| 1 |
BMD - SINGLE SITE |
2000.00-2000.00 |
| 2 |
BMD AP SPINE |
1250.00-1250.00 |
| 3 |
BMD AP SPINE WITH DU |
4000.00-4000.00 |
| 4 |
BMD AP SPINE WITH RI |
3000.00-3000.00 |
| 5 |
BMD FEMUR & AP SPINE |
1750.00-1750.00 |
| 6 |
BMD FOREARM |
1250.00-1250.00 |
| 7 |
BMD LATERAL VERTIBRAL ASSESSMENT |
1250.00-1250.00 |
| 8 |
BMD Left Femur |
1250.00-1250.00 |
| 9 |
BMD LUMBER SPINE |
2000.00-2000.00 |
| 10 |
BMD Right Femur |
1250.00-1250.00 |
| 11 |
BMD TOTAL BODY & AP SPINE |
4250.00-4250.00 |
| 12 |
BMD TOTAL BODY& FEMUR&AP SPINE |
5000.00-5000.00 |
| 13 |
IVP WITH CYST |
3800.00-3800.00 |
| 14 |
MICT CYSTOURETHROGRA |
2700.00-2700.00 |
| 15 |
T TUBE CHOLANGIOGRAM |
3000.00-3000.00 |
| 16 |
WHOLE SPINE AP |
750.00-750.00 |
| 17 |
X RAY LEFT ARM AP/LAT |
400.00-400.00 |
| 18 |
X RAY LS SPINE LATERAL |
200.00-200.00 |
| 19 |
X RAY PELVIS WITH BOTH HIP AP |
200.00-200.00 |
| 20 |
X RAY RIGHT LEG AP/LAT |
400.00-400.00 |
| 21 |
X-RAY - ABDOMEN LAT |
350.00-350.00 |
| 22 |
X-RAY - ABDOMEN PA |
350.00-350.00 |
| 23 |
X-RAY - APICOGRAM |
200.00-200.00 |
| 24 |
X-RAY - B/L CALCANEUM AP/LAT |
700.00-700.00 |
| 25 |
X-RAY - BA UPPER G |
2800.00-2800.00 |
| 26 |
X-Ray - Barium Enema |
2700.00-2700.00 |
| 27 |
X-RAY - Barium Enema Double Contrast |
2500.00-2500.00 |
| 28 |
X-RAY - BILATERAL STYL |
700.00-700.00 |
| 29 |
X-RAY - BILATERAL MASTOID LA |
1000.00-1000.00 |
| 30 |
X-RAY - BILATERAL TM JOINT L |
1000.00-1000.00 |
| 31 |
X-RAY - BOTH FEET AP VIEW |
600.00-600.00 |
| 32 |
X-RAY - BOTH FOOT OBL |
600.00-600.00 |
| 33 |
X-RAY - BOTH FORARM AP |
350.00-350.00 |
| 34 |
X-RAY - BOTH HAND AP/LAT |
700.00-700.00 |
| 35 |
X-RAY - BOTH HEEL AP |
600.00-600.00 |
| 36 |
X-RAY - BOTH HIP JOINT AP/LAT |
1000.00-1000.00 |
| 37 |
X-RAY - BOTH KNEE JOINT AP VIEW |
350.00-350.00 |
| 38 |
X-RAY - BOTH KNEE JOINTS STA |
700.00-700.00 |
| 39 |
X-RAY - BOTH LEG AP VIEW |
600.00-600.00 |
| 40 |
X-RAY - BOTH MANDIBLE OBL |
700.00-700.00 |
| 41 |
X-RAY - BOTH MASTIOD LAT |
700.00-700.00 |
| 42 |
X-RAY - BOTH MASTIOD OBL |
700.00-700.00 |
| 43 |
X-Ray - BOTH S I JOINT |
700.00-700.00 |
| 44 |
X-RAY - BOTH S I JOINT AP/LAT |
900.00-900.00 |
| 45 |
X-RAY - BOTH SI JOINT PRONE |
600.00-600.00 |
| 46 |
X-RAY - BOTH SI JOINTS AP |
200.00-700.00 |
| 47 |
X-RAY - C S AP |
350.00-350.00 |
| 48 |
