| Ultrasound RRI |
Thyroid |
160,00 |
0,00 |
160,00 |
| Ultrasound RRI |
Neck |
160,00 |
0,00 |
160,00 |
| Ultrasound RRI |
Abdomen |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Abdomen Limited |
115,00 |
0,00 |
115,00 |
| Ultrasound RRI |
Pelvis-Transabdominal |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Pelvis-Transvaginal |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Pelvis Limited |
115,00 |
0,00 |
115,00 |
| Ultrasound RRI |
Sono |
250,00 |
0,00 |
250,00 |
| Ultrasound RRI |
Breast |
85,00 |
0,00 |
85,00 |
| Ultrasound RRI |
Testes/Scrotum |
160,00 |
0,00 |
160,00 |
| Ultrasound RRI |
Prostate |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Transrectal |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Soft Tissue |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
OB Dating (< 16 wks) |
125,00 |
0,00 |
125,00 |
| Ultrasound RRI |
OB Routine (>16-20 wks) Anatomy Scan |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
OBS High Risk |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
OBS High Risk (Limited Study) |
125,00 |
0,00 |
125,00 |
| Ultrasound RRI |
BPP |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Multiple Gestation |
295,00 |
0,00 |
295,00 |
| Ultrasound RRI |
IPS / FTS |
135,00 |
0,00 |
135,00 |
| Ultrasound RRI |
IPS (limited OB) |
125,00 |
0,00 |
125,00 |
| Ultrasound RRI |
Wrist |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Elbow |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Shoulder |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Knee |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Ankle |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Foot |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Hip |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Other Muscle |
95,00 |
0,00 |
95,00 |
| Ultrasound RRI |
Abdomen + Thyroid |
0,00 |
0,00 |
0,00 |
| Ultrasound RRI |
Ltd Abdomen + Ltd Pelvis |
230,00 |
0,00 |
230,00 |
| Ultrasound RRI |
Bilateral Breasts |
170,00 |
0,00 |
170,00 |
| Ultrasound RRI |
Bilateral Shoulders |
190,00 |
0,00 |
190,00 |
| Ultrasound RRI |
Bilateral Knees |
190,00 |
0,00 |
190,00 |
| Ultrasound RRI |
Bilateral Ankles |
190,00 |
0,00 |
190,00 |
| Ultrasound RRI |
Bilateral Hips |
190,00 |
0,00 |
190,00 |
| Ultrasound RRI |
Bilateral Other Muscles |
190,00 |
0,00 |
190,00 |
| Ultrasound RRI |
Tubal Patency |
250,00 |
0,00 |
250,00 |
| Ultrasound RRI |
OBS DOPPLER |
64,70 |
0,00 |
64,70 |
| Cardiac |
ECG (Tech) G310 |
0,00 |
12,60 |
12,60 |
| Cardiac |
ECG (Prof) G313 |
0,00 |
8,01 |
8,01 |
| Cardiac |
Stress ECG - Max/Submax (Tech) G315 |
0,00 |
82,71 |
82,71 |
| Cardiac |
Stress ECG - Vector (Tech) G316 |
0,00 |
30,87 |
30,87 |
| Cardiac |
Stress ECG - Max/Submax (Prof) G319 |
0,00 |
111,69 |
111,69 |
| Cardiac |
Stress ECG - Vector (Prof) G335 |
0,00 |
17,91 |
17,91 |
| Cardiac |
Echo Comp.Study 1 Dim (Tech) G560 |
0,00 |
62,55 |
62,55 |
| Cardiac |
Echo Comp.Study 1 Dim (P1) G561 |
0,00 |
63,99 |
63,99 |
| Cardiac |
Echo Comp.Study 1 Dim (P2) G562 |
0,00 |
47,34 |
47,34 |
