|
X-ray bone survey infant
|
$657.63 |
$657.63 |
$657.63 |
$410.73
|
|
X-ray cervical spine 2-3 views
|
$277.74 |
$277.74 |
$277.74 |
$326.04
|
|
X-ray cervical spine 4-5 views
|
$278.10 |
$278.10 |
$278.10 |
$455.65
|
|
X-ray cervical spine >= 6 views
|
$435.42 |
$435.42 |
$435.42 |
$515.35
|
|
X-ray clavicle complete (both sides)
|
$167.31 |
$167.31 |
$167.31 |
$299.65
|
|
X-ray colon abdominal radiograph(s) & delayed images single contrast study
|
$257.67 |
$257.67 |
$257.67 |
$647.40
|
|
X-ray colon abdominal radiograph(s) & delayed images with glucagon double contrast study
|
$348.93 |
$348.93 |
$348.93 |
$820.15
|
|
X-ray elbow 2 views (both sides)
|
$175.05 |
$175.05 |
$175.05 |
$291.94
|
|
X-ray elbow >= 3 views (both sides)
|
$197.64 |
$197.64 |
$197.64 |
$342.00
|
|
X-ray esophogram chest radiograph(s) & delayed images single contrast study
|
$142.65 |
$142.65 |
$142.65 |
$486.24
|
|
X-ray exam entire spi 4/5 vw
|
$328.41 |
$328.41 |
$328.41 |
$486.01
|
|
X-ray exam entire spi 6/> vw
|
$328.41 |
$328.41 |
$328.41 |
$575.76
|
|
X-ray exam of arm infant
|
$230.40 |
$230.40 |
$230.40 |
$248.82
|
|
X-ray exam of eye sockets
|
$308.07 |
$308.07 |
$308.07 |
$349.05
|
|
X-ray exam of femur 1
|
$111.42 |
$111.42 |
$111.42 |
$232.36
|
|
X-ray exam of jaw joint
|
$123.48 |
$123.48 |
$123.48 |
$192.39
|
|
X-ray exam of mastoids
|
$123.48 |
$123.48 |
$123.48 |
$191.91
|
|
X-ray exam of sinuses
|
$183.33 |
$183.33 |
$183.33 |
$211.00
|
|
X-ray exam si joints
|
$114.48 |
$114.48 |
$114.48 |
$246.16
|
|
X-ray eye detection foreign body (both sides)
|
$75.33 |
$75.33 |
$75.33 |
$235.00
|
|
X-ray facial bones complete > 3 views
|
$303.30 |
$303.30 |
$303.30 |
$366.60
|
|
X-ray femur >=2 views (both sides)
|
$111.42 |
$111.42 |
$111.42 |
$304.15
|
|
X-ray finger(s) >= 2 views (both sides)
|
$183.33 |
$183.33 |
$183.33 |
$262.40
|
|
X-ray foot 2 views (both sides)
|
$459.00 |
$459.00 |
$459.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$197.64 |
$197.64 |
$197.64 |
$319.00
|
|
X-ray hand 2 views (both sides)
|
$512.73 |
$512.73 |
$512.73 |
$316.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$192.06 |
$192.06 |
$192.06 |
$270.00
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$184.41 |
$184.41 |
$184.41 |
$370.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$184.41 |
$184.41 |
$184.41 |
$350.35
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$184.41 |
$184.41 |
$184.41 |
$409.24
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$328.41 |
$328.41 |
$328.41 |
$508.00
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$111.42 |
$111.42 |
$111.42 |
$207.35
|
|
X-ray humerus >= 2 views left
|
$183.33 |
$183.33 |
$183.33 |
$304.15
|
|
X-ray joint survey 1 view
|
$223.29 |
$223.29 |
$223.29 |
$211.00
|
|
X-ray knee 1-2 views (both sides)
|
$185.67 |
$185.67 |
$185.67 |
$283.50
|
|
X-ray knee 3 views (both sides)
|
$210.60 |
$210.60 |
$210.60 |
$353.25
|
|
X-ray knee ap standing bilateral
|
$336.15 |
$336.15 |
$336.15 |
$276.25
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$148.05 |
$148.05 |
$148.05 |
$249.13
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$223.74 |
$223.74 |
$223.74 |
$364.75
|
|
X-ray lumbosacral spine >= 4 views
|
$248.22 |
$248.22 |
$248.22 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$468.09 |
$468.09 |
$468.09 |
$559.65
|
|
X-ray mandible complete > 4 views
|
$246.24 |
$246.24 |
$246.24 |
$352.83
|
|
X-ray mandible ltd <4 views
|
$166.41 |