X-RAY - C SPINE OBL |
350.00-350.00 |
| 49 |
X-Ray - CEPHALOGRAM |
600.00-600.00 |
| 50 |
X-Ray - Cervical Spine (lat) |
200.00-350.00 |
| 51 |
X-RAY - CERVICAL SPINE LEFT OBL |
350.00-350.00 |
| 52 |
X-RAY - CERVICAL SPINE RIGHT OBL |
350.00-350.00 |
| 53 |
X-Ray - Chest Right Oblique |
200.00-200.00 |
| 54 |
X-Ray - CHEST AP |
250.00-350.00 |
| 55 |
X-RAY - CHEST LEFT LAT |
200.00-350.00 |
| 56 |
X-RAY - CHEST LEFT OBLIQUE |
200.00-200.00 |
| 57 |
X-RAY - CHEST RIGHT LAT |
200.00-350.00 |
| 58 |
X-RAY - CHEST WITH COMP |
700.00-700.00 |
| 59 |
X-Ray - COCCYX AP |
350.00-350.00 |
| 60 |
X-Ray - Dorsal spine (AP) |
350.00-350.00 |
| 61 |
X-Ray - Dorsal spine (lat) |
200.00-200.00 |
| 62 |
X-RAY - EXTENTION |
350.00-350.00 |
| 63 |
X-RAY - FLEXION |
350.00-350.00 |
| 64 |
X-RAY - INPHANTOGRAM |
600.00-600.00 |
| 65 |
X-RAY - KNEE JOINT AXIAL |
350.00-350.00 |
| 66 |
X-Ray - L S Spine Ap |
350.00-350.00 |
| 67 |
X-RAY - L S SPINE FLEXN/EXTE |
700.00-700.00 |
| 68 |
X-RAY - L S SPINE LEFT OBL |
350.00-350.00 |
| 69 |
X-RAY - L S SPINE OBL |
350.00-350.00 |
| 70 |
X-Ray - L S SPINE RT OBLIQUE |
200.00-200.00 |
| 71 |
X-RAY - LEFT ANKLE LAT VIEW |
350.00-350.00 |
| 72 |
X-RAY - LEFT ARM AP |
350.00-350.00 |
| 73 |
X-RAY - LEFT ELBOW AP |
350.00-350.00 |
| 74 |
X-RAY - LEFT ELBOW LAT |
350.00-350.00 |
| 75 |
X-RAY - LEFT FEMUR AP/LAT |
700.00-700.00 |
| 76 |
X-RAY - LEFT FOOT AP VIEW |
350.00-350.00 |
| 77 |
X-RAY - LEFT FOOT AP,LAT.OBL |
700.00-700.00 |
| 78 |
X-RAY - LEFT FOOT AP/LAT |
600.00-600.00 |
| 79 |
X-RAY - LEFT FOOT LAT |
350.00-350.00 |
| 80 |
X-RAY - LEFT FOOT OBL/LAT |
600.00-600.00 |
| 81 |
X-RAY - LEFT HEEL AP/LAT |
600.00-600.00 |
| 82 |
X-Ray - LEFT HEEL AXIAL LAT |
600.00-600.00 |
| 83 |
X-RAY - LEFT HIP OBL |
350.00-350.00 |
| 84 |
X-RAY - LEFT HUMEROUS AP/LAT |
700.00-700.00 |
| 85 |
X-RAY - LEFT KNEE SKYLINE VIEW |
350.00-350.00 |
| 86 |
X-RAY - LEFT LEG LAT |
350.00-350.00 |
| 87 |
X-RAY - LEFT MANDIBLE AP/LAT |
700.00-700.00 |
| 88 |
X-RAY - LEFT MASTOID LA/OB |
700.00-700.00 |
| 89 |
X-RAY - LEFT ORBIT AP/LAT |
700.00-700.00 |
| 90 |
X-RAY - LEFT WRIST AP |
350.00-350.00 |
| 91 |
X-RAY - LEFT WRIST LAT |
350.00-350.00 |
| 92 |
X-RAY - LEFT WRIST OBL |
350.00-350.00 |
| 93 |
X-RAY - LT SH AXIAL |
350.00-350.00 |
| 94 |
X-RAY - LT SHOULDER LAT |
350.00-350.00 |