| Cardiac |
Echo Comp.Study 2 Dim (Tech) G566 |
0,00 |
107,19 |
107,19 |
| Cardiac |
Echo Comp.Study 2 Dim (P1) G567 |
0,00 |
100,53 |
100,53 |
| Cardiac |
Echo Comp.Study 2 Dim (P2) G568 |
0,00 |
75,51 |
75,51 |
| Cardiac |
Echo Comp.Study 1 and 2 Dim (P1) G571 |
0,00 |
173,16 |
173,16 |
| Cardiac |
Echo Comp.Study 1 and 2 Dim (P2) G570 |
0,00 |
99,72 |
99,72 |
| Nuclear Medicine |
SPEC Site Bone Scan No Flow J851 |
161,28 |
72,54 |
233,82 |
| Nuclear Medicine |
Thyroid Scan J818 |
121,95 |
72,54 |
194,49 |
| Nuclear Medicine |
Myo Rest Non Gated J807 |
413,64 |
68,58 |
482,22 |
| Nuclear Medicine |
Myo Stress Non Gated J808 |
152,28 |
37,62 |
189,90 |
| Nuclear Medicine |
Gastric Emptying Solid J829 |
196,02 |
72,54 |
268,56 |
| Nuclear Medicine |
Liver RBC Scan J878 |
272,25 |
72,54 |
344,79 |
| Nuclear Medicine |
Liver Colloid Scan J832 |
152,28 |
72,54 |
224,82 |
| Nuclear Medicine |
Salivary Scan J833 |
182,97 |
72,54 |
255,51 |
| Nuclear Medicine |
Bone Scan Inj Flow Spect J850 |
197,10 |
89,46 |
286,56 |
| Nuclear Medicine |
Bone Scan Inj No Flow Spect J850 |
197,10 |
89,46 |
286,56 |
| Nuclear Medicine |
Spec Site Bone Scan Inj Spect J851 |
161,28 |
72,54 |
233,82 |
| Nuclear Medicine |
Spec Site Bone Scan No Flow Spect J851 |
161,28 |
72,54 |
233,82 |
| Nuclear Medicine |
Parathyroid Sc J820 |
446,22 |
99,54 |
545,76 |
| Nuclear Medicine |
Muga Scan J813 |
256,95 |
112,50 |
369,45 |
| Nuclear Medicine |
Renal Scan J834 |
182,97 |
58,68 |
241,65 |
| Nuclear Medicine |
Renal Function Static J835 |
250,38 |
104,04 |
354,42 |
| Nuclear Medicine |
Gastric Emptying Liquid J829 |
196,02 |
72,54 |
268,56 |
| Nuclear Medicine |
Labelled RBC`S J878 |
272,25 |
72,54 |
344,79 |
| Cardiac |
Holter - Tech Comp. 72 hours G685 |
0,00 |
186,48 |
186,48 |
| Cardiac |
Holter (Prof 72 hours) G659 |
0,00 |
172,53 |
172,53 |
| Nuclear Medicine |
Myo 1 Day Cardiac Stress J807 |
413,64 |
68,58 |
482,22 |
| Cardiac |
Holter (Prof 48-71 hours) G658 |
0,00 |
135,81 |
135,81 |
| Cardiac |
Holter (Prof 72 hours plus) G657 |
0,00 |
122,76 |
122,76 |
| Cardiac |
Holter (Prof 47-71 hours) G656 |
0,00 |
92,07 |
92,07 |
| Cardiac |
Holter 24hrs |
0,00 |
61,38 |
61,38 |
| Nuclear Medicine |
Hida Scan J831 J867 |
326,70 |
114,39 |
441,09 |
| Nuclear Medicine |
Liver Spleen Scan J832 |
152,28 |
72,54 |
224,82 |
| Nuclear Medicine |
Quantification Si Ratio Y850 |
197,10 |
116,30 |
313,40 |
| Nuclear Medicine |
Liver/Spleen Scan J832 |
152,28 |
72,54 |
224,82 |
| Nuclear Medicine |
Salivary Scintigraphy J833 |
182,97 |
72,54 |
255,51 |
| Nuclear Medicine |
Spec Site Bone Scan Inj J851 |
161,28 |
72,54 |
233,82 |
| Nuclear Medicine |
First Transit with Blood Pools J867 |
108,99 |
41,85 |
150,84 |
| Nuclear Medicine |
Renal Function Physiologic J834 |
182,97 |
58,68 |
241,65 |
| Nuclear Medicine |
Bone Scintigraphy 30% Y851 |
161,28 |
94,30 |
255,58 |
| Nuclear Medicine |
Gastric Emptying Scan J829 |
196,02 |
72,54 |
268,56 |
| Cardiac |
Holter - Tech Comp. 48-71 hours G682 |
0,00 |
90,90 |
90,90 |
| Cardiac |
Holter - Tech Comp. 48-71 hours G683 |
