| ECG (Tech) G310 |
Cardiac |
0.00 |
12.60 |
| ECG (Prof) G313 |
Cardiac |
0.00 |
8.01 |
| Stress ECG - Max/Submax (Tech) G315 |
Cardiac |
0.00 |
82.71 |
| Stress ECG - Vector (Tech) G316 |
Cardiac |
0.00 |
30.87 |
| Stress ECG - Max/Submax (Prof) G319 |
Cardiac |
0.00 |
111.69 |
| Stress ECG - Vector (Prof) G335 |
Cardiac |
0.00 |
17.91 |
| Echo Comp.Study 1 Dim (Tech) G560 |
Cardiac |
0.00 |
62.55 |
| Echo Comp.Study 1 Dim (P1) G561 |
Cardiac |
0.00 |
63.99 |
| Echo Comp.Study 1 Dim (P2) G562 |
Cardiac |
0.00 |
47.34 |
| Echo Comp.Study 2 Dim (Tech) G566 |
Cardiac |
0.00 |
107.19 |
| Echo Comp.Study 2 Dim (P1) G567 |
Cardiac |
0.00 |
100.53 |
| Echo Comp.Study 2 Dim (P2) G568 |
Cardiac |
0.00 |
75.51 |
| Echo Comp.Study 1 and 2 Dim (P1) G571 |
Cardiac |
0.00 |
173.16 |
| Echo Comp.Study 1 and 2 Dim (P2) G572 |
Cardiac |
0.00 |
99.72 |
| SPEC Site Bone Scan No Flow J851 |
Nuclear Medicine |
161.28 |
72.54 |
| Thyroid Scan J818 |
Nuclear Medicine |
121.95 |
72.54 |
| Myo Rest Non Gated J807 |
Nuclear Medicine |
413.64 |
68.58 |
| Myo Stress Non Gated J808 |
Nuclear Medicine |
152.28 |
37.62 |
| Gastric Emptying Solid J829 |
Nuclear Medicine |
196.02 |
72.54 |
| Liver RBC Scan J878 |
Nuclear Medicine |
272.25 |
72.54 |
| Liver Colloid Scan J832 |
Nuclear Medicine |
152.28 |
72.54 |
| Salivary Scan J833 |
Nuclear Medicine |
182.97 |
72.54 |
| Bone Scan Inj Flow Spect J850 |
Nuclear Medicine |
197.10 |
89.46 |
| Bone Scan Inj No Flow Spect J850 |
Nuclear Medicine |
197.10 |
89.46 |
| Spec Site Bone Scan Inj Spect J851 |
Nuclear Medicine |
161.28 |
72.54 |
| Spec Site Bone Scan No Flow Spect J851 |
Nuclear Medicine |
161.28 |
72.54 |
| Parathyroid Sc J820 |
Nuclear Medicine |
446.22 |
99.54 |
| Muga Scan J813 |
Nuclear Medicine |
256.95 |
112.50 |
| Renal Scan J834 |
Nuclear Medicine |
182.97 |
58.68 |
| Renal Function Static J835 |
Nuclear Medicine |
250.38 |
104.04 |
| Gastric Emptying Liquid J829 |
Nuclear Medicine |
196.02 |
72.54 |
| Labelled RBC`S J878 |
Nuclear Medicine |
272.25 |
72.54 |
| Holter - Tech Comp. 72 hours G685 |
Cardiac |
0.00 |
186.48 |
| Holter (Prof 72 hours) G659 |
Cardiac |
0.00 |
172.53 |
| Myo 1 Day Cardiac Stress J807 |
Nuclear Medicine |
413.64 |
68.58 |
| Holter (Prof 48-71 hours) G658 |
Cardiac |
0.00 |
135.81 |
| Holter (Prof 72 hours plus) G657 |
Cardiac |
0.00 |
122.76 |
| Holter (Prof 47-71 hours) G656 |
Cardiac |
0.00 |
92.07 |
| Holter (Prof 12-47 hours) G653 |
Cardiac |
0.00 |
61.38 |
| Hida Scan J831 J867 |
Nuclear Medicine |
326.70 |
114.39 |
| Liver Spleen Scan J832 |