| 95 |
X-RAY - MAMMOGRAPHY (ONE SIDE) |
1100.00-1100.00 |
| 96 |
X-RAY - N. BONE LAT |
350.00-350.00 |
| 97 |
X-Ray - Nasal Bone Ap/Lat |
700.00-700.00 |
| 98 |
X-RAY - NASAL BONE B/L |
600.00-600.00 |
| 99 |
X-RAY - NECK AP VIEW |
350.00-350.00 |
| 100 |
X-RAY - NECK LAT VIEW |
350.00-350.00 |
| 101 |
X-RAY - ORBIT AP/L |
700.00-700.00 |
| 102 |
X-RAY - PNS (OPG) |
600.00-600.00 |
| 103 |
X-RAY - PNS ERECT VIEW |
350.00-350.00 |
| 104 |
X-RAY - PNS L VIEW |
350.00-350.00 |
| 105 |
X-RAY - PNS OBLIQUE |
350.00-350.00 |
| 106 |
X-RAY - PNS TOWENS VIEW |
350.00-350.00 |
| 107 |
X-RAY - PNS/ERECT |
700.00-700.00 |
| 108 |
X-RAY - RIGHT ANKLE OBL VIEW |
350.00-350.00 |
| 109 |
X-RAY - RIGHT ARM AP |
350.00-350.00 |
| 110 |
X-RAY - RIGHT CALCANIUM AP/LAT |
600.00-600.00 |
| 111 |
X-RAY - RIGHT ELBOW AP |
350.00-350.00 |
| 112 |
X-RAY - RIGHT ELBOW LAT |
350.00-350.00 |
| 113 |
X-RAY - RIGHT FEET AP/LAT |
600.00-600.00 |
| 114 |
X-RAY - RIGHT FEMUR AP VIEW |
350.00-350.00 |
| 115 |
X-RAY - RIGHT FOOT AP/LAT |
600.00-600.00 |
| 116 |
X-RAY - RIGHT FOOT LAT |
350.00-350.00 |
| 117 |
X-RAY - RIGHT HEEL LAT |
350.00-350.00 |
| 118 |
X-RAY - RIGHT KNEE AP/LAT STA |
600.00-600.00 |
| 119 |
X-RAY - RIGHT LEG AP |
350.00-350.00 |
| 120 |
X-RAY - RIGHT MASTOID LA/OB |
700.00-700.00 |
| 121 |
X-RAY - RIGHT ORBIT AP VIEW |
350.00-350.00 |
| 122 |
X-RAY - RIGHT ORBIT AP/LAT |
700.00-700.00 |
| 123 |
X-Ray - RIGHT SCAPULA AP |
350.00-350.00 |
| 124 |
X-RAY - RIGHT SKYLINE VIEW |
350.00-350.00 |
| 125 |
X-RAY - RIGHT WRIST AP |
350.00-350.00 |
| 126 |
X-RAY - RIGHT WRIST AP/LAT/OBL |
1000.00-1000.00 |
| 127 |
X-RAY - RIGHT WRIST LAT |
350.00-350.00 |
| 128 |
X-RAY - RT HAND AP/LAT |
600.00-600.00 |
| 129 |
X-RAY - S I JOINT LAT |
600.00-600.00 |
| 130 |
X-RAY - SAC-COCCYX AP/LAT |
700.00-700.00 |
| 131 |
X-RAY - SACRAL SPINE AP |
350.00-350.00 |
| 132 |
X-RAY - SACRO LUMBAR AP/LAT |
700.00-700.00 |
| 133 |
X-Ray - Scapula AP |
350.00-350.00 |
| 134 |
X-RAY - SINOGRAM |
1750.00-1750.00 |
| 135 |
X-RAY - SKULL (OPG) |
700.00-700.00 |
| 136 |
X-Ray - SKULL TOWNES VIEW |
200.00-200.00 |
| 137 |
X-RAY - STN AP/LAT |
700.00-700.00 |
| 138 |
X-RAY - STN EXT NECK L |
350.00-350.00 |
| 139 |
X-RAY - STN OPEN MOUTH |
350.00-350.00 |
| 140 |
X-RAY - STYLOID PROCESS |
350.00-350.00 |
| 141 |
