|
Wrist X-ray
|
$81.06 |
$81.06 |
$81.06 |
$342.80
|
|
Xe133 xenon 10mci
|
$63.43 |
$63.43 |
$63.43 |
$207.00
|
|
Xfer tis f/c/c/m/n/a/g/h/f 10sq cm/<
|
$1,144.50 |
$1,144.50 |
$1,144.50 |
$2,692.80
|
|
X-ray abdomen 1 view
|
$80.43 |
$80.43 |
$80.43 |
$258.50
|
|
X-ray abdomen 2 views
|
$97.86 |
$97.86 |
$97.86 |
$316.47
|
|
X-ray abdomen >=3 views
|
$102.48 |
$102.48 |
$102.48 |
$342.50
|
|
X-ray abdomen complete acute series including spine erect and/or decubitus single view chest
|
$97.86 |
$97.86 |
$97.86 |
$418.63
|
|
X-ray acromioclavicular joints without or w/weighted distraction bilateral
|
$81.27 |
$81.27 |
$81.27 |
$270.20
|
|
X-ray ankle 2 views (both sides)
|
$60.27 |
$60.27 |
$60.27 |
$282.50
|
|
X-ray arthrogram shoulder supervision & interpretation (both sides)
|
$263.13 |
$263.13 |
$263.13 |
$773.40
|
|
X-ray bone age studies
|
$62.16 |
$62.16 |
$62.16 |
$251.40
|
|
X-ray bone length studies
|
$78.12 |
$78.12 |
$78.12 |
$285.30
|
|
X-ray bone survey complete
|
$200.13 |
$200.13 |
$200.13 |
$660.00
|
|
X-ray bone survey infant
|
$77.70 |
$77.70 |
$77.70 |
$394.69
|
|
X-ray cervical spine 2-3 views
|
$102.06 |
$102.06 |
$102.06 |
$333.83
|
|
X-ray cervical spine 4-5 views
|
$164.01 |
$164.01 |
$164.01 |
$457.05
|
|
X-ray cervical spine >= 6 views
|
$191.10 |
$191.10 |
$191.10 |
$508.50
|
|
X-ray clavicle complete (both sides)
|
$80.85 |
$80.85 |
$80.85 |
$300.05
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$135.66 |
$135.66 |
$135.66 |
$657.03
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$258.51 |
$258.51 |
$258.51 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$59.43 |
$59.43 |
$59.43 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$77.70 |
$77.70 |
$77.70 |
$364.12
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$118.86 |
$118.86 |
$118.86 |
$483.50
|
|
X-ray exam entire spi 4/5 vw
|
$132.51 |
$132.51 |
$132.51 |
$441.48
|
|
X-ray exam entire spi 6/> vw
|
$152.88 |
$152.88 |
$152.88 |
$517.80
|
|
X-ray exam of arm infant
|
$62.16 |
$62.16 |
$62.16 |
$248.44
|
|
X-ray exam of eye sockets
|
$59.43 |
$59.43 |
$59.43 |
$328.35
|
|
X-ray exam of femur 1
|
$49.56 |
$49.56 |
$49.56 |
$240.00
|
|
X-ray exam of jaw joint
|
$36.33 |
$36.33 |
$36.33 |
$188.40
|
|
X-ray exam of sinuses
|
$62.16 |
$62.16 |
$62.16 |
$214.50
|
|
X-ray exam si joints
|
$40.11 |
$40.11 |
$40.11 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$146.16 |
$146.16 |
$146.16 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$114.87 |
$114.87 |
$114.87 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$91.35 |
$91.35 |
$91.35 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$89.46 |
$89.46 |
$89.46 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$53.34 |
$53.34 |
$53.34 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$59.22 |
$59.22 |
$59.22 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$77.70 |
$77.70 |
$77.70 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$59.43 |
$59.43 |
$59.43 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$42.42 |
$42.42 |
$42.42 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$119.49 |
$119.49 |
$119.49 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$104.58 |
$104.58 |
$104.58 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$119.49 |
$119.49 |
$119.49 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$138.39 |
$138.39 |
$138.39 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$55.23 |
$55.23 |
$55.23 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$77.70 |
$77.70 |
$77.70 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$62.16 |
$62.16 |
$62.16 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$74.97 |
$74.97 |
$74.97 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$62.16 |
$62.16 |
$62.16 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$67.41 |