Nuclear Medicine |
152.28 |
72.54 |
| Quantification Si Ratio Y850 |
Nuclear Medicine |
197.10 |
116.30 |
| Liver/Spleen Scan J832 |
Nuclear Medicine |
152.28 |
72.54 |
| Salivary Scintigraphy J833 |
Nuclear Medicine |
182.97 |
72.54 |
| Spec Site Bone Scan Inj J851 |
Nuclear Medicine |
161.28 |
72.54 |
| First Transit with Blood Pools J867 |
Nuclear Medicine |
108.99 |
41.85 |
| Renal Function Physiologic J834 |
Nuclear Medicine |
182.97 |
58.68 |
| Bone Scintigraphy 30% Y851 |
Nuclear Medicine |
161.28 |
94.30 |
| Gastric Emptying Scan J829 |
Nuclear Medicine |
196.02 |
72.54 |
| Holter - Tech Comp. 48-71 hours G682 |
Cardiac |
0.00 |
90.90 |
| Holter - Tech Comp. 48-71 hours G683 |
Cardiac |
0.00 |
124.29 |
| Holter - Tech Comp. 72 hours plus G684 |
Cardiac |
0.00 |
136.26 |
| BS Inj Flow J850 |
Nuclear Medicine |
197.10 |
89.46 |
| BS Inj No Flow J850 |
Nuclear Medicine |
197.10 |
89.46 |
| Str Myo Stress Inj J807 |
Nuclear Medicine |
413.64 |
68.58 |
| Str Myo Rest Inj J808 |
Nuclear Medicine |
152.28 |
37.62 |
| Abdomen Complete |
Ultrasound |
92.70 |
47.61 |
| Abdomen Limited |
Ultrasound |
61.02 |
31.59 |
| Abdominal wall |
Ultrasound |
61.02 |
31.59 |
| Hernia |
Ultrasound |
48.51 |
26.91 |
| Groin |
Ultrasound |
48.51 |
26.91 |
| Abdominal U/S & Limited Pelvic |
Ultrasound |
153.72 |
79.20 |
| Female Pelvic |
Ultrasound |
92.70 |
47.79 |
| Pelvic Limited |
Ultrasound |
61.02 |
31.59 |
| Transvaginal |
Ultrasound |
92.70 |
47.70 |
| Male Pelvic |
Ultrasound |
92.70 |
47.79 |
| Pelvic & Limited Abdomen |
Ultrasound |
153.72 |
79.38 |
| OB Dating (< 16 wks) |
Ultrasound |
61.02 |
31.59 |
| EFTS (NT) |
Ultrasound |
74.16 |
37.53 |
| OB Routine (18-20 wks) anatomy scan |
Ultrasound |
92.70 |
60.84 |
| OB Routine (> 20 wks) |
Ultrasound |
92.70 |
58.05 |
| OB Routine Follow Up |
Ultrasound |
92.70 |
58.05 |
| Biophysical Profile |
Ultrasound |
146.88 |
87.93 |
| Pregnancy: OB High Risk |
Ultrasound |
146.88 |
87.93 |
| OB Dating (< 16 wks) - TWINS |
Ultrasound |
139.77 |
71.37 |
| Pregnancy: IPS - TWINS |
Ultrasound |
137.16 |
66.96 |
| OB Routine (18-20 wks) anatomy scan - TWINS |
Ultrasound |
171.45 |
100.62 |
| OB Routine (> 20 wks) - TWINS |
Ultrasound |
171.45 |
97.83 |
| Biophysical Profile - TWINS |
Ultrasound |
225.63 |
127.71 |
| OB Routine Follow Up - TWINS |
Ultrasound |
171.45 |
97.83 |
| Pregnancy: OB High Risk: - TWINS |
Ultrasound |
225.63 |
127.71 |
| Extra Gestation |
Ultrasound |
78.75 |
39.78 |
| Transrectal |
Ultrasound |
185.40 |
95.49 |
| Testes/Scrotum |
Ultrasound |
89.91 |
42.84 |
