|
X-ray exam of tear duct
|
$546.00 |
$546.00 |
$546.00 |
$467.50
|
|
X-ray exam thorac spine4/>vw
|
$374.00 |
$374.00 |
$374.00 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$462.00 |
$462.00 |
$462.00 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$380.00 |
$380.00 |
$380.00 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$428.00 |
$428.00 |
$428.00 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$355.00 |
$355.00 |
$355.00 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$355.00 |
$355.00 |
$355.00 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$432.00 |
$432.00 |
$432.00 |
$291.20
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$427.00 |
$427.00 |
$427.00 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$415.00 |
$415.00 |
$415.00 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$397.50 |
$397.50 |
$397.50 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$365.00 |
$365.00 |
$365.00 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$191.00 |
$191.00 |
$191.00 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$384.00 |
$384.00 |
$384.00 |
$309.31
|
|
X-ray knee 1-2 views (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$468.00 |
$468.00 |
$468.00 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$199.50 |
$199.50 |
$199.50 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$610.00 |
$610.00 |
$610.00 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$300.50 |
$300.50 |
$300.50 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$303.00 |
$303.00 |
$303.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$377.50 |
$377.50 |
$377.50 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$238.50 |
$238.50 |
$238.50 |
$361.61
|
|
X-ray nasal bones complete > 3 views
|
$198.50 |
$198.50 |
$198.50 |
$274.65
|
|
X-ray neck soft tissue
|
$231.00 |
$231.00 |
$231.00 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$865.50 |
$865.50 |
$865.50 |
$225.60
|
|
X-ray of mammary ducts
|
$790.50 |
$790.50 |
$790.50 |
$568.26
|
|
X-ray optic foramina
|
$234.50 |
$234.50 |
$234.50 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$355.00 |
$355.00 |
$355.00 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$224.50 |
$224.50 |
$224.50 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$900.00 |
$900.00 |
$900.00 |
$755.50
|
|
X-ray ribs 2 views left
|
$191.00 |
$191.00 |
$191.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$324.00 |
$324.00 |
$324.00 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$262.00 |
$262.00 |
$262.00 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$358.00 |
$358.00 |
$358.00 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$212.50 |
$212.50 |
$212.50 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$193.50 |
$193.50 |
$193.50 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$436.00 |
$436.00 |
$436.00 |
$285.00
|
|
X-ray sella turcica
|
$191.00 |
$191.00 |
$191.00 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$246.00 |
$246.00 |
$246.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$1,255.00 |
$1,255.00 |
$1,255.00 |
$606.89
|
|
X-ray skull < 4 views
|
$532.50 |
$532.50 |
$532.50 |
$292.50
|
|
X-ray skull > 4 views complete
|
$355.00 |
$355.00 |
$355.00 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$442.50 |
$442.50 |
$442.50 |
$557.70
|
|
X-ray small intestine follow-through study
|
$208.50 |
$208.50 |
$208.50 |
$499.50
|
|
X-ray spine single view
|
$191.00 |
$191.00 |
$191.00 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$191.00 |
$191.00 |
$191.00 |
$264.48
|
|
X-ray sternum > 2 views
|
$191.00 |
$191.00 |
$191.00 |
$274.65
|
|
X-ray surgical specimen
|
$400.00 |
$400.00 |
$400.00 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$436.50 |
$436.50 |
$436.50 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$436.00 |
$436.00 |
$436.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$233.00 |
$233.00 |
$233.00 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$232.00 |
$232.00 |
$232.00 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$219.00 |
$219.00 |
$219.00 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$269.00 |
$269.00 |
$269.00 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$339.50 |
$339.50 |
$339.50 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$191.00 |
$191.00 |
$191.00 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$1,670.50 |
$1,670.50 |
$1,670.50 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$442.50 |
$442.50 |
$442.50 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$382.00 |
$382.00 |
$382.00 |
$290.40
|
|
Yttrium y-90 ibritumomab ther
|
$48,469.00 |
$48,469.00 |
$48,469.00 |
$55,035.00
|
|
Ziconotide injection
|
$12,000.00 |
$12,000.00 |
$12,000.00 |
$7,216.02
|
|
Zika virus dna/rna amp probe
|
$217.00 |
$217.00 |
$217.00 |
$185.00
|
|
Zika virus igm antibody
|
$209.00 |
$209.00 |
$209.00 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$39.13 |
$39.13 |
$39.13 |
$122.45
|
|
Zolbetuximab-clzb 100 mg intravenous solution
|
$48,000.00 |
$48,000.00 |
$48,000.00 |
$7,810.92
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$2,842.20 |
$2,842.20 |
$2,842.20 |
$452.69
|