0,00 |
124,29 |
124,29 |
| Cardiac |
Holter - Tech Comp. 72 hours plus G684 |
0,00 |
136,26 |
136,26 |
| Nuclear Medicine |
BS Inj Flow J850 |
197,10 |
89,46 |
286,56 |
| Nuclear Medicine |
BS Inj No Flow J850 |
197,10 |
89,46 |
286,56 |
| Nuclear Medicine |
Str Myo Stress Inj J807 |
413,64 |
68,58 |
482,22 |
| Nuclear Medicine |
Str Myo Rest Inj J808 |
152,28 |
37,62 |
189,90 |
| Ultrasound |
Abdomen Complete |
97,00 |
48,00 |
145,00 |
| Ultrasound |
Abdomen Limited |
60,00 |
30,00 |
90,00 |
| Ultrasound |
Abdominal wall |
61,02 |
31,59 |
92,61 |
| Ultrasound |
Hernia |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Groin |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Abdominal U/S & Limited Pelvic |
153,72 |
79,20 |
232,92 |
| Ultrasound |
Female Pelvic |
97,00 |
48,00 |
145,00 |
| Ultrasound |
Pelvic Limited |
61,02 |
31,59 |
92,61 |
| Ultrasound |
Transvaginal |
97,00 |
48,00 |
145,00 |
| Ultrasound |
Male Pelvic |
92,70 |
47,79 |
140,49 |
| Ultrasound |
Pelvic & Limited Abdomen |
153,72 |
79,38 |
233,10 |
| Ultrasound |
OB Dating (< 16 wks) |
61,02 |
31,59 |
92,61 |
| Ultrasound |
EFTS (NT) |
74,16 |
37,53 |
111,69 |
| Ultrasound |
OB Routine (18-20 wks) anatomy scan |
92,70 |
60,84 |
153,54 |
| Ultrasound |
OB Routine (> 20 wks) |
92,70 |
58,05 |
150,75 |
| Ultrasound |
OB Routine Follow Up |
92,70 |
58,05 |
150,75 |
| Ultrasound |
Biophysical Profile |
146,88 |
87,93 |
234,81 |
| Ultrasound |
Pregnancy: OB High Risk |
146,88 |
87,93 |
234,81 |
| Ultrasound |
OB Dating (< 16 wks) - TWINS |
139,77 |
71,37 |
211,14 |
| Ultrasound |
Pregnancy: IPS - TWINS |
137,16 |
66,96 |
204,12 |
| Ultrasound |
OB Routine (18-20 wks) anatomy scan - TWINS |
171,45 |
100,62 |
272,07 |
| Ultrasound |
OB Routine (> 20 wks) - TWINS |
171,45 |
97,83 |
269,28 |
| Ultrasound |
Biophysical Profile - TWINS |
225,63 |
127,71 |
353,34 |
| Ultrasound |
OB Routine Follow Up - TWINS |
171,45 |
97,83 |
269,28 |
| Ultrasound |
Pregnancy: OB High Risk: - TWINS |
225,63 |
127,71 |
353,34 |
| Ultrasound |
Extra Gestation |
78,75 |
39,78 |
118,53 |
| Ultrasound |
Male Pelvic + Transrectal |
185,00 |
95,00 |
280,00 |
| Ultrasound |
Testes/Scrotum |
89,91 |
42,84 |
132,75 |
| Ultrasound |
Breast |
46,42 |
23,58 |
70,00 |
| Ultrasound |
Axila |
46,42 |
23,58 |
70,00 |
| Ultrasound |
Wall Mass |
92,70 |
44,19 |
136,89 |
| Ultrasound |
Carotid Doppler |
194,58 |
87,03 |
281,61 |
| Ultrasound |
Upper Arterial Arms |
239,76 |
142,47 |
382,23 |
| Ultrasound |
Lower Arterial Legs |
269,00 |
161,00 |
430,00 |
| Ultrasound |
Renal Vascular |
169,38 |
91,35 |
260,73 |
| Ultrasound |
Aorta & Iliac Arteries |
176,22 |
93,06 |
269,28 |
| Ultrasound |
Upper Venous Arm |
146,88 |
74,07 |
220,95 |
| Ultrasound |
Upper Venous Arms Both |
201,06 |
103,95 |
305,01 |
| Ultrasound |
Lower Venous Leg |
176,22 |
93,06 |
269,28 |
| Ultrasound |
Lower Venous Legs Both |
230,40 |
122,94 |
353,34 |
| Ultrasound |
Thoracic Outlet Syndrome |
146,88 |
74,07 |
220,95 |
| Ultrasound |