| Breast |
Ultrasound |
46.42 |
23.58 |
| Axila |
Ultrasound |
46.42 |
23.58 |
| Wall Mass |
Ultrasound |
92.70 |
44.19 |
| Carotid Doppler |
Ultrasound |
194.58 |
87.03 |
| Upper Arterial Arms |
Ultrasound |
239.76 |
142.47 |
| Lower Arterial Legs |
Ultrasound |
269.10 |
161.46 |
| Renal Vascular |
Ultrasound |
169.38 |
91.35 |
| Aorta & Iliac Arteries |
Ultrasound |
176.22 |
93.06 |
| Upper Venous Arm |
Ultrasound |
146.88 |
74.07 |
| Upper Venous Arms Both |
Ultrasound |
201.06 |
103.95 |
| Lower Venous Leg |
Ultrasound |
176.22 |
93.06 |
| Lower Venous Legs Both |
Ultrasound |
230.40 |
122.94 |
| Thoracic Outlet Syndrome |
Ultrasound |
146.88 |
74.07 |
| Shoulder |
Ultrasound |
48.51 |
26.91 |
| Elbow |
Ultrasound |
48.51 |
26.91 |
| Forearm |
Ultrasound |
48.51 |
26.91 |
| AC Joint |
Ultrasound |
48.51 |
26.91 |
| Wrist |
Ultrasound |
48.51 |
26.91 |
| Leg |
Ultrasound |
48.51 |
26.91 |
| Knee |
Ultrasound |
48.51 |
26.91 |
| Ankle |
Ultrasound |
48.51 |
26.91 |
| Achilles Tendon |
Ultrasound |
48.51 |
26.91 |
| Foot |
Ultrasound |
48.51 |
26.91 |
| Hip |
Ultrasound |
48.51 |
26.91 |
| Lump/Soft Tissue |
Ultrasound |
48.51 |
26.91 |
| Back |
Ultrasound |
48.51 |
26.91 |
| Other Muscle |
Ultrasound |
48.51 |
26.91 |
| Plain Film (K.U.B.) |
X-Ray |
30.51 |
11.52 |
| Acute (2-3 views) + PA Chest |
X-Ray |
77.13 |
27.99 |
| Skull (3/4) |
X-Ray |
61.20 |
23.85 |
| Skull (5+) |
X-Ray |
76.32 |
29.52 |
| Sinuses |
X-Ray |
60.70 |
0.00 |
| Adenoids |
X-Ray |
28.17 |
14.31 |
| Soft Tissue |
X-Ray |
28.17 |
14.31 |
| Sella Turcica |
X-Ray |
30.51 |
11.52 |
| Mastoids |
X-Ray |
58.68 |
25.65 |
| I.A. Meati |
X-Ray |
44.46 |
18.63 |
| Facial Bones |
X-Ray |
44.46 |
18.54 |
| Nasal Bones |
X-Ray |
30.51 |
11.52 |
| Eye (for foreign body/Orbits) |
X-Ray |
30.42 |
16.29 |
| Mandible (3) |
X-Ray |
44.46 |
18.63 |
| Mandible (4+) |
X-Ray |
61.20 |
23.85 |
| T.M. Joints (4+) |
X-Ray |
44.46 |
18.63 |
| Zygomatic Arches 4+ |
X-Ray |
61.20 |
23.85 |
| Chest PA |
X-Ray |
30.51 |
11.43 |
| Chest PA/Lateral |
X-Ray |
45.74 |
19.26 |
| Chest (3+) |
X-Ray |
57.69 |
22.32 |
| Thoracic Inlet |
X-Ray |
30.51 |
11.52 |
| Rib |
X-Ray |
36.72 |
14.13 |
| Sternum |
X-Ray |
36.72 |
14.13 |
| Sterno-Clavicular Joints |
X-Ray |
36.72 |
14.31 |
| Consultation |
X-Ray |
0.00 |
90.00 |
| Radiology Consultation |
X-Ray |
0.00 |
90.00 |
| Bone Age |
X-Ray |
30.51 |
11.52 |
| Bone Age (2+) |
X-Ray |
44.46 |
19.17 |
| Shoulder Under 12 Year or Chiro (2) |
X-Ray |
36.72 |
14.31 |
| Shoulder (3+) |
X-Ray |
52.38 |
19.17 |
| Clavicle |
X-Ray |