X-RAY - TN LAT VIEW |
350.00-350.00 |
| 142 |
X-RAY - WHOLE SPINE AP/LAT |
1000.00-1000.00 |
| 143 |
X-RAY ABDOMEN AP |
200.00-350.00 |
| 144 |
X-RAY ABDOMEN ERECT |
200.00-350.00 |
| 145 |
X-RAY ABDOMEN FOR GALL BLA |
200.00-200.00 |
| 146 |
X-RAY ABDOMEN PREG.[14X17] |
400.00-400.00 |
| 147 |
X-RAY BARIUM SWALLOW |
2700.00-2700.00 |
| 148 |
X-RAY BOTH ANKLE LAT |
600.00-600.00 |
| 149 |
X-RAY BOTH CALCANEUM AXIAL |
200.00-200.00 |
| 150 |
X-RAY BOTH ELBOWS AP VIEW |
200.00-200.00 |
| 151 |
X-RAY BOTH HAND PA |
200.00-200.00 |
| 152 |
X-RAY BOTH HEELS AXIAL VIEW |
200.00-200.00 |
| 153 |
X-RAY BOTH HEELS LATERAL VIEW |
200.00-200.00 |
| 154 |
X-RAY BOTH KNEE JOINTS AP |
200.00-200.00 |
| 155 |
X-RAY BOTH KNEE JOINTS SKYLINE VIEW |
200.00-200.00 |
| 156 |
X-RAY BOTH KNEE JOINTS-LAT |
200.00-200.00 |
| 157 |
X-RAY BOTH LEG AP/LAT |
700.00-700.00 |
| 158 |
X-RAY BOTH ORBITS PA VIEW |
200.00-200.00 |
| 159 |
X-RAY BOTH STERNOCLAVICULAR AP VIEW |
200.00-200.00 |
| 160 |
X-RAY BOTH WRIST JOINTS AP |
200.00-200.00 |
| 161 |
X-RAY BOTH WRIST JT LAT. |
200.00-200.00 |
| 162 |
X-RAY CEPHALOGRAM PA VIEW |
400.00-400.00 |
| 163 |
X-RAY CERVICAL SPINE AP |
350.00-350.00 |
| 164 |
X-RAY CERVICAL SPINE AP VIEW |
200.00-200.00 |
| 165 |
X-RAY CERVICAL SPINE AP/LAT |
700.00-700.00 |
| 166 |
X-RAY CERVICAL SPINE EXTENSION |
200.00-200.00 |
| 167 |
X-RAY CERVICAL SPINE FLEXION |
200.00-200.00 |
| 168 |
X-RAY CERVICAL SPINE LEFT OBLIQUE |
200.00-200.00 |
| 169 |
X-RAY CERVICAL SPINE RIGHT OBLIQUE |
200.00-200.00 |
| 170 |
X-RAY CERVICO DORSAL AP |
200.00-200.00 |
| 171 |
X-RAY CERVICO-DORSAL OBLIQUE |
200.00-200.00 |
| 172 |
X-RAY CHEST FOR RIBS |
200.00-200.00 |
| 173 |
X-RAY CHEST LEFT LAT DECUBIT |
200.00-200.00 |
| 174 |
X-RAY CHEST PA [14X17] |
250.00-250.00 |
| 175 |
X-RAY CHEST RIGHT LAT DECUBIT |
200.00-200.00 |
| 176 |
X-RAY DORSAL SPINE AP VIEW |
200.00-200.00 |
| 177 |
X-RAY DORSAL SPINE EXTENSION |
200.00-200.00 |
| 178 |
X-RAY DORSAL SPINE FLEXION |
200.00-200.00 |
| 179 |
X-RAY DORSO LUMBER AP VIEW |
200.00-200.00 |
| 180 |
X-RAY DORSO-LUMBER LATERAL |
200.00-200.00 |
| 181 |
X-RAY HSG |
1750.00-3500.00 |
| 182 |
X-RAY INTERNAL AUDITORY CA |
200.00-200.00 |
| 183 |
X-RAY KUB |
400.00-400.00 |
| 184 |
X-Ray L / S Spine AP/LAT |
700.00-700.00 |
| 185 |
X-RAY L.S.SPINE AP [14X17] |
