|
X-Ray |
Fee |
| Plain Film (K.U.B.) |
30 |
| Acute (2-3 views) + PA Chest |
55 |
| Skull (3/4) |
75 |
| Skull (5+) |
80 |
| Sinuses |
55.35 |
| Adenoids |
35 |
| Soft Tissue |
35 |
| Sella Turcica |
35 |
| Mastoids |
75 |
| I.A. Meati |
60 |
| Facial Bones |
55 |
| Nasal Bones |
35 |
| Eye (for foreign body/Orbits) |
75 |
| Mandible (3) |
55 |
| Mandible (4+) |
60 |
| T.M. Joints (4+) |
55 |
| Zygomatic Arches 4+ |
75 |
| Chest PA (Immigration) |
50 |
| Chest PA (Immigration) |
50 |
| Chest PA |
40 |
| Chest PA/Lateral |
55 |
| Chest (3+) |
70 |
| Thoracic Inlet |
60 |
| Rib |
40 |
| Sternum |
40 |
| Sterno-Clavicular Joints |
45 |
| Bone Age |
35 |
| Bone Age (2+) |
75 |
| Cervical Spine Under 15 year or Chiro (2/3) |
55 |
| Cervical Spine Regular (4/5) |
70 |
| Cervical Spine (6+) |
85 |
| Thoracic Spine Under 15 Year or Chiro (2) |
50 |
| Thoracic Spine (3+) |
65 |
| Scoliosis(2) |
65 |
| Scoliosis Series Regular (4+) |
120 |
| Lumbar spine, Pelvis & S.I.Joints |
140 |
| Lumbar Spine Under 25 Year or Chiro (2) |
545 |
| Lumbar Spine Regular (4/5) |
70 |
| Lumbar Spine (6+) |
85 |
| S.I. Joints Regular (2/3) |
55 |
| S.I. Joints (4+) |
70 |
| Sacrum & Coccyx (2) |
55 |
| Sacrum & Coccyx Regular (3+) |
70 |
| Pelvis |
40 |
| Pelvis & Right Hip |
60 |
| Pelvis & Left Hip |
60 |
| Pelvis & Both Hips |
70 |
| Survey Arthritic/Metastatic (2+) |
210 |
| Lumbar Spine (2/3) - X028 |
- |
| Shoulder Under 12 Year or Chiro (2) |
45 |
| Shoulder (3+) |
40 |
| Clavicle |
60 |
| Acromioclavicular Joints (with & w/o weights) |
55 |
| Scapula Regular (2) |
45 |
| Scapula (3+) |
65 |
| Humerus |
40 |
| Elbow Under 12 Year or Chiro (2) |
40 |
| Elbow (3/4) |
55 |
| Forearm |
40 |
| Scaphoid(4) |
95 |
| Wrist Regular (2/3) |
40 |
| Wrist (4+) |
95 |
| Hand & Wrist Regular (2/3) |
60 |
| Bilateral Hands and Wrists (3 views) |
70 |
| Hand & Wrist (4+) |
80 |
| Bilateral Hands and Wrists (4+) |
85 |
| Hand Regular (2/3) |
40 |
| Bilateral Hands (3) |
40 |
| Hand (4+) |
70 |
| Finger or Thumb (3+) |
40 |
| Scaphoid (6) - X218 |
- |
| Femur (2) |
40 |
| Knee Under 15 Year or Chiro (2) |
40 |
| Knee (3/4) |
75 |
| Bilateral Knees (3/4 views) |
95 |
| Knee (5+) |
70 |
| Tibia & Fibula (2) |
40 |
| Tibia & Fibula (3+) |
55 |
| Ankle Regular (2/3) |
40 |
| Ankle (4+) |
55 |
| Calcaneus (2) |
40 |
| Calcaneus Regular (3+) |
55 |
| Foot (2/3) |
40 |
| Foot (4+) |
55 |
| Toes (3+) |
65 |
| Leg Length |
70 |
| |
|
|
Mammography |
Fee |
| Mammogram OBSP |
110 |
| Unilateral-Routine |
80 |
| Bilateral-Routine |
110 |
| Additional 2-views-Coned views |
35 |
| Bilateral Mammogram-High Risk |
110 |
| Mammography-Unilateral High Risk |
80 |
| Unilateral Implant |
110 |
| Recall Unilateral |
80 |
| Recall Bilateral |
110 |
| Bilateral Implants |
145 |
| |
|
|
Bone Mineral Density |
Fee |
| Baseline X146 |
200 |
| Second Test Risk- 2 Site - X153 |
200 |
| Subsequent High Risk X155 |
200 |
| Subsequent Low Risk - X148 |
200 |
| |
|
|
Ultrasound |
Fee |
| Abdomen Complete |
115 |
| Abdomen Limited |
90 |
| Abdominal wall |
90 |
| Hernia |
70 |
| Groin |
70 |
| Abdominal U/S & Limited Pelvic |
210 |
| Female Pelvic |
130 |
| Pelvic Limited |
115 |
| Transvaginal |
90 |
| Male Pelvic |
90 |
| Pelvic & Limited Abdomen |
210 |
| OB Dating (< 16 wks) |
90 |
| EFTS (NT) |
110 |
| OB Routine (18-20 wks) anatomy scan |
135 |
| OB Routine (> 20 wks) |
135 |
| OB Routine Follow Up |
135 |
| Biophysical Profile |
210 |
| Pregnancy: OB High Risk |
210 |
| OB Dating (< 16 wks) - TWINS |
180 |
| Pregnancy: IPS - TWINS |
180 |
| OB Routine (18-20 wks) anatomy scan - TWINS |
225 |
| OB Routine (> 20 wks) - TWINS |
225 |
| Biophysical Profile - TWINS |
295 |
| OB Routine Follow Up - TWINS |
225 |
| Pregnancy: OB High Risk: - TWINS |
295 |
| Extra Gestation |
115 |
| Face, Neck and/or Thyroid |
105 |
| Transrectal |
220 |
| Testes/Scrotum |
110 |
| Breast |
55 |
| Axila |
55 |
| Wall Mass |
105 |
| Carotid Doppler |
224 |
| Upper Arterial Arms |
445 |
| Lower Arterial Legs |
485 |
| Renal Vascular |
220 |
| Aorta & Iliac Arteries |
220 |
| Upper Venous Arm |
240 |
| Upper Venous Arms Both |
375 |
| Lower Venous Leg |
280 |
| Lower Venous Legs Both |
410 |
| Thoracic Outlet Syndrome |
240 |
| Shoulder |
60 |
| Elbow |
60 |
| Forearm |
60 |
| AC Joint |
60 |
| Wrist |
60 |
| Knee |
60 |
| Leg |
60 |
| Ankle |
60 |
| Achilles Tendon |
60 |
| Foot |
60 |
| Hip |
60 |
| Lump/Soft Tissue |
60 |
| Back |
60 |
| Other Muscle |
60 |
| Hand |
60 |