61.02 |
23.04 |
| Acromioclavicular Joints (with & w/o weights) |
X-Ray |
44.46 |
18.63 |
| Scapula Regular (2) |
X-Ray |
36.72 |
14.31 |
| Scapula (3+) |
X-Ray |
52.83 |
19.17 |
| Humerus |
X-Ray |
30.51 |
11.52 |
| Elbow Under 12 Year or Chiro (2) |
X-Ray |
30.51 |
11.52 |
| Elbow (3/4) |
X-Ray |
46.89 |
16.29 |
| Forearm |
X-Ray |
30.51 |
11.52 |
| Scaphoid(4) |
X-Ray |
46.89 |
16.29 |
| Wrist Regular (2/3) |
X-Ray |
30.51 |
11.52 |
| Wrist (4+) |
X-Ray |
46.89 |
16.29 |
| Hand & Wrist Regular (2/3) |
X-Ray |
44.46 |
23.49 |
| Bilateral Hands and Wrists (3 views) |
X-Ray |
88.92 |
46.98 |
| Hand Regular (2/3) |
X-Ray |
30.51 |
11.52 |
| Hand & Wrist (4+) |
X-Ray |
56.61 |
28.26 |
| Finger or Thumb (3+) |
X-Ray |
30.51 |
11.52 |
| Femur (2) |
X-Ray |
45.45 |
16.29 |
| Knee Under 15 Year or Chiro (2) |
X-Ray |
30.51 |
11.52 |
| Knee (3/4) |
X-Ray |
46.89 |
16.29 |
| Knee (5+) |
X-Ray |
63.18 |
20.97 |
| Tibia & Fibula (2) |
X-Ray |
30.51 |
11.52 |
| Tibia & Fibula (3+) |
X-Ray |
46.89 |
16.29 |
| Ankle Regular (2/3) |
X-Ray |
30.51 |
11.52 |
| Ankle (4+) |
X-Ray |
46.89 |
16.29 |
| Calcaneus (2) |
X-Ray |
30.51 |
11.52 |
| Calcaneus Regular (3+) |
X-Ray |
46.89 |
16.29 |
| Foot (2/3) |
X-Ray |
30.51 |
11.52 |
| Foot (4+) |
X-Ray |
46.89 |
16.29 |
| Toes (3+) |
X-Ray |
45.45 |
16.29 |
| Leg Length |
X-Ray |
44.46 |
18.63 |
| Cervical Spine Under 15 year or Chiro (2/3) |
X-Ray |
53.10 |
14.31 |
| Cervical Spine Regular (4/5) |
X-Ray |
68.40 |
19.35 |
| Cervical Spine (6+) |
X-Ray |
82.62 |
23.85 |
| Thoracic Spine Under 15 Year or Chiro (2) |
X-Ray |
48.42 |
14.31 |
| Thoracic Spine (3+) |
X-Ray |
61.20 |
19.17 |
| Scoliosis(2) |
X-Ray |
60.75 |
24.03 |
| Scoliosis Series Regular (4+) |
X-Ray |
109.62 |
37.35 |
| Lumbar spine. Pelvis & S.I.Joints |
X-Ray |
143.37 |
49.50 |
| Lumbar Spine Under 25 Year or Chiro (2) |
X-Ray |
53.10 |
14.31 |
| Lumbar Spine Regular (4/5) |
X-Ray |
68.40 |
19.35 |
| Lumbar Spine (6+) |
X-Ray |
82.62 |
24.03 |
| S.I. Joints Regular (2/3) |
X-Ray |
44.46 |
18.63 |
| S.I. Joints (4+) |
X-Ray |
59.31 |
23.49 |
| Sacrum & Coccyx (2) |
X-Ray |
49.05 |
11.52 |
| Sacrum & Coccyx Regular (3+) |
X-Ray |
63.54 |
19.17 |
| Pelvis |
X-Ray |
30.51 |
11.52 |
| Pelvis & Right Hip |
X-Ray |
56.79 |
16.56 |
| Pelvis & Left Hip |
X-Ray |
56.79 |
16.56 |
| Pelvis & Both Hips |
X-Ray |
65.25 |
18.63 |
| Survey Arthritic/Metastatic (2+) |
X-Ray |
257.76 |
102.42 |
| Barium Swallow |
G.I. Tract |
99.36 |
83.52 |
| Upper G.I. Series |
G.I. Tract |
99.36 |
83.52 |
| G.I. & Small Bowel |
G.I. Tract |