400.00-400.00 |
| 186 |
X-RAY L.S.SPINE LATERAL EXTENSION |
200.00-200.00 |
| 187 |
X-RAY L.S.SPINE LATERAL FLEXION |
200.00-200.00 |
| 188 |
X-RAY L.S.SPINE LEFT OBLIQUE |
200.00-200.00 |
| 189 |
X-RAY LEFT ACRAMIOCLAVICULAR AP VIEW |
200.00-200.00 |
| 190 |
X-RAY LEFT ANKLE JT AP/LAT |
400.00-400.00 |
| 191 |
X-RAY LEFT CLAVICLE AP VIEW |
200.00-200.00 |
| 192 |
X-RAY LEFT CLAVICLE I/C SHOU |
200.00-200.00 |
| 193 |
X-RAY LEFT ELBOW JT AP/LAT |
400.00-400.00 |
| 194 |
X-RAY LEFT HAND LATERAL |
200.00-200.00 |
| 195 |
X-RAY LEFT HAND PA & OBL |
400.00-400.00 |
| 196 |
X-RAY LEFT HEEL AXIAL VIEW |
200.00-200.00 |
| 197 |
X-RAY LEFT HEEL LATERAL VIEW |
200.00-200.00 |
| 198 |
X-RAY LEFT HIP JT-OBLIQUE |
200.00-200.00 |
| 199 |
X-RAY LEFT KNEE JT AP/LAT |
400.00-400.00 |
| 200 |
X-RAY LEFT PATELLA-AXIAL |
200.00-200.00 |
| 201 |
X-RAY LEFT SHOULDER AP JOINT |
200.00-200.00 |
| 202 |
X-RAY LEFT SHOULDER AXIAL |
200.00-200.00 |
| 203 |
X-RAY LEFT SHOULDER LAT VIEW |
200.00-200.00 |
| 204 |
X-RAY LEFT STERNOCLAVICULAR OBLIQUE VIEW |
200.00-200.00 |
| 205 |
X-RAY LEFT THIGH I/C HIP JT AP |
200.00-200.00 |
| 206 |
X-RAY LEFT THIGH I/C KNEE LAT |
200.00-200.00 |
| 207 |
X-RAY LEFT WRIST JT AP/LAT |
400.00-400.00 |
| 208 |
X-RAY LS SPINE AP VIEW |
200.00-200.00 |
| 209 |
X-RAY LUMBAR SPINE AP |
350.00-350.00 |
| 210 |
X-RAY LUMBAR SPINE LAT |
350.00-350.00 |
| 211 |
X-RAY MANDIBLE LEFT LATERAL |
200.00-200.00 |
| 212 |
X-RAY MANDIBLE PA VIEW |
200.00-200.00 |
| 213 |
X-RAY MANDIBLE RIGHT LATERAL |
200.00-200.00 |
| 214 |
X-RAY MASTOID LEFT LATERAL |
200.00-200.00 |
| 215 |
X-RAY MASTOID LEFT STENVER`S |
200.00-200.00 |
| 216 |
X-RAY MASTOID RIGHT LATERAL |
200.00-200.00 |
| 217 |
X-RAY MASTOID RIGHT STENVER S |
200.00-200.00 |
| 218 |
X-RAY MASTOID TOWNES VIEW |
200.00-200.00 |
| 219 |
X-RAY NASAL BONE |
200.00-200.00 |
| 220 |
X-RAY NASOPHARYNX LAT |
200.00-200.00 |
| 221 |
X-RAY NEPHRESTROGRAM |
2000.00-2000.00 |
| 222 |
X-RAY ODANTOID PROCESS |
400.00-400.00 |
| 223 |
X-RAY OPTIC FORAMINA |
200.00-200.00 |
| 224 |
X-RAY ORBIT LEFT LAT VIEW |
200.00-200.00 |
| 225 |
X-RAY ORBIT RIGHT LAT VIEW |
200.00-200.00 |
| 226 |
X-RAY P.N.S.LATERAL VIEW |
200.00-200.00 |
| 227 |
X-RAY PELVIS AP |
200.00-200.00 |
| 228 |
X-RAY PNS |
350.00-350.00 |
| 229 |
X-RAY RIGHT ACRAMIOCLAVICULAR AP |