Shoulder |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Elbow |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Forearm |
48,51 |
26,91 |
75,42 |
| Ultrasound |
AC Joint |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Wrist |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Leg |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Knee |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Ankle |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Achilles Tendon |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Foot |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Hip |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Lump/Soft Tissue |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Back |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Other Muscle |
48,51 |
26,91 |
75,42 |
| X-Ray |
Plain Film (K.U.B.) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Acute (2-3 views) + PA Chest |
77,13 |
27,99 |
105,12 |
| X-Ray |
Skull (3/4) |
61,20 |
23,85 |
85,05 |
| X-Ray |
Skull (5+) |
76,32 |
29,52 |
105,84 |
| X-Ray |
Sinuses |
60,70 |
0,00 |
60,70 |
| X-Ray |
Adenoids |
28,17 |
14,31 |
42,48 |
| X-Ray |
Soft Tissue |
28,17 |
14,31 |
42,48 |
| X-Ray |
Sella Turcica |
30,51 |
11,52 |
42,03 |
| X-Ray |
Mastoids |
58,68 |
25,65 |
84,33 |
| X-Ray |
I.A. Meati |
44,46 |
18,63 |
63,09 |
| X-Ray |
Facial Bones |
44,46 |
18,54 |
63,00 |
| X-Ray |
Nasal Bones |
30,51 |
11,52 |
42,03 |
| X-Ray |
Eye (for foreign body/Orbits) |
30,42 |
16,29 |
46,71 |
| X-Ray |
Mandible (3) |
44,46 |
18,63 |
63,09 |
| X-Ray |
Mandible (4+) |
61,20 |
23,85 |
85,05 |
| X-Ray |
T.M. Joints (4+) |
44,46 |
18,63 |
63,09 |
| X-Ray |
Zygomatic Arches 4+ |
61,20 |
23,85 |
85,05 |
| X-Ray |
Chest PA |
30,51 |
11,43 |
41,94 |
| X-Ray |
Chest PA/Lateral |
45,74 |
19,26 |
65,00 |
| X-Ray |
Chest (3+) |
57,69 |
22,32 |
80,01 |
| X-Ray |
Thoracic Inlet |
30,51 |
11,52 |
42,03 |
| X-Ray |
Rib |
36,72 |
14,13 |
50,85 |
| X-Ray |
Sternum |
36,72 |
14,13 |
50,85 |
| X-Ray |
Sterno-Clavicular Joints |
36,72 |
14,31 |
51,03 |
| X-Ray |
Consultation |
0,00 |
90,00 |
90,00 |
| X-Ray |
Radiology Consultation |
0,00 |
90,00 |
90,00 |
| X-Ray |
Bone Age |
30,51 |
11,52 |
42,03 |
| X-Ray |
Bone Age (2+) |
44,46 |
19,17 |
63,63 |
| X-Ray |
Shoulder Under 12 Year or Chiro (2) |
36,72 |
14,31 |
51,03 |
| X-Ray |
Shoulder (3+) |
52,38 |
19,17 |
71,55 |
| X-Ray |
Clavicle |
61,02 |
23,04 |
84,06 |
| X-Ray |
Acromioclavicular Joints (with & w/o weights) |
44,46 |
18,63 |
63,09 |
| X-Ray |
Scapula Regular (2) |
36,72 |
14,31 |
51,03 |
| X-Ray |
Scapula (3+) |
52,83 |
19,17 |
72,00 |
| X-Ray |
Humerus |
30,51 |
11,52 |
42,03 |
| X-Ray |
Elbow Under 12 Year or Chiro (2) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Elbow (3/4) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Forearm |
30,51 |
11,52 |
42,03 |
| X-Ray |
Scaphoid(4) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Wrist Regular (2/3) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Wrist (4+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Hand & Wrist Regular (2/3) |
44,46 |
23,49 |
67,95 |
| X-Ray |