124.74 |
105.12 |
| Mammogram OBSP |
Mammography |
76.14 |
55.80 |
| Unilateral-Routine |
Mammography |
57.51 |
34.92 |
| Additional 2-views-Coned views |
Mammography |
24.48 |
18.72 |
| Bilateral Mammogram-High Risk |
Mammography |
152.28 |
111.60 |
| Mammography-Unilateral High Risk |
Mammography |
57.51 |
34.92 |
| Unilateral Implant |
Mammography |
81.99 |
53.64 |
| Bilateral-Routine |
Mammography |
152.28 |
111.60 |
| Carotid Doppler |
Vascular |
194.58 |
87.03 |
| Upper Arterial Arms |
Vascular |
336.78 |
196.29 |
| Lower Arterial Legs |
Vascular |
366.12 |
233.37 |
| Renal Vascular |
Vascular |
229.14 |
31.59 |
| Aorta & Iliac Arteries |
Vascular |
176.22 |
93.06 |
| Upper Venous Arm |
Vascular |
195.39 |
100.98 |
| Upper Venous Arms Both |
Vascular |
298.08 |
157.77 |
| Lower Venous Leg |
Vascular |
292.41 |
119.97 |
| Lower Venous Legs Both |
Vascular |
462.78 |
176.76 |
| Thoracic Outlet Syndrome |
Vascular |
195.39 |
100.98 |
| Baseline X146 |
Bone Mineral Density |
113.04 |
86.40 |
| Second Test Risk- 2 Site - X153 |
Bone Mineral Density |
113.04 |
86.40 |
| Subsequent High Risk X155 |
Bone Mineral Density |
113.04 |
86.40 |
| Subsequent Low Risk - X148 |
Bone Mineral Density |
113.04 |
86.40 |
| Bilateral Hands (3) |
X-Ray |
61.02 |
23.04 |
| Hand (4+) |
X-Ray |
46.89 |
16.29 |
| Bilateral Knees (3/4 views) |
X-Ray |
93.78 |
32.58 |
| Bilateral Hands and Wrists (4+) |
X-Ray |
113.22 |
56.52 |
| Penile Doppler |
Vascular |
13.05 |
14.04 |
| Recall Unilateral |
Mammography |
57.51 |
34.92 |
| Recall Bilateral |
Mammography |
152.28 |
111.60 |
| Hand |
Ultrasound |
48.51 |
26.91 |
| Bilateral Implants |
Mammography |
125.10 |
93.24 |
| Plain Film (K.U.B.) |
Chiro X-ray |
0.00 |
11.52 |
| Acute (2-3 views) |
Chiro X-ray |
0.00 |
27.99 |
| Skull (3/4) |
Chiro X-ray |
0.00 |
23.85 |
| Skull (5+) |
Chiro X-ray |
0.00 |
29.52 |
| Sinuses |
Chiro X-ray |
0.00 |
18.63 |
| Adenoids |
Chiro X-ray |
0.00 |
14.31 |
| Soft Tissue |
Chiro X-ray |
0.00 |
14.31 |
| Sella Turcica |
Chiro X-ray |
0.00 |
11.52 |
| Mastoids |
Chiro X-ray |
0.00 |
25.65 |
| I.A. Meati |
Chiro X-ray |
0.00 |
18.63 |
| Facial Bones |
Chiro X-ray |
0.00 |
18.54 |
| Nasal Bones |
Chiro X-ray |
0.00 |
11.52 |
| Eye (for foreign body/Orbits) |
Chiro X-ray |
0.00 |
16.29 |
| Mandible (3) |
Chiro X-ray |
0.00 |
18.63 |
| Mandible (4+) |
Chiro X-ray |
0.00 |
23.85 |
| T.M. Joints (4+) |
Chiro X-ray |
0.00 |
18.63 |
| Zygomatic Arches 4+ |
Chiro X-ray |
0.00 |
23.85 |
| Chest PA |
Chiro X-ray |
0.00 |
11.43 |
| Chest PA/Lateral |
Chiro X-ray |
