|
X-ray bone age studies
|
$29.00 |
$29.00 |
$237.00 |
$227.08
|
|
X-ray bone length studies
|
$43.00 |
$43.00 |
$43.00 |
$258.70
|
|
X-ray bone survey complete
|
$111.00 |
$111.00 |
$1,372.00 |
$569.03
|
|
X-ray bone survey infant
|
$112.00 |
$112.00 |
$490.00 |
$362.40
|
|
X-ray cervical spine 2-3 views
|
$41.00 |
$41.00 |
$442.00 |
$308.40
|
|
X-ray cervical spine 4-5 views
|
$96.00 |
$96.00 |
$491.00 |
$439.14
|
|
X-ray cervical spine >= 6 views
|
$67.00 |
$67.00 |
$685.00 |
$479.05
|
|
X-ray clavicle complete (both sides)
|
$50.00 |
$50.00 |
$579.00 |
$277.00
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$1,026.00 |
$1,026.00 |
$1,026.00 |
$594.68
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$1,409.00 |
$1,409.00 |
$1,409.00 |
$785.86
|
|
X-ray elbow 2 views (both sides)
|
$66.00 |
$66.00 |
$555.00 |
$281.40
|
|
X-ray elbow >= 3 views (both sides)
|
$58.00 |
$58.00 |
$707.00 |
$325.88
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$876.00 |
$876.00 |
$876.00 |
$434.76
|
|
X-ray exam entire spi 4/5 vw
|
$939.00 |
$939.00 |
$939.00 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$1,066.00 |
$1,066.00 |
$1,066.00 |
$562.90
|
|
X-ray exam of arm infant
|
$33.00 |
$33.00 |
$439.00 |
$238.26
|
|
X-ray exam of eye sockets
|
$49.00 |
$49.00 |
$520.00 |
$321.48
|
|
X-ray exam of femur 1
|
$372.00 |
$372.00 |
$372.00 |
$194.40
|
|
X-ray exam of jaw joint
|
$37.00 |
$37.00 |
$278.00 |
$179.54
|
|
X-ray exam of jaw joint
|
$88.00 |
$88.00 |
$1,257.00 |
$370.89
|
|
X-ray exam of mastoids
|
$41.00 |
$41.00 |
$41.00 |
$187.60
|
|
X-ray exam of middle ear
|
$61.00 |
$61.00 |
$61.00 |
$322.45
|
|
X-ray exam of penis
|
$66.00 |
$66.00 |
$66.00 |
$339.47
|
|
X-ray exam of perineum
|
$38.00 |
$38.00 |
$38.00 |
$330.96
|
|
X-ray exam of salivary gland
|
$43.00 |
$43.00 |
$43.00 |
$124.24
|
|
X-ray exam of sinuses
|
$36.00 |
$36.00 |
$36.00 |
$192.00
|
|
X-ray exam of tear duct
|
$22.00 |
$22.00 |
$22.00 |
$340.70
|
|
X-ray exam of teeth
|
$20.00 |
$20.00 |
$20.00 |
$97.54
|
|
X-ray exam of teeth
|
$43.00 |
$43.00 |
$43.00 |
$267.78
|
|
X-ray exam si joints
|
$35.00 |
$35.00 |
$35.00 |
$198.38
|
|
X-ray exam thorac spine4/>vw
|
$75.00 |
$75.00 |
$75.00 |
$365.00
|
|
X-ray eye detection foreign body (both sides)
|
$34.00 |
$34.00 |
$34.00 |
$227.80
|
|
X-ray facial bones complete > 3 views
|
$48.00 |
$48.00 |
$410.00 |
$337.95
|
|
X-ray fallopian tube
|
$38.00 |
$38.00 |
$38.00 |
$489.00
|
|
X-ray femur >=2 views (both sides)
|
$633.00 |
$633.00 |
$633.00 |
$290.44
|
|
X-ray finger(s) >= 2 views (both sides)
|
$54.00 |
$54.00 |
$520.00 |
$233.55
|
|
X-ray foot 2 views (both sides)
|
$32.00 |
$32.00 |
$559.00 |
$270.40
|
|
X-ray forearm 2 views (both sides)
|
$69.00 |
$69.00 |
$662.00 |
$317.62
|
|
X-ray hand 2 views (both sides)
|
$33.00 |
$33.00 |
$438.00 |
$270.00
|
|
X-ray head for orthodontia
|
$27.00 |
$27.00 |
$27.00 |
$103.69
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$52.00 |
$52.00 |
$590.00 |
$243.10
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$553.00 |
$553.00 |
$553.00 |
$300.00
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$222.00 |
$222.00 |
$539.00 |
$313.45
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$282.00 |
$282.00 |
$685.00 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$691.00 |
$691.00 |
$691.00 |
$477.10
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$43.00 |
$43.00 |
$276.00 |
$187.20
|
|
X-ray humerus >= 2 views left
|
$45.00 |
$45.00 |
$600.00 |
$285.00
|
|
X-ray knee 1-2 views (both sides)
|
$36.00 |
$36.00 |
$597.00 |
$271.70
|
|
X-ray knee 3 views (both sides)
|
$210.00 |
$210.00 |
$726.00 |
$319.24
|
|
X-ray knee ap standing bilateral
|
$155.00 |
$155.00 |
$343.00 |