$67.41 |
$67.41 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$92.19 |
$92.19 |
$92.19 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$191.10 |
$191.10 |
$191.10 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$222.18 |
$222.18 |
$222.18 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$98.28 |
$98.28 |
$98.28 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$38.64 |
$38.64 |
$38.64 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$71.40 |
$71.40 |
$71.40 |
$274.65
|
|
X-ray neck soft tissue
|
$74.76 |
$74.76 |
$74.76 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$92.40 |
$92.40 |
$92.40 |
$225.60
|
|
X-ray of mammary ducts
|
$212.73 |
$212.73 |
$212.73 |
$568.26
|
|
X-ray optic foramina
|
$53.34 |
$53.34 |
$53.34 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$80.43 |
$80.43 |
$80.43 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$81.06 |
$81.06 |
$81.06 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$129.15 |
$129.15 |
$129.15 |
$755.50
|
|
X-ray ribs 2 views left
|
$69.30 |
$69.30 |
$69.30 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$102.69 |
$102.69 |
$102.69 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$102.69 |
$102.69 |
$102.69 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$112.77 |
$112.77 |
$112.77 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$74.97 |
$74.97 |
$74.97 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$74.97 |
$74.97 |
$74.97 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$80.85 |
$80.85 |
$80.85 |
$285.00
|
|
X-ray shoulder 1 view (both sides)
|
$62.16 |
$62.16 |
$62.16 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$90.93 |
$90.93 |
$90.93 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$263.13 |
$263.13 |
$263.13 |
$606.89
|
|
X-ray skull < 4 views
|
$98.28 |
$98.28 |
$98.28 |
$292.50
|
|
X-ray skull > 4 views complete
|
$114.87 |
$114.87 |
$114.87 |
$417.50
|
|
X-ray slg plne bdy sect without urogr
|
$135.45 |
$135.45 |
$135.45 |
$399.82
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$124.74 |
$124.74 |
$124.74 |
$557.70
|
|
X-ray small intestine follow-through study
|
$146.58 |
$146.58 |
$146.58 |
$499.50
|
|
X-ray spine single view
|
$57.12 |
$57.12 |
$57.12 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$78.12 |
$78.12 |
$78.12 |
$264.48
|
|
X-ray sternum > 2 views
|
$67.41 |
$67.41 |
$67.41 |
$274.65
|
|
X-ray surgical specimen
|
$318.15 |
$318.15 |
$318.15 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$90.72 |
$90.72 |
$90.72 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$85.05 |
$85.05 |
$85.05 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$102.06 |
$102.06 |
$102.06 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$146.16 |
$146.16 |
$146.16 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$94.29 |
$94.29 |
$94.29 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$83.37 |
$83.37 |
$83.37 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$92.40 |
$92.40 |
$92.40 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$87.78 |
$87.78 |
$87.78 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$40.11 |
$40.11 |
$40.11 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$282.87 |
$282.87 |
$282.87 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$246.75 |
$246.75 |
$246.75 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$59.43 |
$59.43 |
$59.43 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$40.53 |
$40.53 |
$40.53 |
$99.89
|
|
Yersinia antibody
|
$57.96 |
$57.96 |
$57.96 |
$55.80
|
|
Yttrium y-90 ibritumomab ther
|
$15,463.35 |
$15,463.35 |
$15,463.35 |
$55,035.00
|
|
Zika virus dna/rna amp probe
|
$33.60 |
$33.60 |
$33.60 |
$185.00
|
|
Zika virus igm antibody
|
$9.66 |
$9.66 |
$9.66 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$18.29 |
$18.29 |
$18.29 |
$122.45
|