0.00 |
19.26 |
| Chest (3+) |
Chiro X-ray |
0.00 |
22.32 |
| Thoracic Inlet |
Chiro X-ray |
0.00 |
11.52 |
| Rib |
Chiro X-ray |
0.00 |
25.56 |
| Sternum |
Chiro X-ray |
0.00 |
14.13 |
| Sterno-Clavicular Joints |
Chiro X-ray |
0.00 |
14.31 |
| Consultation |
Chiro X-ray |
0.00 |
90.00 |
| Radiology Consultation |
Chiro X-ray |
0.00 |
90.00 |
| Bone Age |
Chiro X-ray |
0.00 |
11.52 |
| Bone Age (2+) |
Chiro X-ray |
0.00 |
19.17 |
| Shoulder Under 12 Year or Chiro (2) |
Chiro X-ray |
0.00 |
14.31 |
| Shoulder (3+) |
Chiro X-ray |
0.00 |
19.17 |
| Clavicle |
Chiro X-ray |
0.00 |
23.04 |
| Acromioclavicular Joints (with & w/o weights) |
Chiro X-ray |
0.00 |
18.63 |
| Scapula Regular (2) |
Chiro X-ray |
0.00 |
14.31 |
| Scapula (3+) |
Chiro X-ray |
0.00 |
19.17 |
| Humerus |
Chiro X-ray |
0.00 |
11.52 |
| Elbow Under 12 Year or Chiro (2) |
Chiro X-ray |
0.00 |
11.52 |
| Elbow (3/4) |
Chiro X-ray |
0.00 |
16.29 |
| Forearm |
Chiro X-ray |
0.00 |
11.52 |
| Scaphoid(4) |
Chiro X-ray |
0.00 |
16.29 |
| Wrist Regular (2/3) |
Chiro X-ray |
0.00 |
11.52 |
| Wrist (4+) |
Chiro X-ray |
0.00 |
16.29 |
| Hand & Wrist Regular (2/3) |
Chiro X-ray |
0.00 |
23.49 |
| Bilateral Hands and Wrists (3 views) |
Chiro X-ray |
0.00 |
46.98 |
| Hand Regular (2/3) |
Chiro X-ray |
0.00 |
11.52 |
| Hand & Wrist (4+) |
Chiro X-ray |
0.00 |
28.26 |
| Finger or Thumb (3+) |
Chiro X-ray |
0.00 |
11.52 |
| Femur (2) |
Chiro X-ray |
0.00 |
11.52 |
| Knee Under 15 Year or Chiro (2) |
Chiro X-ray |
0.00 |
11.52 |
| Knee (3/4) |
Chiro X-ray |
0.00 |
16.29 |
| Knee (5+) |
Chiro X-ray |
0.00 |
20.97 |
| Tibia & Fibula (2) |
Chiro X-ray |
0.00 |
11.52 |
| Tibia & Fibula (3+) |
Chiro X-ray |
0.00 |
16.29 |
| Ankle Regular (2/3) |
Chiro X-ray |
0.00 |
11.52 |
| Ankle (4+) |
Chiro X-ray |
0.00 |
16.29 |
| Calcaneus (2) |
Chiro X-ray |
0.00 |
11.52 |
| Calcaneus Regular (3+) |
Chiro X-ray |
0.00 |
16.29 |
| Foot (2/3) |
Chiro X-ray |
0.00 |
11.52 |
| Foot (4+) |
Chiro X-ray |
0.00 |
16.29 |
| Toes (3+) |
Chiro X-ray |
0.00 |
16.29 |
| Leg Length |
Chiro X-ray |
0.00 |
18.63 |
| Cervical Spine Under 15 year or Chiro (2/3) |
Chiro X-ray |
0.00 |
14.31 |
| Cervical Spine Regular (4/5) |
Chiro X-ray |
0.00 |
19.35 |
| Cervical Spine (6+) |
Chiro X-ray |
0.00 |
23.85 |
| Thoracic Spine Under 15 Year or Chiro (2) |
Chiro X-ray |
0.00 |
14.31 |
| Thoracic Spine (3+) |
Chiro X-ray |
0.00 |
19.17 |
| Scoliosis(2) |
Chiro X-ray |
0.00 |
24.03 |
| Scoliosis Series Regular (4+) |
Chiro X-ray |
0.00 |
37.35 |
| Lumbar spine. Pelvis & S.I.Joints |
Chiro X-ray |
