|
X-ray exam of penis
|
$155.00 |
$155.00 |
$155.00 |
$593.46
|
|
X-ray exam of perineum
|
$545.50 |
$545.50 |
$545.50 |
$577.85
|
|
X-ray exam of salivary gland
|
$128.00 |
$128.00 |
$128.00 |
$162.60
|
|
X-ray exam of sinuses
|
$223.50 |
$223.50 |
$223.50 |
$214.50
|
|
X-ray exam of teeth
|
$117.00 |
$117.00 |
$117.00 |
$119.66
|
|
X-ray exam si joints
|
$265.00 |
$265.00 |
$265.00 |
$246.16
|
|
X-ray exam thorac spine4/>vw
|
$341.50 |
$341.50 |
$341.50 |
$387.40
|
|
X-ray eye detection foreign body (both sides)
|
$425.50 |
$425.50 |
$425.50 |
$238.29
|
|
X-ray facial bones complete > 3 views
|
$341.50 |
$341.50 |
$341.50 |
$381.75
|
|
X-ray femur >=2 views (both sides)
|
$417.00 |
$417.00 |
$417.00 |
$317.25
|
|
X-ray finger(s) >= 2 views (both sides)
|
$397.00 |
$397.00 |
$397.00 |
$241.05
|
|
X-ray foot 2 views (both sides)
|
$392.00 |
$392.00 |
$392.00 |
$288.40
|
|
X-ray forearm 2 views (both sides)
|
$213.50 |
$213.50 |
$213.50 |
$322.20
|
|
X-ray hand 2 views (both sides)
|
$427.00 |
$427.00 |
$427.00 |
$291.20
|
|
X-ray head for orthodontia
|
$117.00 |
$117.00 |
$117.00 |
$158.50
|
|
X-ray heel/calcaneus > 2 views (both sides)
|
$213.50 |
$213.50 |
$213.50 |
$274.95
|
|
X-ray hip uni w/wo pelvis min 4 views
|
$262.00 |
$262.00 |
$262.00 |
$376.80
|
|
X-ray hip with pelvis when performed bilateral 2 views
|
$240.00 |
$240.00 |
$240.00 |
$374.40
|
|
X-ray hip with pelvis when performed bilateral 3-4 views
|
$233.00 |
$233.00 |
$233.00 |
$424.05
|
|
X-ray hip with pelvis when performed bilateral >= 5 views
|
$288.00 |
$288.00 |
$288.00 |
$505.60
|
|
X-ray hip with pelvis when performed unilateral 1 view left
|
$212.00 |
$212.00 |
$212.00 |
$231.00
|
|
X-ray humerus >= 2 views left
|
$364.00 |
$364.00 |
$364.00 |
$309.31
|
|
X-ray joint survey 1 view
|
$159.00 |
$159.00 |
$159.00 |
$232.00
|
|
X-ray knee 1-2 views (both sides)
|
$399.00 |
$399.00 |
$399.00 |
$285.00
|
|
X-ray knee 3 views (both sides)
|
$584.00 |
$584.00 |
$584.00 |
$363.20
|
|
X-ray knee ap standing bilateral
|
$208.50 |
$208.50 |
$208.50 |
$252.50
|
|
X-ray lower extremities infant > 2 views (both sides)
|
$424.00 |
$424.00 |
$424.00 |
$254.12
|
|
X-ray l/s-spine bend vw only 2-3 vw
|
$637.50 |
$637.50 |
$637.50 |
$369.15
|
|
X-ray lumbosacral spine >= 4 views
|
$377.00 |
$377.00 |
$377.00 |
$505.83
|
|
X-ray lumbosacral spine complete including bending views >= 6 views
|
$341.50 |
$341.50 |
$341.50 |
$535.91
|
|
X-ray mandible complete > 4 views
|
$339.50 |
$339.50 |
$339.50 |
$361.61
|
|
X-ray mandible ltd <4 views
|
$339.50 |
$339.50 |
$339.50 |
$235.30
|
|
X-ray nasal bones complete > 3 views
|
$226.00 |
$226.00 |
$226.00 |
$274.65
|
|
X-ray neck soft tissue
|
$226.50 |
$226.50 |
$226.50 |
$237.43
|
|
X-ray nose to rectum for foreign body child
|
$359.00 |
$359.00 |
$359.00 |
$225.60
|
|
X-ray of mammary ducts
|
$468.00 |
$468.00 |
$468.00 |
$568.26
|
|
X-ray optic foramina
|
$234.50 |
$234.50 |
$234.50 |
$188.40
|
|
X-ray pelvis 1-2 views
|
$269.00 |
$269.00 |
$269.00 |
$280.80
|
|
X-ray pelvis complete > 3 views
|
$339.50 |
$339.50 |
$339.50 |
$348.19
|
|
X-ray retrograde pyelogram with or without kidney ureter bladder w/supervision & interpretation
|
$1,331.50 |
$1,331.50 |
$1,331.50 |
$755.50
|
|
