|
X-ray exam si joints
|
$226.20 |
$226.20 |
$226.20 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$118.20 |
$118.20 |
$118.20 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$243.60 |
$243.60 |
$243.60 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$470.40 |
$470.40 |
$470.40 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$401.40 |
$401.40 |
$401.40 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$274.20 |
$274.20 |
$274.20 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$270.00 |
$270.00 |
$270.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$382.80 |
$382.80 |
$382.80 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$230.40 |
$230.40 |
$230.40 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$280.20 |
$280.20 |
$280.20 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$330.60 |
$330.60 |
$330.60 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$437.40 |
$437.40 |
$437.40 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$460.20 |
$460.20 |
$460.20 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$460.20 |
$460.20 |
$460.20 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$199.80 |
$199.80 |
$199.80 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$368.40 |
$368.40 |
$368.40 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$267.00 |
$267.00 |
$267.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$390.60 |
$390.60 |
$390.60 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$329.40 |
$329.40 |
$329.40 |
$252.50
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$619.80 |
$619.80 |
$619.80 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$658.20 |
$658.20 |
$658.20 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$966.60 |
$966.60 |
$966.60 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$627.00 |
$627.00 |
$627.00 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$261.00 |
$261.00 |
$261.00 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$424.80 |
$424.80 |
$424.80 |
$274.65
|
|
X-ray neck soft tissue
|
$306.60 |
$306.60 |
$306.60 |
$237.43
|
|
X-ray of mammary ducts
|
$602.40 |
$602.40 |
$602.40 |
$568.26
|
|
X-ray pelvis 1-2 views
|
$180.60 |
$180.60 |
$180.60 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$502.20 |
$502.20 |
$502.20 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$865.80 |
$865.80 |
$865.80 |
$755.50
|
|
X-ray ribs 2 views left
|
$292.80 |
$292.80 |
$292.80 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$312.00 |
$312.00 |
$312.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$531.00 |
$531.00 |
$531.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$565.20 |
$565.20 |
$565.20 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$429.60 |
$429.60 |
$429.60 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$397.20 |
$397.20 |
$397.20 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$322.20 |
$322.20 |
$322.20 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$261.60 |
$261.60 |
$261.60 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$526.20 |
$526.20 |
$526.20 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$494.40 |
$494.40 |
$494.40 |
$606.89
|
|
X-ray skull < 4 views
|
$324.60 |
$324.60 |
$324.60 |
$292.50
|
|
X-ray skull > 4 views complete
|
$670.20 |
$670.20 |
$670.20 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$550.20 |
$550.20 |
$550.20 |
$557.70
|
|
X-ray small intestine follow-through study
|
$589.20 |
$589.20 |
$589.20 |
$499.50
|
|
X-ray spine single view
|
$307.20 |
$307.20 |
$307.20 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$349.80 |
$349.80 |
$349.80 |
$264.48
|
|
X-ray sternum > 2 views
|
$342.00 |
$342.00 |
$342.00 |
$274.65
|
|
X-ray surgical specimen
|
$826.80 |
$826.80 |
$826.80 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$330.00 |
$330.00 |
$330.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$292.20 |
$292.20 |
$292.20 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$481.80 |
$481.80 |
$481.80 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$577.20 |
$577.20 |
$577.20 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$431.40 |
$431.40 |
$431.40 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$162.00 |
$162.00 |
$162.00 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$513.60 |
$513.60 |
$513.60 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$360.00 |
$360.00 |
$360.00 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$270.00 |
$270.00 |
$270.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$455.40 |
$455.40 |
$455.40 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$567.00 |
$567.00 |
$567.00 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$243.00 |
$243.00 |
$243.00 |
$290.40
|
|
Yersinia antibody
|
$50.40 |
$50.40 |
$50.40 |
$55.80
|
|
Yttrium y-90 ibritumomab ther
|
$270,764.50 |
$270,764.50 |
$270,764.50 |
$55,035.00
|
|
Zika virus dna/rna amp probe
|
$273.00 |
$273.00 |
$273.00 |
$185.00
|
|
Zika virus igm antibody
|
$51.00 |
$51.00 |
$51.00 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$390.57 |
$390.57 |
$437.10 |
$122.45
|
|
Ziv-aflibercept 25 mg/ml intravenous solution (wrapper)
|
$7,968.00 |
$7,968.00 |
$9,120.00 |
$5,215.08
|
|
Zolbetuximab-clzb 100 mg intravenous solution
|
$7,968.00 |
$7,968.00 |
$9,120.00 |
$7,810.92
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$137.76 |
$137.76 |
$157.44 |
$452.69
|
