$224.00 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$273.50 |
$273.50 |
$273.50 |
$483.50
|
|
X-ray exam entire spi 6/> vw
|
$24.00 |
$24.00 |
$24.00 |
$517.80
|
|
X-ray exam of eye sockets
|
$229.50 |
$229.50 |
$229.50 |
$328.35
|
|
X-ray exam of femur 1
|
$127.00 |
$127.00 |
$127.00 |
$240.00
|
|
X-ray exam of sinuses
|
$127.50 |
$127.50 |
$127.50 |
$214.50
|
|
X-ray exam thorac spine4/>vw
|
$171.00 |
$171.00 |
$171.00 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$169.00 |
$169.00 |
$169.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$252.50 |
$252.50 |
$252.50 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$372.00 |
$372.00 |
$372.00 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$159.00 |
$159.00 |
$159.00 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$322.00 |
$322.00 |
$322.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$224.00 |
$224.00 |
$224.00 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$347.00 |
$347.00 |
$347.00 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$173.50 |
$173.50 |
$173.50 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$182.50 |
$182.50 |
$182.50 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$147.00 |
$147.00 |
$147.00 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$171.00 |
$171.00 |
$171.00 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$432.00 |
$432.00 |
$432.00 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$198.00 |
$198.00 |
$198.00 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$161.00 |
$161.00 |
$161.00 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$180.00 |
$180.00 |
$180.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$423.00 |
$423.00 |
$423.00 |
$363.20
|
|
X-ray lumbosacral spine >= 4 views
|
$339.00 |
$339.00 |
$339.00 |
$505.83
|
|
X-ray mandible complete > 4 views
|
$337.00 |
$337.00 |
$337.00 |
$361.61
|
|
X-ray nasal bones complete > 3 views
|
$252.50 |
$252.50 |
$252.50 |
$274.65
|
|
X-ray neck soft tissue
|
$127.00 |
$127.00 |
$127.00 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$263.00 |
$263.00 |
$263.00 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$131.00 |
$131.00 |
$131.00 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$177.50 |
$177.50 |
$177.50 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$30.00 |
$30.00 |
$30.00 |
$755.50
|
|
X-ray ribs 2 views left
|
$198.00 |
$198.00 |
$198.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$210.50 |
$210.50 |
$210.50 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$191.00 |
$191.00 |
$191.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$199.00 |
$199.00 |
$199.00 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$171.00 |
$171.00 |
$171.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$193.50 |
$193.50 |
$193.50 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$147.50 |
$147.50 |
$147.50 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$173.00 |
$173.00 |
$173.00 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$241.50 |
$241.50 |
$241.50 |
$345.60
|
|
X-ray skull < 4 views
|
$258.50 |
$258.50 |
$258.50 |
$292.50
|
|
X-ray skull > 4 views complete
|
$337.00 |
$337.00 |
$337.00 |
$417.50
|
|
X-ray small intestine follow-through study
|
$268.50 |
$268.50 |
$268.50 |
$499.50
|
|
X-ray spine single view
|
$149.00 |
$149.00 |
$149.00 |
$251.00
|
|
X-ray sternum > 2 views
|
$143.00 |
$143.00 |
$143.00 |
$274.65
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$174.00 |
$174.00 |
$174.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$203.00 |
$203.00 |
$203.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$172.00 |
$172.00 |
$172.00 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$172.00 |
$172.00 |
$172.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$149.00 |
$149.00 |
$149.00 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$293.00 |
$293.00 |
$293.00 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$104.00 |
$104.00 |
$104.00 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$179.00 |
$179.00 |
$179.00 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$173.00 |
$173.00 |
$173.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$324.00 |
$324.00 |
$324.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$411.50 |
$411.50 |
$411.50 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$153.00 |
$153.00 |
$153.00 |
$290.40
|
|
Ziconotide injection
|
$17.50 |
$17.50 |
$17.50 |
$7,216.02
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$55.80 |
$55.80 |
$55.80 |
$452.69
|
