|
Xe133 xenon 10mci
|
$176.40 |
$176.40 |
$176.40 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,314.60 |
$1,314.60 |
$1,314.60 |
$2,692.80
|
|
X-linked intellectual dblt
|
$2,191.80 |
$2,191.80 |
$2,191.80 |
$1,258.40
|
|
X-linked intellectual dblt
|
$2,418.60 |
$2,418.60 |
$2,418.60 |
$1,173.00
|
|
X-ray abdomen 1 view
|
$149.40 |
$149.40 |
$149.40 |
$258.50
|
|
X-ray abdomen 2 views
|
$247.80 |
$247.80 |
$247.80 |
$316.47
|
|
X-ray abdomen >=3 views
|
$221.40 |
$221.40 |
$221.40 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$252.00 |
$252.00 |
$252.00 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$183.00 |
$183.00 |
$183.00 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$195.60 |
$195.60 |
$195.60 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$712.80 |
$712.80 |
$712.80 |
$773.40
|
|
X-ray bone age studies
|
$176.40 |
$176.40 |
$176.40 |
$251.40
|
|
X-ray bone length studies
|
$156.60 |
$156.60 |
$156.60 |
$285.30
|
|
X-ray bone survey complete
|
$353.40 |
$353.40 |
$353.40 |
$660.00
|
|
X-ray bone survey infant
|
$168.00 |
$168.00 |
$168.00 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$226.80 |
$226.80 |
$226.80 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$319.20 |
$319.20 |
$319.20 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$234.60 |
$234.60 |
$234.60 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$136.80 |
$136.80 |
$136.80 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$315.60 |
$315.60 |
$315.60 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$505.20 |
$505.20 |
$505.20 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$233.40 |
$233.40 |
$233.40 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$277.80 |
$277.80 |
$277.80 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$229.20 |
$229.20 |
$229.20 |
$483.50
|
|
X-ray exam of arm infant
|
$188.40 |
$188.40 |
$188.40 |
$248.44
|
|
X-ray exam of eye sockets
|
$267.60 |
$267.60 |
$267.60 |
$328.35
|
|
X-ray exam of femur 1
|
$89.40 |
$89.40 |
$89.40 |
$240.00
|
|
X-ray exam of sinuses
|
$121.80 |
$121.80 |
$121.80 |
$214.50
|
|
X-ray exam thorac spine4/>vw
|
$612.60 |
$612.60 |
$612.60 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$148.80 |
$148.80 |
$148.80 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$637.80 |
$637.80 |
$637.80 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$223.20 |
$223.20 |
$223.20 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$160.80 |
$160.80 |
$160.80 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$136.80 |
$136.80 |
$136.80 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$189.60 |
$189.60 |
$189.60 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$195.60 |
$195.60 |
$195.60 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$136.80 |
$136.80 |
$136.80 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$171.60 |
$171.60 |
$171.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$906.60 |
$906.60 |
$906.60 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$681.60 |
$681.60 |
$681.60 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$723.60 |
$723.60 |
$723.60 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$219.60 |
$219.60 |
$219.60 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$316.80 |
$316.80 |
$316.80 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$223.20 |
$223.20 |
$223.20 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$253.20 |
$253.20 |
$253.20 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$637.80 |
$637.80 |
$637.80 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$188.40 |
$188.40 |
$188.40 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$186.60 |
$186.60 |
$186.60 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$223.20 |
$223.20 |
$223.20 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$292.80 |
$292.80 |
$292.80 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$147.60 |
$147.60 |
$147.60 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$161.40 |
$161.40 |
$161.40 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$176.40 |
$176.40 |
$176.40 |
$274.65
|
|
X-ray neck soft tissue
|
$115.80 |
$115.80 |
$115.80 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$158.40 |
$158.40 |
$158.40 |
$225.60
|
|
X-ray of mammary ducts
|
$1,116.00 |
$1,116.00 |
$1,116.00 |
$568.26
|
|
X-ray optic foramina
|
$262.20 |
$262.20 |
$262.20 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$210.00 |
$210.00 |
$210.00 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$198.60 |
$198.60 |
$198.60 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$316.20 |
$316.20 |
$316.20 |
$755.50
|
|
X-ray ribs 2 views left
|
$164.40 |
$164.40 |
$164.40 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$208.20 |
$208.20 |
$208.20 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$146.40 |
$146.40 |
$146.40 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$272.40 |
$272.40 |
$272.40 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$183.00 |
$183.00 |
$183.00 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$210.00 |
$210.00 |
$210.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$147.60 |
$147.60 |
$147.60 |
$285.00
|
|
X-ray sella turcica
|
$156.60 |
$156.60 |
$156.60 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$195.60 |
$195.60 |
$195.60 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$212.40 |
$212.40 |
$212.40 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$873.60 |
$873.60 |
$873.60 |
$606.89
|
|
X-ray skull < 4 views
|
$147.00 |
$147.00 |
$147.00 |
$292.50
|
|
X-ray skull > 4 views complete
|
$234.60 |
$234.60 |
$234.60 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$255.00 |
$255.00 |
$255.00 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$365.40 |
$365.40 |
$365.40 |
$557.70
|
|
X-ray small intestine follow-through study
|
$48.00 |
$48.00 |
$48.00 |
$499.50
|
|
X-ray spine single view
|
$121.80 |
$121.80 |
$121.80 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$183.00 |
$183.00 |
$183.00 |
$264.48
|
|
X-ray sternum > 2 views
|
$183.00 |
$183.00 |
$183.00 |
$274.65
|
|
X-ray surgical specimen
|
$501.00 |
$501.00 |
$501.00 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$483.00 |
$483.00 |
$483.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$93.00 |
$93.00 |
$93.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$259.20 |
$259.20 |
$259.20 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$242.40 |
$242.40 |
$242.40 |
$381.60
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$121.80 |
$121.80 |
$121.80 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$287.40 |
$287.40 |
$287.40 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$203.40 |
$203.40 |
$203.40 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$292.80 |
$292.80 |
$292.80 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$414.60 |
$414.60 |
$414.60 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$380.40 |
$380.40 |
$380.40 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$118.80 |
$118.80 |
$118.80 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$111.60 |
$111.60 |
$111.60 |
$99.89
|
|
Yersinia antibody
|
$84.00 |
$84.00 |
$84.00 |
$55.80
|
|
Zika virus dna/rna amp probe
|
$135.60 |
$135.60 |
$135.60 |
$185.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$186.12 |
$186.12 |
$186.12 |
$122.45
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$105.36 |
$105.36 |
$105.36 |
$452.69
|