200.00-200.00 |
| 230 |
X-RAY RIGHT ANKLE JT AP/LAT |
400.00-400.00 |
| 231 |
X-RAY RIGHT ARM AP/LAT |
400.00-400.00 |
| 232 |
X-RAY RIGHT CLAVICLE AP VIEW |
200.00-200.00 |
| 233 |
X-RAY RIGHT CLAVICLE I/C SHOU |
200.00-200.00 |
| 234 |
X-RAY RIGHT ELBOW JT AP/LAT |
400.00-400.00 |
| 235 |
X-RAY RIGHT HAND PA & OBL. |
400.00-400.00 |
| 236 |
X-RAY RIGHT HEEL AXIAL VIEW |
200.00-200.00 |
| 237 |
X-RAY RIGHT HEEL LATERAL VIEW |
200.00-200.00 |
| 238 |
X-RAY RIGHT HIP JOINT-AP |
200.00-200.00 |
| 239 |
X-RAY RIGHT HIP JT-LAT OBL |
200.00-200.00 |
| 240 |
X-RAY RIGHT KNEE JT AP/LAT |
400.00-400.00 |
| 241 |
X-RAY RIGHT PATELLA-AXIAL |
200.00-200.00 |
| 242 |
X-RAY RIGHT SHOULDER AXIAL |
200.00-200.00 |
| 243 |
X-RAY RIGHT SHOULDER JOINT AP |
200.00-200.00 |
| 244 |
X-RAY RIGHT SHOULDER JT-LAT |
200.00-200.00 |
| 245 |
X-RAY RIGHT STERNOCLAVICULAR OBLIQUE VIEW |
200.00-200.00 |
| 246 |
X-RAY RIGHT THIGH I/C HIP JT AP |
200.00-200.00 |
| 247 |
X-RAY RIGHT THIGH I/C KNEE LAT |
200.00-200.00 |
| 248 |
X-RAY RIGHT WRIST JT AP/LAT |
400.00-400.00 |
| 249 |
X-RAY S.I.JT LEFT OBLIQUE |
200.00-200.00 |
| 250 |
X-RAY S.I.JT RIGHT OBLIQUE |
200.00-200.00 |
| 251 |
X-RAY SACRO-COCCYGEAL AP |
200.00-200.00 |
| 252 |
X-RAY SACRO-COCCYGEAL LAT |
200.00-200.00 |
| 253 |
X-RAY SCREENING OF CHEST |
200.00-200.00 |
| 254 |
X-RAY SKULL LEFT LATERAL |
200.00-200.00 |
| 255 |
X-RAY SKULL RIGHT LATERAL |
200.00-200.00 |
| 256 |
X-RAY SOFT TISSUE NECK AP |
200.00-200.00 |
| 257 |
X-RAY SOFT TISSUES NECK LA |
200.00-200.00 |
| 258 |
X-RAY TM JOINT AP VIEW |
200.00-200.00 |
| 259 |
X-RAY TM JOINT LEFT LAT O/M |
200.00-200.00 |
| 260 |
X-RAY TM JOINT LEFT VIEW C/M |
200.00-200.00 |
| 261 |
X-RAY TM JOINT RIGHT LAT C/M |
200.00-200.00 |
| 262 |
X-RAY TM JOINT RIGHT LAT O/M |
200.00-200.00 |
| 263 |
Xray Left Ankle AP |
350.00-350.00 |
| 264 |
Xray Left Clavicle |
700.00-700.00 |
| 265 |
Xray Left Foot AP/OBL |
400.00-400.00 |
| 266 |
Xray Left Hand AP |
200.00-350.00 |
| 267 |
Xray Right Foot AP |
350.00-350.00 |
| 268 |
Xray Right Foot AP/OBL |
400.00-400.00 |
| 269 |
Xray Right Forearm AP/LAT |
400.00-400.00 |
| 270 |
Xray Right Hand AP |
350.00-350.00 |
| 271 |
Xray Right Hand AP/Lat |
1000.00-1000.00 |
| 272 |
Xray Skull Base |
200.00-200.00 |
| 273 |
XRAY STYLOID PROCESSES |
200.00-200.00 |