|
X-ray bone survey complete
|
$412.10 |
$412.10 |
$412.10 |
$666.60
|
|
X-ray bone survey infant
|
$272.35 |
$272.35 |
$272.35 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$226.85 |
$226.85 |
$226.85 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$288.60 |
$288.60 |
$288.60 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$347.10 |
$347.10 |
$347.10 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$369.20 |
$369.20 |
$369.20 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$517.40 |
$517.40 |
$517.40 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$651.95 |
$651.95 |
$651.95 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$391.30 |
$391.30 |
$391.30 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$456.30 |
$456.30 |
$456.30 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$346.45 |
$346.45 |
$346.45 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$273.00 |
$273.00 |
$273.00 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$319.80 |
$319.80 |
$319.80 |
$575.76
|
|
X-ray exam of arm infant
|
$474.50 |
$474.50 |
$474.50 |
$248.82
|
|
X-ray exam of eye sockets
|
$267.15 |
$267.15 |
$267.15 |
$349.05
|
|
X-ray exam of femur 1
|
$265.20 |
$265.20 |
$265.20 |
$232.36
|
|
X-ray exam of jaw joint
|
$141.70 |
$141.70 |
$141.70 |
$192.39
|
|
X-ray exam of middle ear
|
$1,119.30 |
$1,119.30 |
$1,119.30 |
$341.25
|
|
X-ray exam of penis
|
$553.80 |
$553.80 |
$553.80 |
$565.20
|
|
X-ray exam of perineum
|
$1,806.35 |
$1,806.35 |
$1,806.35 |
$420.93
|
|
X-ray exam of sinuses
|
$137.80 |
$137.80 |
$137.80 |
$211.00
|
|
X-ray exam si joints
|
$166.40 |
$166.40 |
$166.40 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$308.10 |
$308.10 |
$308.10 |
$395.59
|
|
X-ray eye detection foreign body (both sides)
|
$349.70 |
$349.70 |
$349.70 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$242.45 |
$242.45 |
$242.45 |
$366.60
|
|
X-ray fallopian tube
|
$2,627.95 |
$2,627.95 |
$2,627.95 |
$501.00
|
|
X-ray femur >=2 views (both sides)
|
$323.70 |
$323.70 |
$323.70 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$315.90 |
$315.90 |
$315.90 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$388.70 |
$388.70 |
$388.70 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$413.40 |
$413.40 |
$413.40 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$338.00 |
$338.00 |
$338.00 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$399.10 |
$399.10 |
$399.10 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$253.50 |
$253.50 |
$253.50 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$218.40 |
$218.40 |
$218.40 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$279.50 |
$279.50 |
$279.50 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$340.60 |
$340.60 |
$340.60 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$198.90 |
$198.90 |
$198.90 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$208.00 |
$208.00 |
$208.00 |
$304.15
|
|
X-ray joint survey 1 view
|
$206.70 |
$206.70 |
$206.70 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$429.00 |
$429.00 |
$429.00 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$488.80 |
$488.80 |
$488.80 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$214.50 |
$214.50 |
$214.50 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$361.40 |
$361.40 |
$361.40 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$198.25 |
$198.25 |
$198.25 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$274.95 |
$274.95 |
$274.95 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$352.30 |
$352.30 |
$352.30 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$226.85 |
$226.85 |
$226.85 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$132.60 |
$132.60 |
$132.60 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$163.80 |
$163.80 |
$163.80 |
$277.70
|
|
X-ray neck soft tissue
|
$198.25 |
$198.25 |
$198.25 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$605.80 |
$605.80 |
$605.80 |
$225.96
|
|
X-ray of mammary ducts
|
$469.30 |
$469.30 |
$469.30 |
$473.55
|
|
X-ray optic foramina
|
$474.50 |
$474.50 |
$474.50 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$225.55 |
$225.55 |
$225.55 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$289.25 |
$289.25 |
$289.25 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$954.20 |
$954.20 |
$954.20 |
$742.00
|
|
X-ray ribs 2 views left
|
$200.20 |
$200.20 |
$200.20 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$339.95 |
$339.95 |
$339.95 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$315.25 |
$315.25 |
$315.25 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$403.00 |
$403.00 |
$403.00 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$226.20 |
$226.20 |
$226.20 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$214.50 |
$214.50 |
$214.50 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$429.00 |
$429.00 |
$429.00 |
$292.50
|
|
X-ray sella turcica
|
$170.95 |
$170.95 |
$170.95 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$367.90 |
$367.90 |
$367.90 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$248.95 |
$248.95 |
$248.95 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$584.35 |
$584.35 |
$584.35 |
$601.30
|
|
X-ray skull < 4 views
|
$223.60 |
$223.60 |
$223.60 |
$291.78
|
|
X-ray skull > 4 views complete
|
$324.35 |
$324.35 |
$324.35 |
$414.60
|
|
X-ray slg plne bdy sect without urogr
|
$481.00 |
$481.00 |
$481.00 |
$387.00
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$484.25 |
$484.25 |
$484.25 |
$557.70
|
|
X-ray small intestine follow-through study
|
$371.15 |
$371.15 |
$371.15 |
$504.14
|
|
X-ray spine single view
|
$195.65 |
$195.65 |
$195.65 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$222.30 |
$222.30 |
$222.30 |
$263.49
|
|
X-ray sternum > 2 views
|
$186.55 |
$186.55 |
$186.55 |
$269.75
|
|
X-ray surgical specimen
|
$691.60 |
$691.60 |
$691.60 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$269.75 |
$269.75 |
$269.75 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$233.35 |
$233.35 |
$233.35 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$207.35 |
$207.35 |
$207.35 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$248.95 |
$248.95 |
$248.95 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$215.15 |
$215.15 |
$215.15 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$124.80 |
$124.80 |
$124.80 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$228.15 |
$228.15 |
$228.15 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$382.20 |
$382.20 |
$382.20 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$377.00 |
$377.00 |
$377.00 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$612.95 |
$612.95 |
$612.95 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$525.20 |
$525.20 |
$525.20 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$283.40 |
$283.40 |
$283.40 |
$290.40
|
|
Yersinia antibody
|
$165.75 |
$165.75 |
$165.75 |
$66.95
|
|
Zika virus dna/rna amp probe
|
$337.35 |
$337.35 |
$337.35 |
$175.00
|
|
Zika virus igm antibody
|
$138.45 |
$138.45 |
$138.45 |
$75.40
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$132.70 |
$132.70 |
$132.70 |
$405.10
|