0.00 |
49.50 |
| Lumbar Spine Under 25 Year or Chiro (2) |
Chiro X-ray |
0.00 |
14.31 |
| Lumbar Spine Regular (4/5) |
Chiro X-ray |
0.00 |
19.35 |
| Lumbar Spine (6+) |
Chiro X-ray |
0.00 |
24.03 |
| S.I. Joints Regular (2/3) |
Chiro X-ray |
0.00 |
18.63 |
| S.I. Joints (4+) |
Chiro X-ray |
0.00 |
23.49 |
| Sacrum & Coccyx (2) |
Chiro X-ray |
0.00 |
11.52 |
| Sacrum & Coccyx Regular (3+) |
Chiro X-ray |
0.00 |
19.17 |
| Pelvis |
Chiro X-ray |
0.00 |
11.52 |
| Pelvis & Right Hip |
Chiro X-ray |
0.00 |
16.56 |
| Pelvis & Left Hip |
Chiro X-ray |
0.00 |
16.56 |
| Pelvis & Both Hips |
Chiro X-ray |
0.00 |
18.63 |
| Survey Arthritic/Metastatic (2+) |
Chiro X-ray |
0.00 |
31.14 |
| Bilateral Hands (3) |
Chiro X-ray |
0.00 |
23.04 |
| Hand (4+) |
Chiro X-ray |
0.00 |
16.29 |
| Bilateral Knees (3/4 views) |
Chiro X-ray |
0.00 |
32.58 |
| Bilateral Feet (2/3 views) |
Chiro X-ray |
0.00 |
23.04 |
| Bilateral Hands and Wrists (4+) |
Chiro X-ray |
0.00 |
56.52 |
| Thyroid FNA |
Ultrasound |
89.91 |
66.33 |
| Face. Neck and/or Thyroid |
Ultrasound |
89.91 |
42.66 |
| Blood Work Fee |
BLOOD WORK |
25.00 |
0.00 |
| Blood Work |
BLOOD WORK |
25.00 |
0.00 |
| ALT |
BLOOD WORK |
6.00 |
0.00 |
| AST |
BLOOD WORK |
6.00 |
0.00 |
| Glucose. Random |
BLOOD WORK |
6.00 |
0.00 |
| HbA1C |
BLOOD WORK |
15.00 |
0.00 |
| Urinalysis Chemical |
BLOOD WORK |
6.00 |
0.00 |
| Urinalysis Microscopic |
BLOOD WORK |
6.00 |
0.00 |
| Hepatitis B Surface Antibody |
BLOOD WORK |
20.00 |
0.00 |
| Hepatitis B Surface Antigen |
BLOOD WORK |
20.00 |
0.00 |
| Hepatitis B Core Antibody |
BLOOD WORK |
20.00 |
0.00 |
| Hepatitis C |
BLOOD WORK |
20.00 |
0.00 |
| Immigration Medical Fee Age 0-4 |
IMMIGRATION MEDICAL FEE |
100.00 |
0.00 |
| Immigration Medical Fee Age 5-49 |
IMMIGRATION MEDICAL FEE |
150.00 |
0.00 |
| Immigration Medical Fee Age 50-74 |
IMMIGRATION MEDICAL FEE |
150.00 |
0.00 |
| Immigration Medical Fee Age 75+ |
IMMIGRATION MEDICAL FEE |
220.00 |
0.00 |
| Immigration Medical Fee CUAET 0-14 |
IMMIGRATION MEDICAL FEE |
50.00 |
0.00 |
| Immigration Medical Fee CUAET 14+ |
IMMIGRATION MEDICAL FEE |
100.00 |
0.00 |
| Creatinine |
BLOOD WORK |
5.00 |
0.00 |
| Upper Extremity |
Ultrasound |
75.42 |
0.00 |
| Lower Extremity |
Ultrasound |
75.42 |
0.00 |
| Appendix |
Ultrasound |
48.51 |
26.91 |
| Aorta |
Ultrasound |
48.51 |
26.91 |
| Mammography OBSP Implants |
Mammography |
125.10 |
93.24 |
| Chest PA (Immigration) |
X-Ray |
50.00 |
0.00 |
| Chest PA (Immigration) |
X-Ray |
50.00 |
0.00 |
| 3D/ 4D Ultrasound |
3D/4D Ultrasound |
80.00 |
0.00 |