$243.09
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$33.00 |
$33.00 |
$506.00 |
$227.92
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$46.00 |
$46.00 |
$46.00 |
$345.15
|
|
X-ray lumbosacral spine >= 4 views
|
$100.00 |
$100.00 |
$778.00 |
$475.04
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$69.00 |
$69.00 |
$861.00 |
$513.63
|
|
X-ray male genital tract
|
$87.00 |
$87.00 |
$87.00 |
$267.55
|
|
X-ray mandible complete > 4 views
|
$45.00 |
$45.00 |
$568.00 |
$323.70
|
|
X-ray mandible ltd <4 views
|
$40.00 |
$40.00 |
$40.00 |
$200.20
|
|
X-ray nasal bones complete > 3 views
|
$39.00 |
$39.00 |
$321.00 |
$260.52
|
|
X-ray neck soft tissue
|
$34.00 |
$34.00 |
$359.00 |
$221.10
|
|
X-ray nose to rectum for foreign body child
|
$32.00 |
$32.00 |
$345.00 |
$201.00
|
|
X-ray of mammary ducts
|
$85.00 |
$85.00 |
$85.00 |
$437.00
|
|
X-ray optic foramina
|
$41.00 |
$41.00 |
$41.00 |
$165.09
|
|
X-ray pelvis 1-2 views
|
$157.00 |
$157.00 |
$365.00 |
$242.58
|
|
X-ray pelvis complete > 3 views
|
$74.00 |
$74.00 |
$411.00 |
$299.46
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$869.00 |
$869.00 |
$869.00 |
$663.18
|
|
X-ray ribs 2 views left
|
$75.00 |
$75.00 |
$412.00 |
$281.45
|
|
X-ray ribs 3 views bilateral
|
$46.00 |
$46.00 |
$634.00 |
$361.20
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$66.00 |
$66.00 |
$438.00 |
$327.21
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$59.00 |
$59.00 |
$608.00 |
$466.80
|
|
X-ray sacroiliac joints >= 3 views
|
$55.00 |
$55.00 |
$471.00 |
$270.40
|
|
X-ray sacrum/coccyx >= 2 views
|
$40.00 |
$40.00 |
$397.00 |
$260.65
|
|
X-ray scapula complete (both sides)
|
$45.00 |
$45.00 |
$607.00 |
$264.80
|
|
X-ray sella turcica
|
$36.00 |
$36.00 |
$194.00 |
$144.00
|
|
X-ray shoulder 1 view (both sides)
|
$29.00 |
$29.00 |
$320.00 |
$242.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$90.00 |
$90.00 |
$508.00 |
$324.53
|
|
X-ray sinus tract/fistula/abscess
|
$66.00 |
$66.00 |
$581.00 |
$539.50
|
|
X-ray skull < 4 views
|
$43.00 |
$43.00 |
$292.00 |
$277.54
|
|
X-ray skull > 4 views complete
|
$78.00 |
$78.00 |
$440.00 |
$404.30
|
|
X-ray slg plne bdy sect without urogr
|
$105.00 |
$105.00 |
$876.00 |
$370.64
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$113.00 |
$113.00 |
$1,150.00 |
$511.38
|
|
X-ray spine single view
|
$28.00 |
$28.00 |
$329.00 |
$225.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$43.00 |
$43.00 |
$332.00 |
$236.88
|
|
X-ray sternum > 2 views
|
$41.00 |
$41.00 |
$412.00 |
$230.00
|
|
X-ray surgical specimen
|
$24.00 |
$24.00 |
$685.00 |
$457.47
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$458.00 |
$458.00 |
$458.00 |
$463.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$54.00 |
$54.00 |
$371.00 |
$276.00
|
|
X-ray thoracic spine 2 views
|
$39.00 |
$39.00 |
$435.00 |
$286.65
|
|
X-ray thoracic spine 3 views
|
$63.00 |
$63.00 |
$532.00 |
$343.00
|
|
X-ray thoracolumbar spine >=2 views
|
$65.00 |
$65.00 |
$414.00 |
$269.10
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$491.00 |
$491.00 |
$491.00 |
$211.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$539.00 |
$539.00 |
$539.00 |
$346.50
|
|
X-ray tibia/fibula 2 views (both sides)
|
$63.00 |
$63.00 |
$513.00 |
$306.47
|
|
X-ray toe(s) > 2 views (both sides)
|
$50.00 |
$50.00 |
$522.00 |
$225.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$120.00 |
$120.00 |
$120.00 |
$497.93
|
|
X-ray wrist 2 views (both sides)
|
$36.00 |
$36.00 |
$510.00 |
$268.49
|
|
Zika virus dna/rna amp probe
|
$426.00 |
$426.00 |
$426.00 |
$197.25
|
|
Zika virus igm antibody
|
$290.00 |
$290.00 |
$290.00 |
$84.83
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$352.50 |
$352.50 |
$352.50 |
$83.13
|