Bilateral Hands and Wrists (3 views) |
88,92 |
46,98 |
135,90 |
| X-Ray |
Hand Regular (2/3) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Hand & Wrist (4+) |
56,61 |
28,26 |
84,87 |
| X-Ray |
Finger or Thumb (3+) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Femur (2) |
45,45 |
16,29 |
61,74 |
| X-Ray |
Knee Under 15 Year or Chiro (2) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Knee (3/4) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Knee (5+) |
63,18 |
20,97 |
84,15 |
| X-Ray |
Tibia & Fibula (2) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Tibia & Fibula (3+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Ankle Regular (2/3) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Ankle (4+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Calcaneus (2) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Calcaneus Regular (3+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Foot (2/3) |
30,51 |
11,52 |
42,03 |
| X-Ray |
Foot (4+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Toes (3+) |
45,45 |
16,29 |
61,74 |
| X-Ray |
Leg Length |
44,46 |
18,63 |
63,09 |
| X-Ray |
Cervical Spine Under 15 year or Chiro (2/3) |
53,10 |
14,31 |
67,41 |
| X-Ray |
Cervical Spine Regular (4/5) |
68,40 |
19,35 |
87,75 |
| X-Ray |
Cervical Spine (6+) |
82,62 |
23,85 |
106,47 |
| X-Ray |
Thoracic Spine Under 15 Year or Chiro (2) |
48,42 |
14,31 |
62,73 |
| X-Ray |
Thoracic Spine (3+) |
61,20 |
19,17 |
80,37 |
| X-Ray |
Scoliosis(2) |
60,75 |
24,03 |
84,78 |
| X-Ray |
Scoliosis Series Regular (4+) |
109,62 |
37,35 |
146,97 |
| X-Ray |
Lumbar spine, Pelvis & S.I.Joints |
143,37 |
49,50 |
192,87 |
| X-Ray |
Lumbar Spine Under 25 Year or Chiro (2) |
53,10 |
14,31 |
67,41 |
| X-Ray |
Lumbar Spine Regular (4/5) |
68,40 |
19,35 |
87,75 |
| X-Ray |
Lumbar Spine (6+) |
82,62 |
24,03 |
106,65 |
| X-Ray |
S.I. Joints Regular (2/3) |
44,46 |
18,63 |
63,09 |
| X-Ray |
S.I. Joints (4+) |
59,31 |
23,49 |
82,80 |
| X-Ray |
Sacrum & Coccyx (2) |
49,05 |
11,52 |
60,57 |
| X-Ray |
Sacrum & Coccyx Regular (3+) |
63,54 |
19,17 |
82,71 |
| X-Ray |
Pelvis |
30,51 |
11,52 |
42,03 |
| X-Ray |
Pelvis & Right Hip |
56,79 |
16,56 |
73,35 |
| X-Ray |
Pelvis & Left Hip |
56,79 |
16,56 |
73,35 |
| X-Ray |
Pelvis & Both Hips |
65,25 |
18,63 |
83,88 |
| X-Ray |
Survey Arthritic/Metastatic (2+) |
257,76 |
102,42 |
360,18 |
| G.I. Tract |
Barium Swallow |
99,36 |
83,52 |
182,88 |
| G.I. Tract |
Upper G.I. Series |
99,36 |
83,52 |
182,88 |
| G.I. Tract |
G.I. & Small Bowel |
124,74 |
105,12 |
229,86 |
| Mammography |
Mammogram OBSP |
76,14 |
55,80 |
131,94 |
| Mammography |
Unilateral-Routine |
57,51 |
34,92 |
92,43 |
| Mammography |
Additional 2-views-Coned views |
24,48 |
18,72 |
43,20 |
| Mammography |
Bilateral Mammogram-High Risk |
152,28 |
111,60 |
263,88 |
| Mammography |
Mammography-Unilateral High Risk |
57,51 |
34,92 |
92,43 |
| Mammography |
Unilateral Implant |
81,99 |
53,64 |
135,63 |
| Mammography |
Bilateral-Routine |
152,28 |
111,60 |
263,88 |
| Vascular |
Carotid Doppler |
194,58 |
87,03 |
281,61 |