X-ray ribs 2 views left
|
$247.00 |
$247.00 |
$247.00 |
$292.80
|
|
X-ray ribs 3 views bilateral
|
$341.50 |
$341.50 |
$341.50 |
$395.76
|
|
X-ray ribs w/posterior anterior chest 3 views left
|
$384.50 |
$384.50 |
$384.50 |
$356.20
|
|
X-ray ribs w/posterior anterior chest > 4 views bilateral
|
$347.50 |
$347.50 |
$347.50 |
$491.70
|
|
X-ray sacroiliac joints >= 3 views
|
$438.50 |
$438.50 |
$438.50 |
$312.75
|
|
X-ray sacrum/coccyx >= 2 views
|
$212.00 |
$212.00 |
$212.00 |
$288.80
|
|
X-ray scapula complete (both sides)
|
$410.00 |
$410.00 |
$410.00 |
$285.00
|
|
X-ray sella turcica
|
$191.00 |
$191.00 |
$191.00 |
$162.50
|
|
X-ray shoulder 1 view (both sides)
|
$196.00 |
$196.00 |
$196.00 |
$260.00
|
|
X-ray sinuses paranasal complete > 3 views
|
$349.00 |
$349.00 |
$349.00 |
$345.60
|
|
X-ray sinus tract/fistula/abscess
|
$1,332.00 |
$1,332.00 |
$1,332.00 |
$606.89
|
|
X-ray skull < 4 views
|
$643.00 |
$643.00 |
$643.00 |
$292.50
|
|
X-ray skull > 4 views complete
|
$358.00 |
$358.00 |
$358.00 |
$417.50
|
|
X-ray small bowel multi serial images abdominal radiographs(s)&delayed images single contrast study
|
$402.00 |
$402.00 |
$402.00 |
$557.70
|
|
X-ray small intestine follow-through study
|
$234.50 |
$234.50 |
$234.50 |
$499.50
|
|
X-ray spine single view
|
$160.50 |
$160.50 |
$160.50 |
$251.00
|
|
X-ray sternoclavicular joint(s) > 3 views
|
$269.00 |
$269.00 |
$269.00 |
$264.48
|
|
X-ray sternum > 2 views
|
$228.00 |
$228.00 |
$228.00 |
$274.65
|
|
X-ray surgical specimen
|
$1,210.50 |
$1,210.50 |
$1,210.50 |
$504.00
|
|
X-ray swallowing function w/ciner/videoradiography neck radiographs(s)&delayed images contrast study
|
$372.00 |
$372.00 |
$372.00 |
$523.25
|
|
X-ray temporomandibular joint open/closed mouth bilateral
|
$275.00 |
$275.00 |
$275.00 |
$327.80
|
|
X-ray thoracic spine 2 views
|
$341.50 |
$341.50 |
$341.50 |
$320.45
|
|
X-ray thoracic spine 3 views
|
$341.50 |
$341.50 |
$341.50 |
$381.60
|
|
X-ray thoracolumbar spine >=2 views
|
$208.50 |
$208.50 |
$208.50 |
$282.50
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 1 view
|
$283.50 |
$283.50 |
$283.50 |
$257.04
|
|
X-ray thoracolumbar spine including skull cervical & sacral spine 2-3 views
|
$569.00 |
$569.00 |
$569.00 |
$352.95
|
|
X-ray tibia/fibula 2 views (both sides)
|
$397.00 |
$397.00 |
$397.00 |
$332.00
|
|
X-ray toe(s) > 2 views (both sides)
|
$208.50 |
$208.50 |
$208.50 |
$258.50
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images double contrast
|
$472.00 |
$472.00 |
$472.00 |
$657.77
|
|
X-ray upper gastrointestinal tract scout abdominal radiographs delayed images single contrast study
|
$425.00 |
$425.00 |
$425.00 |
$603.20
|
|
X-ray wrist 2 views (both sides)
|
$196.00 |
$196.00 |
$196.00 |
$290.40
|
|
X-ray xm phrnx&/crv esoph c+
|
$259.50 |
$259.50 |
$259.50 |
$354.00
|
|
Ziconotide injection
|
$26.50 |
$26.50 |
$26.50 |
$7,216.02
|
|
Zika virus igm antibody
|
$129.50 |
$129.50 |
$129.50 |
$85.00
|
|
Ziprasidone 20 mg/ml (final concentration) intramuscular solution
|
$13.13 |
$13.13 |
$13.13 |
$122.45
|
|
Zolbetuximab-clzb 100 mg intravenous solution
|
$44,800.00 |
$44,800.00 |
$44,800.00 |
$7,810.92
|
|
Zoledronic acid 4 mg/5 ml intravenous solution
|
$225.00 |
$225.00 |
$225.00 |
$452.69
|