$166.41 |
$166.41 |
$238.00
|
|
X-ray nasal bones complete > 3 views
|
$169.02 |
$169.02 |
$169.02 |
$277.70
|
|
X-ray neck soft tissue
|
$137.16 |
$137.16 |
$137.16 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$112.50 |
$112.50 |
$112.50 |
$225.96
|
|
X-ray optic foramina
|
$93.78 |
$93.78 |
$93.78 |
$171.00
|
|
X-ray pelvis 1-2 views
|
$179.82 |
$179.82 |
$179.82 |
$270.84
|
|
X-ray pelvis complete > 3 views
|
$308.07 |
$308.07 |
$308.07 |
$342.30
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$336.15 |
$336.15 |
$336.15 |
$742.00
|
|
X-ray ribs 2 views left
|
$237.60 |
$237.60 |
$237.60 |
$296.32
|
|
X-ray ribs 3 views bilateral
|
$333.45 |
$333.45 |
$333.45 |
$394.34
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$234.81 |
$234.81 |
$234.81 |
$359.47
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$270.81 |
$270.81 |
$270.81 |
$497.00
|
|
X-ray sacroiliac joints >= 3 views
|
$132.84 |
$132.84 |
$132.84 |
$313.95
|
|
X-ray sacrum/coccyx >= 2 views
|
$154.71 |
$154.71 |
$154.71 |
$285.60
|
|
X-ray scapula complete (both sides)
|
$210.60 |
$210.60 |
$210.60 |
$292.50
|
|
X-ray sella turcica
|
$96.30 |
$96.30 |
$96.30 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$134.37 |
$134.37 |
$134.37 |
$264.48
|
|
X-ray sinuses paranasal complete > 3 views
|
$270.81 |
$270.81 |
$270.81 |
$339.00
|
|
X-ray sinus tract/fistula/abscess
|
$405.99 |
$405.99 |
$405.99 |
$601.30
|
|
X-ray skull < 4 views
|
$224.82 |
$224.82 |
$224.82 |
$291.78
|
|
X-ray skull > 4 views complete
|
$359.28 |
$359.28 |
$359.28 |
$414.60
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$268.83 |
$268.83 |
$268.83 |
$557.70
|
|
X-ray spine single view
|
$198.81 |
$198.81 |
$198.81 |
$252.60
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$112.95 |
$112.95 |
$112.95 |
$263.49
|
|
X-ray sternum > 2 views
|
$191.43 |
$191.43 |
$191.43 |
$269.75
|
|
X-ray surgical specimen
|
$163.08 |
$163.08 |
$163.08 |
$482.24
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$583.02 |
$583.02 |
$583.02 |
$514.00
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$183.33 |
$183.33 |
$183.33 |
$317.70
|
|
X-ray thoracic spine 2 views
|
$246.24 |
$246.24 |
$246.24 |
$318.50
|
|
X-ray thoracic spine 3 views
|
$279.72 |
$279.72 |
$279.72 |
$387.60
|
|
X-ray thoracolumbar spine >=2 views
|
$253.71 |
$253.71 |
$253.71 |
$294.00
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$111.42 |
$111.42 |
$111.42 |
$256.85
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$184.41 |
$184.41 |
$184.41 |
$385.80
|
|
X-ray tibia/fibula 2 views (both sides)
|
$184.32 |
$184.32 |
$184.32 |
$328.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$191.43 |
$191.43 |
$191.43 |
$264.00
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$302.13 |
$302.13 |
$302.13 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$302.13 |
$302.13 |
$302.13 |
$555.04
|
|
X-ray wrist 2 views (both sides)
|
$179.55 |
$179.55 |
$179.55 |
$290.40
|
|
Xylose absorption test blood &/or urine
|
$106.38 |
$106.38 |
$106.38 |
$64.28
|
|
Xyntha inj
|
$6.03 |
$6.03 |
$6.03 |
$1.54
|
|
Yersinia antibody
|
$52.02 |
$52.02 |
$52.02 |
$66.95
|
|
Zika virus dna/rna amp probe
|
$89.64 |
$89.64 |
$89.64 |
$175.00
|
|
Zika virus igm antibody
|
$56.70 |
$56.70 |
$56.70 |
$75.40
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$73.76 |
$73.76 |
$73.76 |
$128.10
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$286.65 |
$286.65 |
$286.65 |
$346.14
|