| Vascular |
Upper Arterial Arms |
336,78 |
196,29 |
533,07 |
| Vascular |
Lower Arterial Legs |
366,12 |
233,37 |
599,49 |
| Vascular |
Renal Vascular |
229,14 |
31,59 |
260,73 |
| Vascular |
Aorta & Iliac Arteries |
176,22 |
93,06 |
269,28 |
| Vascular |
Upper Venous Arm |
195,39 |
100,98 |
296,37 |
| Vascular |
Upper Venous Arms Both |
298,08 |
157,77 |
455,85 |
| Vascular |
Lower Venous Leg |
292,41 |
119,97 |
412,38 |
| Vascular |
Lower Venous Legs Both |
462,78 |
176,76 |
639,54 |
| Vascular |
Thoracic Outlet Syndrome |
195,39 |
100,98 |
296,37 |
| Bone Mineral Density |
Baseline X146 |
113,04 |
86,40 |
199,44 |
| Bone Mineral Density |
Second Test Risk- 2 Site - X153 |
113,04 |
86,40 |
199,44 |
| Bone Mineral Density |
Subsequent High Risk X155 |
113,04 |
86,40 |
199,44 |
| Bone Mineral Density |
Subsequent Low Risk - X148 |
113,04 |
86,40 |
199,44 |
| X-Ray |
Bilateral Hands (3) |
61,02 |
23,04 |
84,06 |
| X-Ray |
Hand (4+) |
46,89 |
16,29 |
63,18 |
| X-Ray |
Bilateral Knees (3/4 views) |
93,78 |
32,58 |
126,36 |
| X-Ray |
Bilateral Hands and Wrists (4+) |
113,22 |
56,52 |
169,74 |
| Vascular |
Penile Doppler |
13,05 |
14,04 |
27,09 |
| Mammography |
Recall Unilateral |
57,51 |
34,92 |
92,43 |
| Mammography |
Recall Bilateral |
152,28 |
111,60 |
263,88 |
| Ultrasound |
Hand |
48,51 |
26,91 |
75,42 |
| Mammography |
Bilateral Implants |
125,10 |
93,24 |
218,34 |
| Chiro X-ray |
Plain Film (K.U.B.) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Acute (2-3 views) |
0,00 |
27,99 |
27,99 |
| Chiro X-ray |
Skull (3/4) |
0,00 |
23,85 |
23,85 |
| Chiro X-ray |
Skull (5+) |
0,00 |
29,52 |
29,52 |
| Chiro X-ray |
Sinuses |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Adenoids |
0,00 |
14,31 |
14,31 |
| Chiro X-ray |
Soft Tissue |
0,00 |
14,31 |
14,31 |
| Chiro X-ray |
Sella Turcica |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Mastoids |
0,00 |
25,65 |
25,65 |
| Chiro X-ray |
I.A. Meati |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Facial Bones |
0,00 |
18,54 |
18,54 |
| Chiro X-ray |
Nasal Bones |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Eye (for foreign body/Orbits) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Mandible (3) |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Mandible (4+) |
0,00 |
23,85 |
23,85 |
| Chiro X-ray |
T.M. Joints (4+) |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Zygomatic Arches 4+ |
0,00 |
23,85 |
23,85 |
| Chiro X-ray |
Chest PA |
0,00 |
11,43 |
11,43 |
| Chiro X-ray |
Chest PA/Lateral |
0,00 |
19,26 |
19,26 |
| Chiro X-ray |
Chest (3+) |
0,00 |
22,32 |
22,32 |
| Chiro X-ray |
Thoracic Inlet |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Rib |
0,00 |
25,56 |
25,56 |
| Chiro X-ray |
Sternum |
0,00 |
14,13 |
14,13 |
| Chiro X-ray |
Sterno-Clavicular Joints |
0,00 |
14,31 |
14,31 |
| Chiro X-ray |
Consultation |
0,00 |
90,00 |
90,00 |
| Chiro X-ray |
Radiology Consultation |
0,00 |
90,00 |
90,00 |
| Chiro X-ray |
Bone Age |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Bone Age (2+) |
0,00 |
19,17 |
19,17 |
