|
X-ray ankle 2 views (both sides)
|
$212.40 |
$212.40 |
$212.40 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$725.40 |
$725.40 |
$725.40 |
$773.40
|
|
X-ray bone age studies
|
$97.20 |
$97.20 |
$97.20 |
$251.40
|
|
X-ray bone length studies
|
$348.00 |
$348.00 |
$348.00 |
$285.30
|
|
X-ray bone survey complete
|
$816.60 |
$816.60 |
$816.60 |
$660.00
|
|
X-ray bone survey infant
|
$816.60 |
$816.60 |
$816.60 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$180.60 |
$180.60 |
$180.60 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$516.60 |
$516.60 |
$516.60 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$677.40 |
$677.40 |
$677.40 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$276.00 |
$276.00 |
$276.00 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$750.00 |
$750.00 |
$750.00 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,086.60 |
$1,086.60 |
$1,086.60 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$250.20 |
$250.20 |
$250.20 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$226.20 |
$226.20 |
$226.20 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$544.80 |
$544.80 |
$544.80 |
$483.50
|
|
X-ray exam of arm infant
|
$424.80 |
$424.80 |
$424.80 |
$248.44
|
|
X-ray exam of eye sockets
|
$406.20 |
$406.20 |
$406.20 |
$328.35
|
|
X-ray exam of femur 1
|
$263.40 |
$263.40 |
$263.40 |
$240.00
|
|
X-ray exam of sinuses
|
$227.40 |
$227.40 |
$227.40 |
$214.50
|
|
X-ray exam thorac spine4/>vw
|
$612.60 |
$612.60 |
$612.60 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$275.40 |
$275.40 |
$275.40 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$431.40 |
$431.40 |
$431.40 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$205.20 |
$205.20 |
$205.20 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$149.40 |
$149.40 |
$149.40 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$262.20 |
$262.20 |
$262.20 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$168.60 |
$168.60 |
$168.60 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$141.60 |
$141.60 |
$141.60 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$286.20 |
$286.20 |
$286.20 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$420.60 |
$420.60 |
$420.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$243.00 |
$243.00 |
$243.00 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$531.00 |
$531.00 |
$531.00 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$420.60 |
$420.60 |
$420.60 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$209.40 |
$209.40 |
$209.40 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$213.60 |
$213.60 |
$213.60 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$156.00 |
$156.00 |
$156.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$420.60 |
$420.60 |
$420.60 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$280.20 |
$280.20 |
$280.20 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$405.00 |
$405.00 |
$405.00 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$322.80 |
$322.80 |
$322.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$391.80 |
$391.80 |
$391.80 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$616.20 |
$616.20 |
$616.20 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$413.40 |
$413.40 |
$413.40 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$304.20 |
$304.20 |
$304.20 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$319.20 |
$319.20 |
$319.20 |
$274.65
|
|
X-ray neck soft tissue
|
$267.60 |
$267.60 |
$267.60 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$189.60 |
$189.60 |
$189.60 |
$225.60
|
|
X-ray pelvis 1-2 views
|
$249.00 |
$249.00 |
$249.00 |
$280.80
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$549.60 |
$549.60 |
$549.60 |
$755.50
|
|
X-ray ribs 2 views left
|
$399.60 |
$399.60 |
$399.60 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$485.40 |
$485.40 |
$485.40 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$377.40 |
$377.40 |
$377.40 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$631.20 |
$631.20 |
$631.20 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$223.80 |
$223.80 |
$223.80 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$320.40 |
$320.40 |
$320.40 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$272.40 |
$272.40 |
$272.40 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$193.20 |
$193.20 |
$193.20 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$498.00 |
$498.00 |
$498.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$385.20 |
$385.20 |
$385.20 |
$606.89
|
|
X-ray skull < 4 views
|
$271.80 |
$271.80 |
$271.80 |
$292.50
|
|
X-ray skull > 4 views complete
|
$541.80 |
$541.80 |
$541.80 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$273.00 |
$273.00 |
$273.00 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$647.40 |
$647.40 |
$647.40 |
$557.70
|
|
X-ray small intestine follow-through study
|
$226.80 |
$226.80 |
$226.80 |
$499.50
|
|
X-ray spine single view
|
$387.60 |
$387.60 |
$387.60 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$367.20 |
$367.20 |
$367.20 |
$264.48
|
|
X-ray sternum > 2 views
|
$305.40 |
$305.40 |
$305.40 |
$274.65
|
|
X-ray surgical specimen
|
$379.80 |
$379.80 |
$379.80 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$694.80 |
$694.80 |
$694.80 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$455.40 |
$455.40 |
$455.40 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$376.20 |
$376.20 |
$376.20 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$336.00 |
$336.00 |
$336.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$376.20 |
$376.20 |
$376.20 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$234.60 |
$234.60 |
$234.60 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$322.80 |
$322.80 |
$322.80 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$213.60 |
$213.60 |
$213.60 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$216.60 |
$216.60 |
$216.60 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$817.20 |
$817.20 |
$817.20 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$802.20 |
$802.20 |
$802.20 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$272.40 |
$272.40 |
$272.40 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$126.00 |
$126.00 |
$126.00 |
$99.89
|
|
Yersinia antibody
|
$139.80 |
$139.80 |
$139.80 |
$55.80
|
|
Zika virus dna/rna amp probe
|
$135.60 |
$135.60 |
$135.60 |
$185.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$123.00 |
$123.00 |
$123.00 |
$122.45
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$90.00 |
$90.00 |
$90.00 |
$452.69
|