| Chiro X-ray |
Shoulder Under 12 Year or Chiro (2) |
0,00 |
14,31 |
14,31 |
| Chiro X-ray |
Shoulder (3+) |
0,00 |
19,17 |
19,17 |
| Chiro X-ray |
Clavicle |
0,00 |
23,04 |
23,04 |
| Chiro X-ray |
Acromioclavicular Joints (with & w/o weights) |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Scapula Regular (2) |
0,00 |
14,31 |
14,31 |
| Chiro X-ray |
Scapula (3+) |
0,00 |
19,17 |
19,17 |
| Chiro X-ray |
Humerus |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Elbow Under 12 Year or Chiro (2) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Elbow (3/4) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Forearm |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Scaphoid(4) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Wrist Regular (2/3) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Wrist (4+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Hand & Wrist Regular (2/3) |
0,00 |
23,49 |
23,49 |
| Chiro X-ray |
Bilateral Hands and Wrists (3 views) |
0,00 |
46,98 |
46,98 |
| Chiro X-ray |
Hand Regular (2/3) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Hand & Wrist (4+) |
0,00 |
28,26 |
28,26 |
| Chiro X-ray |
Finger or Thumb (3+) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Femur (2) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Knee Under 15 Year or Chiro (2) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Knee (3/4) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Knee (5+) |
0,00 |
20,97 |
20,97 |
| Chiro X-ray |
Tibia & Fibula (2) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Tibia & Fibula (3+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Ankle Regular (2/3) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Ankle (4+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Calcaneus (2) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Calcaneus Regular (3+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Foot (2/3) |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Foot (4+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Toes (3+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Leg Length |
0,00 |
18,63 |
18,63 |
| Chiro X-ray |
Cervical Spine Under 15 year or Chiro (2/3) |
0,00 |
15,00 |
15,00 |
| Chiro X-ray |
Cervical Spine Regular (4/5) |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Cervical Spine (6+) |
0,00 |
25,00 |
25,00 |
| Chiro X-ray |
Thoracic Spine Under 15 Year or Chiro (2) |
0,00 |
15,00 |
15,00 |
| Chiro X-ray |
Thoracic Spine (3+) |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Scoliosis(2) |
0,00 |
25,00 |
25,00 |
| Chiro X-ray |
Scoliosis Series Regular (4+) |
0,00 |
40,00 |
40,00 |
| Chiro X-ray |
Lumbar spine, Pelvis & S.I.Joints |
0,00 |
50,00 |
50,00 |
| Chiro X-ray |
Lumbar Spine Under 25 Year or Chiro (2) |
0,00 |
15,00 |
15,00 |
| Chiro X-ray |
Lumbar Spine Regular (4/5) |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Lumbar Spine (6+) |
0,00 |
24,03 |
24,03 |
| Chiro X-ray |
S.I. Joints Regular (2/3) |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
S.I. Joints (4+) |
0,00 |
25,00 |
25,00 |
| Chiro X-ray |
Sacrum & Coccyx (2) |
0,00 |
15,00 |
15,00 |
| Chiro X-ray |
Sacrum & Coccyx Regular (3+) |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Pelvis |
0,00 |
11,52 |
11,52 |
| Chiro X-ray |
Pelvis & Right Hip |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Pelvis & Left Hip |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Pelvis & Both Hips |
0,00 |
20,00 |
20,00 |
| Chiro X-ray |
Survey Arthritic/Metastatic (2+) |
0,00 |
31,14 |
31,14 |
| Chiro X-ray |
Bilateral Hands (3) |
0,00 |
23,04 |
23,04 |
| Chiro X-ray |
Hand (4+) |
0,00 |
16,29 |
16,29 |
| Chiro X-ray |
Bilateral Knees (3/4 views) |
0,00 |
32,58 |
32,58 |
| Chiro X-ray |
Bilateral Feet (2/3 views) |
0,00 |
23,04 |
23,04 |
| Chiro X-ray |
Bilateral Hands and Wrists (4+) |
0,00 |
56,52 |
56,52 |
| Ultrasound |
Thyroid FNA |
89,91 |
66,33 |
156,24 |
| Ultrasound |
Face, Neck and/or Thyroid |
89,91 |
42,66 |
132,57 |
| BLOOD WORK |
Blood Work Fee |
25,00 |
0,00 |
25,00 |
| BLOOD WORK |
Blood Work |
25,00 |
0,00 |
25,00 |
| BLOOD WORK |
ALT |
6,00 |
0,00 |
6,00 |
| BLOOD WORK |
AST |
6,00 |
0,00 |
6,00 |
| BLOOD WORK |
Glucose, Random |
6,00 |
0,00 |
6,00 |
| BLOOD WORK |
HbA1C |
15,00 |
0,00 |
15,00 |
| BLOOD WORK |
Urinalysis Chemical |
6,00 |
0,00 |
6,00 |
| BLOOD WORK |
Urinalysis Microscopic |
6,00 |
0,00 |
6,00 |
| BLOOD WORK |
Hepatitis B Surface Antibody |
20,00 |
0,00 |
20,00 |
| BLOOD WORK |
Hepatitis B Surface Antigen |
20,00 |
0,00 |
20,00 |
| BLOOD WORK |
Hepatitis B Core Antibody |
20,00 |
0,00 |
20,00 |
| BLOOD WORK |
Hepatitis C |
20,00 |
0,00 |
20,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee Age 0-4 |
100,00 |
0,00 |
100,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee Age 5-49 |
150,00 |
0,00 |
150,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee Age 50-74 |
150,00 |
0,00 |
150,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee Age 75+ |
220,00 |
0,00 |
220,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee CUAET 0-14 |
50,00 |
0,00 |
50,00 |
| IMMIGRATION MEDICAL FEE |
Immigration Medical Fee CUAET 14+ |
100,00 |
0,00 |
100,00 |
| BLOOD WORK |
Creatinine |
5,00 |
0,00 |
5,00 |
| Ultrasound |
Upper Extremity |
75,42 |
0,00 |
75,42 |
| Ultrasound |
Lower Extremity |
75,42 |
0,00 |
75,42 |
| Ultrasound |
Appendix |
48,51 |
26,91 |
75,42 |
| Ultrasound |
Aorta |
48,51 |
26,91 |
75,42 |
| Mammography |
Mammography OBSP Implants |
125,10 |
93,24 |
218,34 |
| X-Ray |
Chest PA (Immigration) |
50,00 |
0,00 |
50,00 |
| X-Ray |
Chest PA (Immigration) |
50,00 |
0,00 |
50,00 |
| 3D/4D Ultrasound RRI |
3D/ 4D Ultrasound |
50,00 |
0,00 |
50,00 |
| HDC BIOPSY/MSK/HYSTERO |
Biopsy - Thyroid |
89,91 |
66,38 |
156,29 |
| Ultrasound |
NAFLD |
80,00 |
0,00 |
80,00 |
| Ultrasound |
ALD |
80,00 |
0,00 |
80,00 |
| Ultrasound |
fibrosis |
80,00 |
0,00 |
80,00 |
| Ultrasound |
Venous Reflux Study-1 LEG |
176,00 |
94,00 |
270,00 |
| Ultrasound |
Venous Reflux Study-BOTH LEGS |
230,00 |
120,00 |
350,00 |
| HDC BIOPSY/MSK/HYSTERO |
Thyroid biopsy |
89,91 |
66,38 |
156,29 |